Breaking News!

A US study published in the Journal of Neuroinflammation proves that 'daily caffeine "protects" brain' against diseases such as Alzheimer's.

Not that I really need another excuse to drink tea, but it's nice to have options.

World TB Day

Yesterday was World TB Day. Global Health Policy has a run-down of the good and bad news about TB, as well as a link to the World TB Day website.

To celebrate, there's some good news from South Africa.

The AIDS Political Crisis

In my continuing quest to completely eliminate any free time, I stumbled across AIDS and Power: Why There is No Political Crisis - Yet by Alex de Waal on the Social Science Research Council's website.

I haven't bought the book yet, but the Table of Contents and the first chapter, A Manageable Catastrophe, are available online.De Waal's premise is interesting: while we're doing a decent (but not good) job of managing AIDS - getting antiretrovirals to where they are needed, at affordable prices, we haven't focused on eliminating AIDS - changing behavioral patterns to limit incidences of HIV infections. This has two important ramifications:

1. Teenagers in developing countries have a shockingly high likelihood of developing AIDS
2. 'Today's generation faces a greater inequity in global life chances than its predecessors, and this is increasingly due to adult mortality and not child deaths.'

However,

demographic modelling suggests that even at very high prevalence levels - up to 40% or so - can be sustained indefinitely without a fall in the absolute numbers of a population. At that prevalence, the great majority of adults will end their lives early to AIDS. Today's crash in life expectancy will not be quickly reversed... (de Waal 6)

It is this final point - that current population levels will be maintained, but the demographic makeup will shift downward, to a population primarily of children, teenagers, and young adults, that leads de Waal to consider this a 'perpetuated calamity'. As this New York Times article discusses, very young populations contribute to strife and instability:

In poor countries with rapidly growing populations, intense competition for education, jobs and land among the young contributes to discontent and makes it easier for rebel groups to recruit, said Elizabeth Leahy, the primary author of a new report for Population Action, a nonprofit group in Washington.

Hence, the concern, at least from the West.

But it is not a simple matter of government officials ignoring the news. African rulers are canny, with a 'sound appreciation of how power functions.' They know that 'they won't be removed from office or even face political threats on account of AIDS.' (de Waal 2) If the opposite were true, believe that Mbeki and others would not have bothered with the AIDS denial that has so shocked and outraged Westerners. They might privately admit it, but they wouldn't base policy on it.

Sadly, AIDS does not head the population's list of priorities. Concerns such as unemployment, poverty, crime, education and general health improvements regularly outrank AIDS. (7) De Waal ends the chapter:

We should not mistake managing the political and social threats emanating from the AIDS epidemic for an effective response to the immense human tragedy of HIV/AIDS itself... [W]e still lack the kind of evidence we need if we are to be able to design effective policies and programmes to overcome HIV/AIDS. We are not seriously demanding that our leaders prevent HIV infections, and we should not be surprised that they are failing to do so. (10)

I'm intrigued.

GlaxoSmithKline Tears Down the Barriers

Somehow I missed the importance of this post over at Global Health Policy, the Center for Global Development's Health blog.

Yesterday, the Financial Times reported GlaxoSmithKline's exciting new strategy to expand markets and increase access to medicines in low- and middle-income countries. Through an internal policy known as "tearing down the barriers," the company has established differential pricing schemes within and between India, South Africa and other developing countries, in hopes of shifting to a new low price, high volume business model. While similar initiatives have existed for AIDS antiretrovirals (in part through the work of the Clinton Foundation), the GSK strategy notably moves beyond the "Big Three" infectious diseases to tackle the growing challenge of diabetes and other noncommunicable diseases with a dual market among the rich and poor.

This is big news. Development groups and charities (and many others, myself included) tend to focus on AIDS, malaria, TB, and other 'big name' diseases, but forget to think about non-communicable diseases and conditions that can make a productive and healthy life very difficult. This might be a symptom of the general health (or at least easy access to medications) enjoyed by most people who support international projects, who are usually not the same ones who are most often debilitated by these diseases. It's nice to see a multinational pharmaceutical company stepping in to fill the gap.