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AIDS 2012: In a watershed year, breakthroughs await

David Wilson's picture

When the International AIDS Conference was last held in Washington, D.C. in 1987, Ronald Reagan was U.S. president, the Soviet Union stood, a wall scarred a divided Berlin and China’s economy was roughly the size of Spain’s. The wider world – and the AIDS epidemic – has changed more than anyone foresaw.

 

The conference returns to Washington in a watershed year. AIDS remains the greatest infectious disease challenge of our age: more than 65 million people infected and 30 million deaths since the epidemic began, and roughly 3 million new infections and 2 million deaths a year.

 

These are grim statistics, but they belie the incredible progress made. When we met at the 1987 AIDS conference, the world had few tools to prevent deadly infections and no drugs to commute slow, agonizing, wasting death. Today, there is an expanding armory of proven prevention tools; new HIV infections have been reduced in more than 33 countries; and there are more drugs to treat HIV than for every retrovirus in history combined.  Annual treatment costs have been reduced 100-fold and AIDS treatment has been expanded 60-fold to reach 8 million people worldwide in the largest-ever expansion of lifesaving treatment.

 

As the pace of scientific progress accelerates, even greater breakthroughs await us.

 

Nowhere is this amazing progress more evident than in Africa. At its peak in Eastern and Southern Africa, AIDS was responsible for 50-70% of bed occupancy and two-thirds of all adult deaths. Let each of us simply try to imagine experiencing this in our own neighborhoods. In my country, Zimbabwe, hospitals overflowed with emaciated, dying people, nurses and doctors were undertakers, hospitals were hospices, and an entire society’s social life rotated from hospital beds to funeral gravesides. Coffin-making was the fastest growing business, lining miles of roads to overcrowded cemeteries.

Need to buy Treasury Bills and Bonds? There's an app for that!

OK, not exactly an App, but investors in Kenya will soon be able to buy T-bills and bonds offered by the Central Bank of Kenya (CBK), as agents of the Treasury, through their mobile phones (with or without a bank account)!

Buying T-bills and bonds through your mobile phone? It's possible! (Credit: kiwanja, Flickr Creative Commons)

This innovative project, led by CBK, with the support of the World Bank, is known as Treasury Mobile Direct. It will aim to extend the use of mobile technology beyond money transfers and broaden the choice of savings products for retail investors. Potential investors will only need a mobile phone line and a subscription to a mobile money service, which will enable telecoms operators open an electronic account with the Central Securities Depository (CDSC) or CBK on their behalf. These accounts are a requirement if you wish to invest in Government debt. The service will include purchase, interest payment and redemption of securities (short-term paper and bonds) through the mobile platform.

Transitions in financing HIV/AIDS programs

Patrick Osewe's picture

(Portrait of mother and child. Botswana. Photo: Curt Carnemark / World Bank)

While participating in a study of HIV spending efficiency in South Africa, I met a young HIV-positive mother who had just received the joyful news that her new-born daughter was healthy and HIV-free. Wiping away tears of relief, she described the gratitude she felt for the antenatal clinic staff, who had helped start her on antiretroviral treatment (ART) and thanks to whom she now had the hope of a bright future for her daughter. This encounter was just one among many similar incidents during the study – and, as our preliminary data show, is representative of the positive impact of the Government’s strong commitment to bringing down rates of HIV.

 

South Africa has mounted one of the strongest responses to HIV in the world. Its most dramatic success has been the scale-up of ART since 2003, growing from almost nothing to the country’s largest health program that treated about 1.5 million people in 2011 (out of a total HIV-infected population of 5.6 million).

 

The impacts of this treatment drive are already showing, with overall mortality, maternal and infant deaths all on a downward trend following their HIV-related peaks in the early-to mid-2000s. However, the cost of sustaining this success is huge: South Africa has committed to putting an estimated target of almost 10% of the entire population on a life-long course of expensive drug treatment. And, even with government negotiators bringing down ART drug prices by 65% since 2008, successful testing campaigns coupled with the worrying increase in resistance to first-line therapies look set to further raise the financial risk.

 

These challenges extend beyond South Africa. An analysis of the fiscal dimensions of HIV/AIDS released by the World Bank earlier this year in a number of countries concluded that without significant additional investments in prevention starting now, the cost of treatment will rapidly become unaffordable for even the most cash-rich countries on the African continent.

Bringing together earth-friendly products and South Africa's poor

Forget about flying cars and wristwatch phones—innovators Will green innovations such as solar cookers be embraced? And by whom? (Credit: infoDev)today are more likely to be tackling solar lamps, cleaner cookstoves, energy-efficient housing and water filters. Such products promise the tantalizing combination of steady jobs, better lifestyles, and a cleaner planet…but for whom, exactly?

The big challenge is making sure that those opportunities reach the more than a billion people living in poverty. Recently infoDev teamed up with the Innovation, Technology and Entrepreneurship global practice, the World Bank Country Office in Pretoria, and the Gauteng government’s The Innovation Hub to run four workshops on low-income communities’ needs, attitudes and perceptions about climate technology products.

Growing Book Program Gives Rural School Children Access to Textbooks

Victoire Ngounoue's picture

Thousands of schoolchildren in the northwest region of Cameroon are benefiting from a co-investment schoolbook program established by Knowledge for Children (KFC), a Cameroon-Dutch based non-governmental organization (NGO).

-Despite high enrollment rates, one in two students in Cameroon leaves school without basic literacy skills, a metric that is significantly worse among students without access to textbooks
-In the northwest region of Cameroon, a local development project has made school books available to more than 27,000 children in rural primary schools, which provides the potential to hugely enhance a student’s academic performance
-Since 2005, the number of primary school students in the northwest region with access to books has increased from 15% to 25%


if you think education is expensive, try ignoranceManjong Sixtus, Delegate for Basic Education, Donga-Mantung

 

 

During the 2010 – 2011 academic year, 95 schools participated in the program that has made school books available to children in rural primary schools. But, thanks to a US$20,000 (XAF 10,470.900) grant awarded during the 2011 Development Marketplace competition in Cameroon, KFC has been able to extend the program to 15 new schools during the 2011-2012 academic year, bringing the total number of participating schools to 110 and reaching 27,500 children.

Weekly Wire: the Global Forum

Kalliope Kokolis's picture

These are some of the views and reports relevant to our readers that caught our attention this week.

Journalism
Report published on 'delivering trust' in digital age

“Former director of BBC News Richard Sambrook has called for "new ways to place a premium" on reporting that shows a focus on evidence, diversity and transparency, in a bid to "help rescue the core of what impartiality and objectivity delivered in the past" in a digital world.

In a report published today by the Reuters Institute for the Study of Journalism, Sambrook asks whether there is a need for "different codes or journalistic norms for the digital age" in order to ensure trust in the media, particularly in light of the Leveson inquiry into the press in the UK and "debate about a ‘post-truth’ political environment in the US".

He identifies that the journalism industry is ‘in transition from the old analogue world of limited supply, where professional codes and regulation were effective in ensuring quality, to the digital age of plenty’.”  READ MORE

Laboratory accreditation: Critical to quality care

Miriam Schneidman's picture

The quest for an accurate, timely and affordable medical diagnosis remains elusive in many developing countries.  In East Africa, laboratories are often poorly staffed; ill-equipped; and lack quality systems. Obsolete equipment clogs up limited space. Clinicians often resort to presumptive diagnoses rather than requesting lab confirmations. Individuals suffering from infectious diseases, such as tuberculosis, run the risk of going undetected and transmitting the disease to others, or being misdiagnosed, which in turn leads to compromised care and higher health care costs. 

 

Many laboratories are not adequately prepared to respond during public health emergencies, yet their services are critical to detecting new pathogens and containing disease outbreaks. 

 

World Laboratory Accreditation Day, observed recently, offers a good opportunity to draw attention to the critical role of laboratories in health, and the importance of accreditation in promoting quality.  Accurate and reliable laboratory services are critical for conducting clinical diagnosis, guiding treatment, and responding to disease outbreaks.  There’s a growing recognition of the importance of laboratory services, and several important initiatives have been launched, including the WHO-AFRO Stepwise Laboratory Improvement Process towards Accreditation (SLIPTA).

Isolated West Nile Region Home to First Sub-Saharan World Bank Project to Issue Carbon Credits

Isabel Hagbrink's picture

Electricity transmissions lines in Uganda. Credit: Arne Hoel/World Bank

Wedged between the Congo, the south of Sudan, and the West Nile River, the 1.5 million people in Uganda’s West Nile region live in relative isolation from the rest of the country.

Nowhere in Uganda is oil and gasoline more expensive than in the West Nile. The national power grid does not reach into the northwest of Uganda, and power from generators is available only for a lucky few and only for a few hours a day.

Some entrepreneurs have started mills and small workshops, outfitting them with old diesel generators that are inefficient and very expensive to operate. Some institutions, such as hospitals, and some of the richer households have their own diesel generators that help them escape the scarce and unreliable public power service. The growth in individual generators is indicative of a general upswing in economic activity in the region, but life without reliable electric power has remained a challenge.

That is now beginning to change, and carbon credits are playing an important role.

It’s a Capital (plus Advisory) Problem not a Pipeline Problem

Aleem Walji's picture

Photo Credit: methodlogical.wordpress.comI recently returned from travel to India and East Africa where I attended a round table on social enterprise with the Government of India and met impact investors focused on Kenya, Tanzania, Rwanda, and Uganda. After listening carefully to entrepreneurs, investors, and government officials, I’m compelled to say something entirely inconsistent with conventional wisdom in the world of impact investing: there is not enough capital to support the pipeline of enterprises focused on solving our most vexing social problems. By social problems, I mean the provision of basic goods and services to the bottom of the economic pyramid where governments and markets often fail.

Take access to energy for example or access to sanitation in much of Africa and South Asia. More than 1.3 billion people on the globe still lack access to electricity and over 2.5 billion lack basic sanitation. Every 20 seconds a child dies because of poor sanitation.

These are public goods and unambiguously the responsibility of public actors. But in reality, governments often don’t have the resources, the will, or the capacity to provide these basic services to many of their citizens. And purely commercial enterprises lack incentives to provide services where financial upside is limited and the ability of poor people to pay is constrained. But this is precisely where inclusive (or socially driven) businesses and social entrepreneurs, for profit and not-for-profit, are innovating and developing new business models to solve our most pressing social challenges.


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