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Bloomberg Examines Aid Shortfall In Philippines; Clinton Commits Additional $5.2M During Visit

Bloomberg examines the U.N.’s continued appeal for aid for the people of the Philippines “after three tropical cyclones left almost 1,000 people dead” and an estimated 1.7 million people displaced or living in flooded areas. “The UN’s humanitarian agency issued a ‘flash appeal’ for $74 million in October and has received $26 million, according to the world body’s newswire,” the news service writes. “Among the key concerns for aid agencies remain access to safe water, sanitation facilities and hygiene items in the relocation camps and in residential areas affected by floods,” the Office for the Coordination of Humanitarian affairs said (Sheldrick, 11/12).

During a visit to the Philippines on Thursday, Secretary of State Hillary Clinton on Thursday committed $5.2 million for disaster aid for the country, Inquirer.net’s “Global Nation” blog reports. “This foreign aid is in addition to the more than $14 million in rescue and relief aid already provided by the U.S. government after the three storms that hit the country between September and October,” the blog writes (11/12).

Indian AIDS Drug Receives WHO Approval

Indian drug maker Ranbaxy Laboratories announced on Thursday it had received WHO “pre-qualification for its Indinavir anti-retroviral AIDS drug. Pre-qualification is a mechanism that “acts as a guide to United Nations agencies and countries that select suppliers for drugs,” Reuters reports (Narayanan, 11/12).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

In the last 10 years, the St. Louis area has seen an alarming increase in new diagnoses of HIV and sexually transmitted infections among 13-24 year-olds. Between 1997-2007, more than 50 new diagnoses of HIV were made each year among adolescents and young adults, who are often disconnected from the health-care system or support services. Nationwide, St. Louis has among the highest rates of sexually transmitted diseases in this age group.

To head off this trend, Project ARK (AIDS/HIV Resources and Knowledge) and the Adolescent Center in the Department of Pediatrics in collaboration with community partners have launched the SPOT (Supporting Positive Opportunities for and with Teens) aimed specifically at the 13-24 year age group. The first of its kind in the St. Louis area, the SPOT is a one-stop, drop-in center for youth that will provide testing for HIV and sexually transmitted diseases, health care and counseling, social support, prevention and case management services at no cost. School of Medicine physicians and staff from a variety of disciplines will provide services.

“This is a huge public-health epidemic that we have to address,” said Katie Plax, M.D., director of the Adolescent Center, assistant professor of pediatrics and medical director for the SPOT. “Leaving it unchecked means the rates of sexually transmitted diseases and HIV will continue to rise. With cuts to Medicaid and the economy getting worse, it’s not surprising that this epidemic is getting worse and young people have fewer places to turn.”

The SPOT opened in September 2008 at 4169 Laclede Ave. The colorful and modern drop-in center has a living room with cozy furniture and computers, offices for physicians and staff, exam rooms, a kitchenette, showers, lockers and laundry facilities.

“We are looking for the disenfranchised youth who are disconnected because of barriers or perceived barriers to the health-care system,” Donica said. “We will try to address these barriers and connect them into the system to prevent future infections. If a patient comes in with an STD or symptoms, we don’t want anything to prevent care.”

In its first year, the SPOT celebrated the accomplishment of meeting its three-year goal of helping 1,500 youth.

Katie Plax, M.D., medical director of the SPOT, director of the Adolescent Center and assistant professor of pediatrics, and Adam Kepka, youth center health specialist, discuss some of the services offered at the SPOT drop-in center.

The SPOT offers rapid HIV tests, which provide results in about 20 minutes, and is open accessible hours for testing and other services.

“We are excited to get the message to teens that this is a safe space to received medical care with no strings attached,” said Regina Whittington, program director of the SPOT. “We hope to provide a place that will establish regular health care for these teens as they transition into young adults.”

A youth advisory group was instrumental in the program’s design, Donica said.

“The group helped with the design of the space and told us they wanted a homey feel,” she said. “Their top requests were to obtain testing for HIV or STDs and have mental health and counseling services available.”

Among the University disciplines contributing to SPOT are the departments of pediatric and adult infectious diseases; the Adolescent Center; Jeffrey Peipert, M.D., the Robert J. Terry Professor of Obstetrics and Gynecology and principal investigator of the Contraceptive Choice Project; and Denise Willers, M.D., assistant professor of obstetrics and gynecology. Supporting the project are the Barnes-Jewish Hospital and St. Louis Children’s Hospital foundations, BJC Health Care, the City of St. Louis and the Missouri Foundation for Health.

The SPOT relies on a variety of community partnerships for clients and services, including Youth in Need, Epworth Children & Family Services, Planned Parenthood/St. Louis Region, St. Louis Area National Council on Alcoholism and Drug Abuse, St. Louis Agency on Training and Employment and local health departments.

“This is really a community partnership, with the University taking a role in public health,” Donica said.

Source: Washington University in St. Louis

Igor Grant, MD, professor of psychiatry at the University of California, San Diego School of Medicine, and colleagues have been awarded a $17 million grant from the National Institute on Drug Abuse to establish the Translational Methamphetamine AIDS Research Center (TMARC) at UC San Diego. Grant is director of the HIV Neurobehavioral Research Center (HNRC), a clinical research center designated and funded by the National Institute of Mental Health. HNRC researchers strive for greater understanding of how HIV enters the central nervous system and why it affects some people but does not cause neurological deficits in others.

“The establishment of TMARC will advance our knowledge of the multiple interactions that occur with HIV-induced neurological complications, substance abuse, and other comorbid disorders,” noted NIDA Director Dr. Nora Volkow. “This in turn can inform the development of more responsive treatment strategies for both drug abuse and HIV, linked through the risky behaviors like needle sharing and unprotected sex that drug abuse can provoke.”

The funding - $3.6 million annually for five years will allow TMARC to research the combined effects of methamphetamine (meth) and HIV on the central nervous system. This will be the first center in the United States to study the convergent effects of meth and HIV on the brain. Its ultimate goal is to become a national resource for translational multidisciplinary research and training in the neuropathogenesis of HIV and substance abuse.

Over one million people in the USA used meth in the past year, and in communities such as San Diego over one third of people newly infected with HIV had recent meth use.

“Currently, the combined effects of meth and HIV are poorly understood,” Grant said. “Although antiviral treatments for HIV have reduced mortality rates, neurological complications remain prevalent, with approximately 40% of persons treated with antivirals still experiencing neurocognitive problems such as memory and attention impairment that can reduce efficiency in everyday life. There is a converging HIV epidemic among young, gay habitual meth users, which suggests meth may be amplifying the effects of HIV.”

Meth causes users to be less inhibited, decreases the sensation of pain and increases energy. In chronic meth users, it may also create an inflammatory response in the brain that makes them more susceptible to HIV, according to UC San Diego researchers. Also meth may accelerate the transformation of the virus to a more invasive form.

“A person receiving antiviral treatment is more likely to have detectable HIV if he is also a meth user,” said Grant. He added that meth may increase viral replication and alter response to antiviral drugs. Because both meth and HIV affect brain function, their combined impact on neurological processes may lessen the impact of anti-retroviral treatments.

Source: University of California