22 January 2013

Africa: Critical Chance Exists to Contain Some Diseases, Expert Says

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Washington — An influential leader in the global health community says scientific advances have created a great opportunity to "completely control highly dangerous infectious diseases such as AIDS, tuberculosis and malaria."

Dr. Mark Dybul writes about this opportunity in an essay released by the Global Fund to Fight AIDS, Tuberculosis and Malaria as he becomes executive director of the Geneva-based organization. Dybul, a U.S. citizen and a physician, served as the global AIDS ambassador in President George W. Bush's administration.

Dybul says it is critical that the global community seize that opportunity now "or else face the risk that the disease finds new forms that are far more complex and expensive to defeat."

The emergence of extensively multidrug-resistant tuberculosis (XDR-TB) exemplifies Dybul's warning about the emergence of more dangerous disease forms. Ordinarily, TB can be effectively treated with four standard medications. A variety of circumstances can result in the mismanagement or misuse of those drugs, however, and a resistant form of the TB bacteria can result, multidrug-resistant TB (MDR-TB). This form of the disease will respond to a second tier of anti-TB drugs, which are more expensive and have greater side effects. If treatment fails again, XDR-TB may surface and "treatment options are severely limited," according to World Health Organization documents.

Prevention and treatment of infectious diseases is a great investment, writes Dybul, one that benefits entire societies, including "the larger communities and regions and countries whose economies and social fabric thrive on a healthy population."

The new Global Fund executive director says it is challenging to push this agenda when financial constraints trouble so many nations. He believes it can be done with a concerted plan of action, including these elements:

  • Demonstrate that investments in disease treatment and prevention programs are put to excellent use.
  • Focus on impact and evaluation of investments.
  • Combine every "evidence-based approach" that can prevent disease, and recognize that different countries will find different strategies effective.
  • Make programs, and specifically the Global Fund, accountable and transparent.
  • Work together, coordinating the efforts of technical experts, public health advocates and civil society.

With efforts guided by these principles, Dybul concludes, "these three diseases can be completely controlled and -- with further scientific advancements -- can actually be eliminated."

Simon Bland, chairman of the Global Fund's governing board, said, "We are delighted to welcome Mark to the Global Fund [January 21]. We share his excitement and commitment to defeating the three diseases, and we look forward to working with him over the coming years."

Prior to joining the U.S. President's Emergency Plan for AIDS Relief and rising to head that program as global AIDS ambassador, Dybul worked in a number of positions in U.S. government health agencies, including the National Institute of Allergy and Infectious Diseases and the Department of Health and Human Services. In those positions, he also acted as a U.S. representative to international health organizations such as the Joint United Nations Programme on HIV-AIDS (UNAIDS).

The Global Fund is an international financing institution created to raise and distribute funds to wage the global battle against infectious diseases. More than 1,000 programs in 151 countries have won backing from the fund to conduct a broad variety of carefully designed and targeted anti-disease initiatives since it was established in 2002. Over the decade, the organization presents a record of providing AIDS treatment for 4.2 million people, anti-tuberculosis treatment for 9.7 million people, and 310 million insecticide-treated bed nets to protect sleeping people from the bite of malaria-carrying mosquitoes.

The United States is the single largest donor to the Global Fund, having contributed almost $7.3 billion since the organization began. Governments are the largest category of donors to the organization's work, with pledges exceeding $28 billion since the inception of the fund.

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