Kaisernetwork.org (Washington, DC)
28 May 2009
Politics and Policy
Farmer Still Under Consideration for Obama Administration Position, Takes Harvard Medical School Appointment
[May 28, 2009]
While Partners in Health co-founder Paul Farmer is still being considered for a senior role in the Obama administration, Farmer has been appointed chair of Harvard Medical School's Department of Global Health and Social Medicine -- Jeffrey Flier, the medical school's dean, said on Wednesday -- the Boston Globe reports. Flier said that Farmer will take a leave of absence from the medical school if he is offered a position with the administration. For now, Farmer is slated to succeed the current chair, Jim Kim, on July 1 (Smith, Boston Globe, 5/28).
Foreign Policy's "The Cable" reports that Farmer is "under consideration to head" USAID or "serve in a top administration international assistance post that would encompass it." An unnamed "international health activist" said that Farmer might be appointed USAID administrator "as an interim thing" and that he might go on to lead a new position focused on "global health in the process of foreign assistance reform over the coming year." Rep. Howard Berman (D-Calif.), chair of the House Foreign Affairs Committee, is organizing efforts to reform the Foreign Assistance Act later this year. The act was originally written in 1961 (Rozen, "The Cable," Foreign Policy, 5/26).
On Tuesday, Jack Lew, Deputy Secretary Of State for Management and Resources, said that the government is considering ways to significantly improve coordination of various agencies that work with global health assistance. "We're open to creative ideas about how to bring appropriate resources to bear," Lew said, adding, "When we look at public-private partnerships and recruiting, we're looking at how to cast the broadest net to bring in the right talent and commitment to address the challenge" (Boston Globe, 5/28).
Partners in Health said it is pleased that Farmer is being considered along with other strong candidates. Wendy Sherman, an advisor to Secretary of State Hillary Clinton, and Aaron Williams, a former USAID official who is now with RTI International, are among some of the "[p]reviously rumored contenders for the USAID administrator job," according to "The Cable."
Last week, Farmer had a meeting with Clinton, Partners in Health said. Andrew Marx, a spokesman for the group, said that one of the reasons why people are "excited about the idea of Paul is that he and Partners in Health in the past have been quite prepared to challenge the accepted wisdom." According to Marx, Farmer did not buy into the conventional approach to multi-drug resistant tuberculosis in the 1990s, when WHO's official policy was not to treat people who were diagnosed with the disease because it was complicated and the costs were high.
When asked if Farmer would be interested in a USAID administrator position that has strong democracy and governance components, Marx said, "Good governance and democracy are important to us," adding that the group's work focuses on building up countries' public health systems rather than creating independent health clinics.
David Bryden, senior program policy officer for the Center for Global Health Policy, said, "There are many exciting things about Paul Farmer." According to Bryden, Farmer "has been a person with a very practical mindset, he knows how to get the job done, put aside conventional wisdom when it's wrong. ... It's really exciting" ("The Cable," Foreign Policy, 5/26).
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Global Challenges
About 0.59% of Vietnamese Fishery Workers are HIV-Positive, Prevalence Could Rise by 2013, Survey Says
[May 28, 2009]
An estimated 33,000 of the total 5.5 million workers in Vietnam's fishery sector, or about 0.59%, were living with HIV in 2008, according to a survey released Tuesday by Vietnam's fishery program, VNA/VOV News reports (VNA/VOV News, 5/27). The report also predicted that the number of HIV-positive people in Vietnam's fishery sector could rise to 58,000 by 2013. According to a second survey, conducted simultaneously, a lack of knowledge about the disease has contributed to the fishery sector's relatively high HIV prevalence. Vietnam's Ministry of Agriculture and Rural Development as part of its Strengthening of Fisheries Administration conducted the survey with support from the Danish International Development Agency.
For the first survey, researchers selected five provinces that were geographically and occupationally representative of the fishery industry. They surveyed 2,350 volunteers from four fishery trades: exploitation, processing, cultivation and provision. Fourteen of the survey participants disclosed that they had tested positive for HIV. Researchers then applied the Means of Transmission Model to estimate that about 0.59% of the country's fishery workers are HIV-positive. Do Thanh Nam, who led the survey, said the industry's "alarming" HIV rates are "caused by a lack of attention on HIV/AIDS risk among fishery workers" (VietNamNet Bridge, 5/27). Do also said that the survey might provide only a "snapshot" of the sector's HIV prevalence (VNA/VOV News, 5/27).
For the second survey, STOFA researchers surveyed 3,400 participants from nine provinces and found that many lacked sufficient knowledge about HIV. About 14.4% of survey respondents mistakenly believed HIV could be transmitted through mosquitoes or sharing tools; about 6.4% believed that hugging or kissing could transmit the virus; and about 15.8% believed having unprotected sex with commercial sex workers carried no risk of contracting HIV. In addition, 17.3% of male fishery workers reported using condoms with commercial sex workers. Le Thi Mong Phuong, who led the second survey, said that fishery workers often receive inadequate and unsystematic information about the disease. "Most of them learn about HIV/AIDS from television or radio, but rarely and irregularly," she said. Furthermore, many fishery workers reported spending long periods of time away from home, with 67% of 817 workers reporting absences of more than seven months per year and 21% reporting absences of four to six months per year.
Vu Van Tam, deputy minister for agriculture and rural development, said that his ministry will use the results of the survey to develop HIV prevention and control strategies for the industry. Peter Lysholt Hansen, Danish ambassador to Vietnam, added that HIV/AIDS could jeopardize the recent growth in Vietnam's agricultural sector because the disease poses high treatment costs for families, as well as costs from a weakened labor force. The surveys recommended that Vietnam address HIV/AIDS among fishery workers by strengthening a communications campaign and launching a program to provide condoms for high-risk groups (VietNamNet Bridge, 5/27).
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About 75% of People in Rwanda Who Have Experienced Discrimination Are HIV-Positive, Survey Finds
[May 28, 2009]
A recently released survey on stigma in Rwanda indicates that at least 74% of people in various segments of society who have experienced discrimination are HIV-positive, the New Times/AllAfrica.com reports. The discrimination often is in the form of isolation from family and physical harassment, according to the survey.
The study was conducted by the Association of Vulnerable Widows Infected and Affected by HIV and AIDS in conjunction with the Network of People Living with HIV and UNAIDS Rwanda. It found that although 87% of respondents reported never having been denied health services, 88% reported being denied other social services, such as family planning, because of their HIV status. An estimated one-third of respondents reported that their rights had been abused because of their HIV-positive status.
Chantal Nyiramanyana, AVVAIS president, said, "We conducted this survey as a way of providing basis for advocacy, policy change, and programmatic interventions by the government and other interested bodies to address stigma and discrimination related to HIV." The survey found that other groups experiencing stigma in the country include commercial sex workers and asylum seekers (Kwizera, New Times/AllAfrica.com, 5/27).
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Thailand Aims To Halve New HIV Cases by 2011, Prime Minister Says
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