30 June 2017 VOLUME 18 ISSUE 26

Sue Desmond-Hellmann, CEO, Bill & Melinda Gates Foundation, was drawn to one particular item in President Donald Trump’s proposed budget – the massive cuts to foreign aid....Desmond-Hellmann says she is concerned that if the cuts came into fruition, it could stymie the progress of the world’s largest philanthropic organizations to eradicate diseases like polio and promote family planning for women.

Andrew Owen and Steve Rannard, two professors at the University of Liverpool, are leading efforts to use nanotechnology to improve delivery of HIV drug treatments so they're more effective and less expensive....[Their] research...over the last 8 years has so far proven that nanotechnology can be used to reduce dosage in half "and still get the same amount of drug exposure...; you can make more drugs and therefore treat more patients," said Owen.

A new discussion paper released by ICASO and EANNASO suggests that the Global Fund might not be investing enough money in HIV prevention in Africa to meet its targets....The paper confronts the reality that the benchmark of investing “a quarter for prevention” is not being met, and progress on HIV prevention has stalled as a result. Indeed, since 2010, the number of new adult HIV infections has remained unchanged, with an estimated 1.9 million occurring globally each year.

[T]he Cochrane Library...is a collection of databases containing high quality systemic reviews and other evidence to inform decisions about health care....Now...funding from the South African Medical Research Council...has procured a national licence that provides “one-click” access to the Cochrane Library for everyone in South Africa....It’s a chance for practitioners, policymakers and patients to get up-to-date, scientifically rigorous information about health care.

Studies of long-term survival of HIV infection...are important in preparing for a demographic shift in the epidemic. But further close observations of the ageing populations of people living with HIV in various settings are needed to better understand the interaction between ageing, infection, treatment, and comorbidities [as well as] new infections, and...target testing to those at risk, even if this is not a population in which health programmes regularly consider such risk factors.

Proven interventions, most notably pre-exposure prophylaxis have been limited in rollout and impact. Treatment as prevention has the promise to improve clinical outcomes but remains uncertain as a prevention tool to reduce population-level HIV incidence.

In 2012, Makerere University, Johns Hopkins University, and Mulago National Referral Hospital, with NIH support, undertook operational research at Mulago PMTCT/PNC clinics....[D]uring the intervention, the proportion of referred mothers in need of family planning increased by 30.4 percentage points, FP uptake by over 31 percentage points, [and] over 57% of mothers took up Depo-Provera injectable-FP. The study provides additional evidence on utilization of peer mothers in HIV care [and] improves health services uptake including family planning.

A number of barriers frustrate efforts to take the response to STIs to scale, including insufficient incidence data and disease surveillance, and political resistance to scientifically-proven and often cost-effective interventions and approaches....This paper applies an analytical approach to global strategy that includes investigation of 3 domains: process, programmatic, and political. Key questions are proposed to guide exploration of these domains to help identify and address barriers to, and leverage solutions for, policy success.

This retrospective study included adults initiating HAART before 2004 at 8 sites in Argentina, Brazil, Chile, Haiti, Honduras, and Mexico. Patient status...was assessed at 6-month intervals for 10 years, along with CD4 count and HIV-1 viral load for patients in care....Despite advanced disease and predominant use of older antiretrovirals, a large percentage of early HAART initiators in this Latin American cohort were alive and in care with sustained virologic suppression and progressive immune recovery after 10 years.

In 2011, the WHO, with funding from Global Affairs Canada, began support to 6 implementation research projects in Malawi, Nigeria, and Zimbabwe....Five of the studies were cluster randomized controlled trials, and 1 adopted a matched cohort design. Here, we summarize some main findings and key lessons learned. We also consider some broader implications, remaining knowledge gaps, and how implementation research is integral to, and essential for, global guideline development and to inform HIV/AIDS strategies.