by Bianca Auping-Kamps –Senior Fund Portfolio Manager, the Global Fund
In remote parts of Papua New Guinea, focusing HIV prevention on those most at risk of the virus is not straightforward. I was confronted with this in Port Moresby recently as I discussed the condom use of sex workers with some of the Global Fund’s implementing partners.
What happens, for example, when someone is trading sex for transport? While they may not identify as a sex worker, they are nonetheless potentially exposed to HIV. Reaching people like this is an absolute necessity.
Challenges like this informed a new grant we formalised in Papua New Guinea today. While Papua New Guinea has made good progress in reducing its HIV epidemic, only a grassroots, community-led approach will make fresh inroads against the disease.
That’s why the new grant focusses on behaviour. It looks at how people at risk of HIV act in the real world, but also the attitudes of those who need to support them, such as medical and criminal justice workers. In Papua New Guinea, gender based violence and stigma against men who have sex with men and transgender people is still very real. So the solutions need to be grounded and realistic.
For example, peer leaders in the transgender community will be trained to distribute condoms among their friends and colleagues and point them towards medical services, when necessary. Since these peer leaders will work with specific clinics, trust will deepen. At the same time, health workers will be trained to be more sensitive and receptive to groups such as men who have sex with men. In a more trusting, open environment, people are more likely to discuss their behaviour and address risk.
Today’s grant agreement is a good encapsulation of the Global Fund Partnership. Partners such as the Australian and US Government have worked with people affected by HIV as well as Papua New Guinea churches, health officials and private sector partners such as Oil Search Health Foundation to create this program. No one has all the answers but by working together in partnership we can have a genuine impact.
Global Fund News Flash
Viral load testing is the best way to know if a child is HIV positive. It’s also a powerful tool to determine if HIV drugs are working. The problem is that until now, the tests were often prohibitively expensive and contract terms varied.
New agreements struck between the Global Fund and seven diagnostic manufacturers aim to change that. After a year of in-depth negotiation and intense study of the market, the Global Fund sourcing team believes it’s found a route to affordable and stable prices, better contracting, and hopefully, expanded testing.
The manufacturers have agreed to provide the test components at a stable and competitive all-inclusive price as low as US$15 per test, which includes the cost of testing equipment. Today, tests can cost as much as US$85.
A more competitive price is welcome, but Christopher Game, the Global Fund Procurement head, explained that it’s not the only benefit of the agreement.
“What we were really after was transparency and reliability,” Game said. “So yes, the price reduction is great, because it will free up money to do more testing. But just as importantly, we now have transparency around the various components of that price, such as transport and machine maintenance.”
The machines required for the tests don’t come cheap, selling for around US$150,000. By stabilizing the other elements required to test, Game and his team expect to see an expansion in the number of tests done.
The agreement should deliver net savings of at least US$30 million over three years to the Global Fund, and potentially much more. Seven manufacturers have been through a technical and commercial evaluation before being added to the panel of suppliers. The framework agreements last at least three years. Other public health funders and agencies will also be able to enter into agreements based on the benchmark prices and contracting negotiated.
Global Fund News Flash
The Stop TB Partnership launched an online consultation process today to engage a wide group of stakeholders in developing the Global Plan to Stop TB 2016-2020. The development of the Global Plan seeks to be as inclusive as possible, and the online consultation (http://stoptbplan2020.org/) aims to reflect a diverse range of input, including the voices of people, professional groups and TB constituencies who may not have been reached previously. The consultation process will run from 10 June to 10 August 2015. Participants are encouraged to provide comments based on top line questions.
Since its creation, the Stop TB Partnership has issued five and ten-year Global Plans for concerted global advocacy actions, and to provide an estimate for the resources needed to reach the WHO End TB Strategy goals by 2035. The current Global Plan provides a ‘business case’ for the period 2016-2020. It is meant as an instrument for those working with TB and those allocating funding.
The Stop TB Partnership said that to achieve WHO’s End TB Strategy goals, significant changes need to be made in the way most countries organize and run their TB interventions and programmes. An acceleration in research and development of new drugs, diagnostics tools and a vaccine is also imperative, it said.
In addition to the online consultation, the Global Plan to Stop TB 2016-2020 will be informed by the outcomes of four regional consultation meetings. The Global Plan will be launched at the end of the year in Cape Town, South Africa, during the 46th Union World Conference on Lung Health.
GENEVA, 18 May 2015—On HIV Vaccine Awareness Day, UNAIDS is calling for a renewed global commitment to finding an effective HIV vaccine.
“A vaccine would be a major step towards ending the AIDS epidemic,” said UNAIDS Executive Director Michel Sidibé. “There have been encouraging recent scientific advances that give us hope for the future development of an HIV vaccine.”
UNAIDS is committed to leaving nobody behind in the HIV response. A major advantage of vaccines is that they promote equity and can be used effectively in all communities and settings, including those where many other health services can be harder to deliver.
Studies show that an HIV vaccine is possible. The RV144 vaccine trial in 2009 lowered the rate of HIV infection by 31%. There is much hope that ongoing research will build on this trial and deliver results. Newer vaccine candidates, as well as neutralizing antibodies, are also being studied.
Vaccines have eradicated smallpox, and polio is close to eradication. Vaccines have also effectively controlled diphtheria, pertussis, tetanus, mumps, measles and rubella, among other infectious diseases.
However, in 2013, HIV vaccine research and development saw the largest decline in investment since 2008. In order to transform promising concepts into an effective and accessible vaccine increased and sustained funding will be critical.
By Dr Mark Dybul, Executive Director of the Global Fund
from the Post Courier pg 13, 15 May 2015
At the turn of the century, it became clear that the threat of infectious diseases like HIV, tuberculosis and malaria demanded a new approach: A partnership between people affected by the diseases, government, civil society and the private sector. With a focus on results, tremendous gains can be made.
Today, Papua New Guinea has become a living embodiment of this approach, and it is working.
We start with a tremendous global challenge. Malaria and tuberculosis have been with us for more than one thousand years.
HIV, the modern plague, has not only taken almost 40 million lives, it has flourished in the shadows of discrimination. The world has been forced to face confronting questions about stigma.
Yet no single institution or individual has the wisdom or capacity to end the three epidemics. Such deeply complex problems demand a multi-faceted response.
On my recent trip to Port Moresby, it was encouraging to see genuine progress, despite ongoing challenges.
The role of churches in delivering health care in PNG is widely acknowledged, yet insufficiently celebrated. Particularly in remote parts of PNG, the vast majority of services are delivered by faith-based organisations.
For this reason, the Global Fund is partnering with organisations like Anglicare and Catholic HIV & AIDS in areas such as Enga and the Western Highlands.
This partnership approach is able to provide care and support, while fighting stigma against those who live with HIV – as well as those at risk of it.
The Government’s recent decision to support an extra 375 church health positions and fund 162 church health facilities is a strong sign that they are also keenly aware of the power of this model.
Similarly, the distribution of mosquito nets across PNG by Rotarians Against Malaria (RAM) provides an excellent example of Global Fund principles in action.
An established and respected Global Fund partner, RAM distributes nets in remote and difficult environments. The organisation is committed to continual net distribution, rather than grand one-off campaigns.
As such, it is constantly learning and refining its approach. It helps that RAM is informed by real world private sector experience, an organisation well versed in getting things done.
Indeed, RAM has been pivotal in getting mosquito nets into PNG homes in practically every part of the country, helping to drive down malaria prevalence from 12.1 per cent to 1.8 per cent.
The Oil Search Health Foundation also shows how PNG is putting results ahead of process.
Oil Search understands that the health and wellbeing of Papua New Guineans is inextricably tied up with its own business goals. Since 2012, the Oil Search Health Foundation has partnered with the National Department of Health to manage and implement Global Fund resources to fight HIV and malaria.
It has delivered care and support to people living with HIB, raised community awareness to fight stigma and discrimination and supported health clinics to build functional HIV testing, counselling and treatment pathways.
No one would deny there are great challenges in delivering health care and disease prevention in PNG. Yet there is also cause for great hope.
The Government of PNG can increasingly act as a powerful connector, bringing the best out of the many and varied PNG institutions to improve health outcomes.
As these examples demonstrate, there is no single answer to ending HIV, tuberculosis and malaria as epidemics.
This is a problem that must be hit from every angle with sustained effort. I’m privileged to say that the Global Fund is committed to partnering with the vast array of people doing their bit to create a brighter, healthier future in PNG. We are here for the long haul.
Global Health News
Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.