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Eleven current and former Fogarty International and Doris Duke clinical research fellows made their way to Capitol Hill Thursday for congressional office visits with key legislators.

Four Fogarty fellows and the Center's Christine Lubinski meet with a staff member from the Senate Foreign Relations Committee.

The Center for Global Health Policy staff escorted the group to meetings with the offices of 15 policymakers. The fellows highlighted their research experience abroad through the Fogarty and Doris Duke programs, the first of which is funded through the National Institutes of Health, emphasizing the value of U.S. investment in global HIV and tuberculosis programs.

The Fogarty International and Doris Duke clinical research fellowships send medical students and young physicians with an interest in global health to sites in the developing world to perform a year of hands-on clinical research training. The U.S. fellows who participated in the Hill visits had spent their year abroad either in Uganda, South Africa, Thailand or Malawi. Their research projects ranged from monitoring antiretroviral treatment adherence among female South African patients with the use of text messaging and SMS, to evaluating treatment outcomes for Kaposi’s sarcoma patients undergoing combination chemotherapy for advanced or persistent disease in Malawi.

The Fogarty program, which started in 2003, uses what is called “twinning” to match the visiting U.S. scholars with in-country medical students and physicians, helping the fellows to integrate into the system more quickly.  Four foreign nationals joined in the day of Hill meetings. These fellows hailed from South Africa, Kenya, Zambia and Peru.

The scholars brought various issues to the table when meeting with legislators, like the linkages between HIV and cancer risks and the impact of HIV on maternal and child health.. They also spoke about the intrinsic value of international physician fellowship programs, which support U.S. foreign assistance by increasing the training of in-country physicians and building health infrastructure abroad. They also support the treatment and research education of U.S. doctors that take what they learn abroad and bring it back to improve patient care in the U.S., including a new awareness of how to treat refugees and new immigrants from other countries.

“These experiences broaden how doctors will approach patient care and the ethos of training,” said Doris Duke fellow Andrea Dean, a medical student at Brown University who spent her fellowship year in South Africa.

The following post is by Annmarie Leadman, Director of Communications at the Aeras Global TB Vaccine Foundation, and Babs Verblackt, Associate Communications at TuBerculosis Vaccine Initiative – TBVI

Knowledge about the global tuberculosis epidemic is misunderstood and will only change with greater understanding of the disease, said TB advocates during a facilitated discussion on TB vaccine advocacy September 24 in Tallinn, Estonia, part of the 2nd Global Forum on TB Vaccines.  Advocates and researchers discussed methods to reframe the issues for donors and stakeholders to significantly increase general support and funding for TB vaccine research.

Sixty-one percent of the TB vaccine funding pool comes from The Bill & Melinda Gates Foundation, according to Claire Wingfield, TB/HIV Project Coordinator of the Treatment Action Group (TAG).  Her organization publishes a report called “Tuberculosis Research Funding Trends,” the second edition was published last year. The first TAG funding report called for an increase in TB research and development spending to $2 billion per year to eliminate TB by 2050. “We need to diversify the funding pool,” Wingfield commented. “Basic research and operational research are woefully under funded.”

“The major misconception Continue Reading »

What We’re Reading

The ONE campaign has launched a campaign to ensure that by 2015, no child is born with HIV (campaign video accompanies this post). Erin Hohlfelder has a great post on the ONE blog explaining how we can accomplish that goal.

Alanna Shaikh discusses the “corporatization of global health” on the End the Neglect blog this week. Prompted by a session at the Clinton Global Initiative, Continue Reading »

Dr. Prakash Mishra, director of the Regional TB Centre in Pokhara, Nepal, looks at a chest X-ray of a patient. Photo by Kiran Panday

KATHMANDU, Nepal – In a walk-up doctor’s office, off a busy street in Kathmandu, Dr. Dirgh Singh Bam sees patients every day in relative anonymity. His walls, though, reveal a history of being in the limelight: plaques and ribbons and framed photographs covering every inch, highlighting Dr. Bam’s efforts in leading Nepal’s TB control program from 1995 to 2004.

With assistance from the World Health Organization, Bam and a dedicated team of health workers ushered in an era of DOTS – directly observed treatment, short-course – by traveling all around the mountainous country to ensure that the strategy was followed. Health workers had to watch each patient swallow their TB pills every day.

“We made sure we had a DOTS committee in every sub-health post, every health post, every district hospital and the central hospital,’’ Bam said. “We went to mosques, temples, churches, all religious organizations, just to make sure they supported us.’’

In five years, Nepal installed the DOTS strategy across the country. In 1995, Nepal’s TB cure TB rate was around 45 percent; today it is 90 percent.

These advances made Nepal a model country around the world in TB control. But the question today is whether the country can remain a leader.

It has a major new challenge: controlling the spread of multi-drug resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB). Continue Reading »

Dr. Robert Hecht is Principal and Managing Director at Results for Development Institute, a Washington, D.C.-based nonprofit that works on health, development, and education issues.

Dr. Robert Hecht is Principal and Managing Director at Results for Development Institute, a Washington, D.C.-based nonprofit that works on health, development, and education issues. He is editor of the just-published “Costs and Choices: Financing the Long-Term Fight Against AIDS,” an aids2031 project.

Hecht spoke with John Donnelly about the recent UNAIDS report that showed HIV prevalence declined by at least 25 percent in 22 countries in sub Saharan Africa over the last decade.

Q: What do these findings tell you?

A: It tells me that the rate of new infections is starting to come down in a number of countries from frightening high levels in the past. It means that some of the things we are doing in prevention are starting to have an impact. At the same time, looking at the other side of the coin, looking at infections that continue to accrue, it suggests a lot more needs to be done to go further in order to have significant HIV reduction. What it means is, until we make a further dent on the prevention side and stopping people from becoming infected, we are setting up a situation in the future where we are adding to the numbers of the people who need to be cared for and who need to be put on treatment. Those numbers of people continue to grow.

Q: What’s working in prevention that would account for the 25 percent drop? Continue Reading »

In the lead up to this week’s MDG Summit, health experts discussed integration of HIV/AIDS programs with other health programs at a special event in Washington, DC.  David Hoos, MD, of Columbia University’s International Center for AIDS Care and Treatment Programs (ICAP), one of the largest PEPFAR implementers, spoke on the panel, which was sponsored by the Global Health Council and partners, including the IDSA/HIVMA Center for Global Health Policy.

The springboard for the discussion was a showing of an excerpt of a new film by the company Vestergaard-Frandsen, called “The Test.” The film captures a testing campaign they launched in Kenya to massively scale up HIV testing in the Western Kenyan district of Kakamega, in September, 2008.  The company stated that, “By conducting an HIV test for more than 49,000 people, the campaign demonstrated that it is possible for Kenya to reach its national goal of having 80 percent of adults know their HIV status.”

The company has posted a trailer of the film and background information on a special website.   The campaign was also discussed in more detail in a recent PLoS ONE article. Continue Reading »

The following is a guest blog posting by Peg Willingham, the Senior Director of the Aeras Global TB Vaccine Foundation.

World leaders are meeting at the United Nations in New York this week to discuss the ambitious global poverty reduction agenda set forth in the Millennium Development Goals (MDGs).  With five years left in the timeline set out to halve global poverty through health, education and environmental programs, there is an urgent need to address issues that cut across the MDGs, such as tuberculosis, a devastating disease of poverty that continues to kill nearly 2 million men, women and children every year.  New tools to fight TB are urgently needed and momentum in TB vaccine research provides an opportunity for optimism.

Simultaneous to the MDG Summit in New York, TB vaccine researchers and stakeholders from around the world  are meeting in Tallinn, Estonia for the 2nd Global Forum on TB Vaccines to assess a decade of progress in the search for more effective TB vaccines and to chart a path forward to sustain the momentum over the next decade. Continue Reading »