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GAN’s
Meeting Monitors Results of ARV Price Negotiation.
Andean countries and Mexico
achieved a decline from 15% to 55% in the price of first line ARV
after the II round of ARV price negotiations, compared with the
prices obtained in the 1st round. The findings come from a
preliminary report presented at the second meeting of the ARV
Negotiation Monitoring Group (GAN, for its Spanish acronym)
carried out in Washington in June.
However, the report developed by
the GAN, with PAHO technical support, shows that high prices
persist for several medicines, particularly those from research
and development companies.
The report points out the need
for monitoring the negotiations in the countries as a shared
responsibility of government, international organizations, and
civil society. It also highlights the need to improve the
coordination among drug regulatory bodies, National HIV Programs
and the areas that define policies for the purchase of ARV.
The meeting was attended by PAHO
staff members and representatives from ORAS, UNAIDS, people with
HIV, GCTH, Agua Buena, and FIOCRUZ. Participants discussed the
need to identify strategies for the III round of negotiations, to
be held in November and coordinated by ORAS with PAHO’s support.
During the meeting, FIOCRUZ
presented a project to monitor the ARV price negotiations in Latin
America, which consists of a methodology in which countries self
evaluate
progress toward the
implementation of prices. The objective is to better prepare
countries for future negotiations, both at regional and national
levels. The project, that was already validated and is in its
pilot test stage in Peru, will soon be implemented in the
Caribbean and Honduras.
ORAS presented the terms of
reference for a study aiming at characterizing the institutional
market for ARV medicines in the Andean region, as contribution for
the forthcoming III round of negotiations.
More information:
http://www.paho.org/spanish/ad/fch/ai/antiretrovirals_HP.htm
New
Evidence for Prevention through Male Circumcision
PAHO is planning to promote an
expert consultation in the second half of 2007 to review studies
conducted in the region and explore the possibility of
recommending a large scale intervention in Latin America and the
Caribbean.
The initiative draws from
epidemiological and population studies in African countries, which
provide evidence of the reduction of HIV transmission in
circumcised men. According to some of these studies, circumcised
men have to up to 60% protection against HIV and other STI.
However, it is necessary to develop more comprehensive studies in
order to determine the real benefits, in accordance with
epidemiological evidence, as well as the possible risks associated
with complications for lack of hygiene during the surgical
intervention. Another concern is the possible desinhibition
effect, which could increase risky behavior and reduce the use of
other protective measures by those who feel safe as a consequence
of circumcision.
Andean Countries
Update Knowledge of Second Generation Surveillance
A workshop was held in July in
Guayaquil (Ecuador) to review and update the concepts of second
generation surveillance. Additionally, the meeting aimed at
promoting the use of epidemiological surveillance systems on the
development of plans in response to the HIV epidemic. The event
was coordinated by PAHO, in collaboration with UNAIDS and CDC.
Epidemiologists, heads of national HIV programs, representatives
of civil society, academics, and staff from ORAS and PAHO
participated in the workshop.
Among the most important
agreements reached during the meeting is the development of
monitoring and evaluation of the epidemiological surveillance
plans, the establishment of common indicators and generic
protocols in HIV surveillance, and the development of a research
agenda. The workshop was part of the common work agenda
established by PAHO and ORAS.
PAHO
Harmonizes HIV Agenda with ORAS
With the objective of
coordinating current HIV work strategies with Andean health
systems and optimizing the opportunities for joint intervention, a
coordination meeting between staff from PAHO’s Family and
Community Health area and their counterparts from the Andean
Regional Health Agency (ORAS) was held in June in Lima.
The areas identified for the
coordination of joint activities in HIV with the health systems
include access to ARV drugs, prevention, the need for process and
impact indicators, and the optimization of resources by
strengthening interagency work.
Subjects such as pediatric AIDS,
which includes the development and presentation of therapeutic
formulas for pediatric use, monitoring and evaluation of
surveillance systems, and the development of a subregional project
based on strengthening human resources and improving research,
which should be submitted to the Global Fund, were also examined.
Developing HIV Estimates for Latin America and the Caribbean
A series of workshops in Trinidad
and Tobago and Panama were conducted by UNAIDS and PAHO/WHO in
order to familiarize technical staff from countries of the region
in the management of tools and software that are used for the
development of HIV data on Latin America and the Caribbean.
After the training, participants
will be able to develop preliminary data for 2007 in different
aspects related to HIV, such as the number people with HIV, new
HIV infections, need for antiretroviral treatment, and the number
of deaths and orphans related to AIDS.
The countries were each
represented by two or more professionals (epidemiologists,
specialists in evaluation, specialists in public health, and heads
of national HIV programs). Professionals from PAHO/WHO, UNDP,
UNICEF, UNAIDS, and UNFPA also participated.
The workshops were facilitated by
Karen Stanecki, Paloma Cuchi, and Rob Leerla of UNAIDS, Jesus
Maria García of WHO, Irum Zaidi of the CDC, and Bilali Camara of
PAHO.
As a result of this training, new
global estimates for HIV will be available for the celebration of
World AIDS Day 2007. The final result of this work, information
broken down by country, should be ready and published for the 2008
International AIDS Conference in Mexico.
Third Meeting of
the TAC in September 2007 in Guatemala
 The
third meeting of the Technical Advisory Committee in HIV/STI will
be held from 16 to 18 September in Guatemala.
The TAC consists of ten members,
among them academics, medical technical personnel, and members of
civil society, who advise the PAHO Secretariat on the definition
of priorities, best strategies to reach the objectives proposed by
the Member States, and the methods and research necessary for
meeting the HIV targets in the Americas.
The TAC had its first meeting in
Boca Chica (Dominican Republic), in January 2005, and its second
meeting in Brasilia (Brazil), in January 2006.
More
information:
http://www.paho.org/english/ad/fch/ai/TAC_2006.htm
“Know your
Status” Initiative launched on 27 June— HIV Testing and Counseling
Services Awareness Day
The
"Know your Status” Initiative, promoted by PAHO throughout the
region, was launched on June 27, the date on which many countries
commemorate the HIV Testing and Counseling Services Awareness
Day. Countries throughout the Americas launched outreach efforts
on that day urging their citizens to get tested for HIV as the
first step in prevention, treatment, and care for disease. Started
in the United States in 1994 by the National Association of People
with AIDS (NAPWA), HIV Testing Awareness Day is now observed by
countries around the world.
El Salvador has been one of the
first countries being added to this regional initiative, producing
a national communication campaign aimed at promoting testing on 27
June. Thousands of people visited health centers and hospitals
being used for counseling and testing services. Additionally,
other countries such as Cuba, Mexico, and the Bahamas joined this
day with awareness campaigns promoting testing.
This initiative complements
PAHOs activities to support the countries’ efforts to stenghen and
expand HIV testing and counseling services, within the broader
context of the goal of universal access to comprehensive
prevention, care, and treatment services.
A web site for the Know Your
Status Initiative was launched, making information available about
activities promoting testing and counseling in the region:
www.haztelaprueba.info (Spanish). An English web site is
under development and will be available soon at
www.knowyourstatus.info
The Global HIV
Prevention Working Group launches New Report for “Scaling up” HIV
prevention
In a new report released in June,
Bringing HIV Prevention to Scale: An Urgent Global Priority
, a panel of leading AIDS experts call for a major scale-up of
global HIV prevention programs, citing new data projecting that
expanded access to prevention could avert approximately 30 million
of the 60 million HIV infections expected to occur by 2015.
The report, released by the
Global HIV Prevention Working Group, warns that prevention efforts
are not keeping pace with the gains being made in treating people
infected with HIV. For every person who began antiretroviral
therapy in 2006, six people were infected.
More:
http://www.globalhivprevention.org/pdfs/PWG-HIV_prevention_report_FINAL.pdf
Central America Moves Towards
Implementation of Regional HIV Plan
Central American countries, Cuba,
and the Dominican Republic are carrying out a series of actions in
order to prioritize PAHO’s technical cooperation to support
National HIV Programs in the analysis of the national response in
the face of the Regional HIV/STI Plan for the Health Sector
2006-2015.
This analysis has made it
possible to reach a consensus, validate, and approve strategic
lines for cooperation in this region for the purpose of addressing
themes, such as masculinity, sexual abuse, sex education and
aspects related to the logistics and supplies for ARV medicines.
According to María Dolores Pérez-Rosales,
Adviser on HIV for the Central American sub region, the
priorities, defined jointly with National HIV Programs, include a
series of workshops to strengthen epidemiological surveillance,
programming, planning and procurement of strategic commodities for
HIV. Another workshop will present the results of the gender-based
violence study conducted in Honduras, Nicaragua, and Belize. The
geographical expansion of this study to the entire subregion is
underway, with the goal of presenting the results at the CONCASIDA
meeting in Nicaragua, in November.
An evaluation of the Honduras
PMTCT+ program is also underway, focusing on the need to
strengthen the prevention of mother-to-child transmission of HIV
and Syphilis. The goal of this program is to reduce HIV
transmission to less than 5% and to reduce congenital syphilis to
less than 0.5 cases in 1,000 newborns.
More Information:
http://www.paho.org/english/ad/fch/ai/hiv_reg_plan.htm
Third
Latin American Health Journalism Award Launched
The RED-SALUD network, with
support of PAHO, the Communication Initiative, and the Foundation
for a New Ibero-American Journalism, launched the third edition of
the Latin American Award for Health Journalism. The theme for this
year’s contest is HIV testing and counseling.
The goal is to give visibility
and recognition to journalists whose work helps to inform the
population about testing and promote its use, raise awareness
among governments and civil society about the need for guaranteed
access to testing, compile and disseminate materials and
information about experiences in promoting HIV testing and
counseling, and inform users and providers about the 3 C’s of HIV
testing (counseling, confidentiality, and informed consent). The
deadline for submitting articles is November 9. Currently RED-SALUD
only accepts submissions in Spanish.
More information:
http://www.comminit.com/la/redsalud/awards/2007/index.html
WHO
Removes Viracept® from Roche of its Prequalified List
Recently the pharmaceutical
industry Roche announced the recall of batches of the
antiretroviral product Viracept®, because of detection of the
presence of a genotoxic impurity in produced batches. Viracept®
contains nelfinavir as an active ingredient and was prequalified
by WHO based on scientific evaluation of European Medicines Agency
(EMEA) and a valid marketing authorization in the European Union (EU).
The information on the presence
of genotoxic impurity relates to batches of Viracept® supplied by
Roche to the countries outside the US, Canada and Japan.
WHO issued recommendations that
may be found on: http://www.who.int/prequal/info_press/ViraceptWHOstatementJune14-07_En.pdf
WHO also suspended Viracept® from
the list of WHO prequalified products and is following the
situation with relevant stakeholders to be able to provide more
specific information and advice. To ensure access to current
information on this, please visit the homepage of the WHO
Prequalification Program at
http://www.who.int/prequal.
Colleagues in HIV/AIDS Unit to Receive PAHO’s Annual Award for
Outstanding Team
Left photo:
Rafael Mazin, Jeanne Kent, Paul de la Croix, Mónica Alonso, Javier
Muñoz, and Susan Mangan show the award received during the
ceremony. Right photo: Dr. Cristina Beato, Deputy Director of
PAHO at the time of giving the recognition to the Rafael Mazin who
received it on behalf of the team
A team of colleagues from the HIV
Unit and the Unit of Human Development Resources of PAHO received,
directly from the hands of the Deputy Director of PAHO, Dr.
Cristina Beato, the award for "Outstanding Team", during the
annual Award Ceremony held on 22 June in Washington.
Rafael Mazin, Mónica Alonso, and
Javier Muñoz, of the Unit of HIV, along with Paul de la Croix-Vaubois,
Jeanne Kent and Susan Mangan of the Area de Human Resources
Development, with the support of Michèle Ooms, Miguel Agüero, and
focal points selected in the countries, were responsible for the
training and implementation of the policy, both at headquarters
and in the country offices.
The 28 training sessions were
attended by over 600 headquarters staff members (77% of HQ
staff). The team also furnished assistance to the country offices
to identify focal points for implementing the policy in the
country offices and specialized centers.
Part of the success of this
policy is PAHO’s decision to endorse the creation and development
of United Nations Cares, a global initiative
designed to harmonize the work of all United Nations agencies in
the HIV in the Workplace Program. The Director of PAHO approved a
special budget for this initiative for the period 2008‑2011.
Suggested Readings
·
Guidance on
provider-initiated HIV testing and counseling in health facilities
(English):
http://www.who.int/hiv/who_pitc_guidelines.pdf
·
HIV testing and
Counseling:
http://www.who.int/hiv/topics/vct/en/index.html
·
Male Circumcision
recent news from American Academy of Pediatrics:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=1&DR_ID=45660
·
HIV and Infant:
Feeding Framework for Priority Action:
http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/HIV_IF_Framework_pp.pdf
·
Management of HIV
infection and antiretroviral therapy in infants and children:
http://www.searo.who.int/LinkFiles/AIDS_Management_of_HIV_infection.pdf
Most frequently used HIV Acronyms:
http://www.paho.org/English/AD/FCH/AI/Acronym_hivAIDS.pdf
The purpose of this bulletin, produced by the FCH/AI Unit, is to
share information
on
the efforts of PAHO professionals involved in the response to HIV/STI.
It
is not an official document of the Organization.
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