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'Complacency,' 'Stigma' Hindering Efforts To Reduce HIV/AIDS In Black Communities, Opinion Piece Says
"Nearly 30 years after the discovery of HIV and AIDS, the epidemic is still ravaging black neighborhoods in Baltimore and across the nation," Kevin Fenton -- director of CDC"s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention -- writes in a Baltimore Sun opinion piece. Fenton writes that "complacency about HIV and the continued stigma associated with the disease are hindering progress by preventing too many African-Americans from seeking either HIV testing and treatment or support from their friends and family," adding that "this is a challenge that can be overcome."According to Fenton, the Obama administration last month "took an important step in confronting the United States" HIV epidemic" when CDC and White House officials announced a five-year campaign called Act Against AIDS, which is "designed to refocus the nation"s attention on the HIV crisis here at home." Fenton notes that 14 black civic organizations -- including the NAACP, the National Urban League, the Southern Christian Leadership Conference and the National Council of Negro Women -- are "joining the CDC to increase knowledge, awareness and action within black communities across the country." He adds that the campaign "will harness the strength and reach of these organizations by enhancing their ability to make HIV prevention a core component of their daily activities." "By raising the visibility of HIV and AIDS, the new campaign also aims to confront and overcome the fear and stigma that help keep HIV alive in black communities," Fenton says. He adds that he has "been encouraged in recent years to see black leaders, including black faith leaders, speak out more openly across the nation about the need to confront HIV and the stigma that persists surrounding this disease." Fenton writes that "[e]nding this epidemic will require not only frank and difficult discussions about HIV but also a shared sense of responsibility and commitment," concluding, "All of us can and must be part of the solution" (Fenton, Baltimore Sun, 5/27).
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Technology To Improve Accuracy Of Ovarian Cancer Diagnosis
Moffitt Cancer Center and Frantz BioMarkers, LLC have signed a license agreement on phospholipid biomarkers of ovarian cancer. Frantz BioMarkers, which has been granted exclusive worldwide rights to Moffitt"s interests in the biomarkers, will pay initiation, developmental milestone and license maintenance fees, and royalties on sales. Moffitt and Frantz BioMarkers will collaborate on ovarian cancer biomarker research, combining use of these licensed markers with lipid markers developed independently by Frantz BioMarkers.
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Warranties And Reimbursements For Family Caregivers Provide Alternative Payment Methods
The New York Times reports on a proposal for a new health care reimbursement model that offers warranties to patients, a topic also examined in a piece by Francois de Brantes in the journal, Health Affairs. Brantes and co-authors developed a model, called the Prometheus Payment, which offers set fees to providers that "cover all recommended services, treatments and procedures for specific conditions but are also "risk-adjusted" for patients who may be older or frail. The warranty is based on the costs incurred by avoidable complications. In current fee-for-service plans, all costs from these complications are covered by the third party payer, regardless. But in the Prometheus Payment model, half of the costs from avoidable complications must be paid for by the providers themselves. The result, Mr. de Brantes and his co-authors write, is a payment system that offers patients a health care warranty, since "providers win or lose financially based on their actual performance in reducing the incidence of avoidable complications.""
Diagnostics

New Global Subsidy For Malaria Medicines Must Ensure Quality Of Care

A new subsidy designed to increase access to life-saving antiretrovirals must remain focused on quality patient care if it is to succeed, argues Tido von Schoen-Angerer and colleagues in this week"s open access journal PLoS Medicine. The subsidy, called the Affordable Medicines Facility-malaria (AMFm), will be rolled out in 2009 and is designed to address concerns of poor access to artemisinin combination therapies (ACTs) for malaria, and fears about growing resistance to the drugs. Dr. von Schoen-Angerer and colleagues cite a recent household survey across 18 African countries that found only about 3% of children under five years with fever had received an ACT. The authors say that in order to enhance quality of care, the AMFm should adopt policies to exclusively fund fixed dose combinations, withhold support for ineffective combinations, and support wider adoption of rapid diagnostic tests (RDTs). The authors demonstrate how generic competition has reduced the price of antimalarials over time. "The AMFm is an innovative but untested global initiative with the potential for both positive and unintended consequences for health," say the authors. "Keeping the focus on quality care-through patient-centered policies on drug choice, diagnostics, delivery, and M&E-will help the AMFm to meet the long unfulfilled promise of artemisinin for the millions who continue to suffer from malaria today." The Affordable Medicines Facility-malaria (AMFm), a new global health initiative, aims to address inadequate access to ACTs for treating P. falciparum malaria by subsidizing producer prices. First proposed in 2004, the facility aims to lower end-user prices to the level of older antimalarials in order to save lives by making ACTs more affordable and to delay resistance to artemisinin derivatives by driving artemisinin monotherapy and substandard antimalarials out of the market. The AMFm is hosted by the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and 11 countries have been invited to participate in the initial phase: Benin, Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Rwanda, Senegal, Tanzania, and Uganda. Funding: The authors received no specific funding for this article. Competing Interests: Jean-Marie Kindermanswas an unpaid member of the Committee on the Economics of Antimalarial Drugs for the Institute of Medicine 2004 report ""Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance,"" which first proposed a subsidy. JMK and Tido von Schoen-Angerer have been consulted as stakeholders during the preparation of the technical proposal of the AMFm, but none of the authors had any role in the design nor any other official role Citation: "Focusing on Quality Patient Care in the New Global Subsidy for Malaria Medicines." Moon S, Perez Casas C, Kindermans J-M, de Smet M, von Schoen-Angerer T (2009) PLoS Med 6(7): e1000106. doi:10.1371/journal.pmed.1000106 PLoS Medicine


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