Kim Lufkin

Ahead of World AIDS Day, Secretary of State Hillary Rodham Clinton launched a new State Department blueprint to reach an “AIDS-free generation” within five years. “An AIDS-free generation will be within our sight,” Clinton said as she described the blueprint, which outlines key strategies the US will undertake to fight the HIV and AIDS pandemic. She also warned: “Now we have to deliver. … The history of global health is littered with grand plans that never panned out.” According to Clinton, an AIDS-free generation means that the world “can reach a point where virtually no children are born with the virus, and as these children become teenagers and adults, they are at a far lower risk of becoming infected than they are today. And if they do acquire HIV, they have access to treatment that helps prevent them from not only from developing AIDS, but from and passing the virus on to others.” The blueprint outlines several key actions to reach this goal, including: Scaling up the most effective prevention and treatment interventions. Targeting the populations at the greatest risk of contracting HIV, including people who inject drugs, sex workers, those trafficked into prostitution, and men who have sex with men. This also includes ensuring that HIV and AIDS programs recognize the particular needs of women and girls. Promoting sustainability, efficiency, and effectiveness. Promoting a global effort to achieve an AIDS-free generation. There have been several notable breakthroughs in HIV and AIDS science and research in recent years, and it’s critical that the US government prioritizes the development of new tools in any HIV and AIDS strategies and goals it creates. Photo credit: PATH. According to Clinton, science and research are key principles that must underlie each aspect of the AIDS-free generation blueprint. This includes US support for research to develop the next generation of “innovative technologies for prevention and treatment, such as microbicides and approaches that stave off opportunistic infections” like tuberculosis. It’s commendable that the US government is continuing its legacy as a leader in the fight against HIV and AIDS, as this blueprint indicates. It’s also encouraging that the blueprint focuses on developing new scientific breakthroughs in the fight against the disease. As Mitchell Warren from AVAC said in response to Clinton’s speech, “Powerful new HIV prevention options could together lead to dramatic reductions in HIV infections, but we don’t have all the information we need to scale them up in the right combinations for various communities. Urgent questions about the real-world use of new prevention tools in combination have been clear for months or even years, yet the work to answer them is barely under way. That’s as unconscionable as it is unnecessary.” There have been several notable breakthroughs in HIV and AIDS science and research in recent years, and it’s critical that the US government prioritizes the development of new tools in any HIV and AIDS strategies and goals it creates. But as Clinton stressed, it’s vital that the United States and its partners deliver on the promises outlined in the blueprint. According to the International AIDS Vaccine Initiative, the “realization of all this promise depends on sustained funding for HIV prevention research. Political will, too, must be sustained to secure the progress already made in the campaign against HIV. We must remember that any call to bring about the ‘end of AIDS’ will only be fulfilled if HIV prevention remains high on the list of global health priorities.” As the Obama Administration enters its second term in the new year, leaders across the Administration must ensure that the priorities outlined in this blueprint are fulfilled, particularly the US commitment to research and new HIV and AIDS tools. We cannot reach an AIDS-free generation otherwise.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The latest G-FINDER report finds that annual investment in neglected disease research and development (R&D) from donors worldwide has been in the decline in recent years. And while the report finds that the United States has maintained its position as the top funder of neglected disease R&D, US funding still decreased in 2011 by $30.6 million. A treatment for sleeping sickness has entered clinical trials in the Democratic Republic of the Congo, and trials will start soon in Central African Republic. The study was initiated by the Drugs for Neglected Diseases initiative (DNDi) and its partners. A new opinion piece argues that sequestration “would significantly delay new, life-saving medical treatments. But what many people don’t realize is that the massive cuts also would put a chokehold on the creation of high-tech jobs and threaten US global competitiveness.” The US Food and Drug Administration approved 35 new medicines in its fiscal year 2012, which ended in September, according to a new report. That number is one of the highest levels in years. Senators Patrick Leahy (D-VT) and Christopher Coons (D-DE) have introduced legislation that aims to bolster the US Patent and Trademark Office’s Patents for Humanity initiative by making certificates awarded through the program transferable to third parties.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The latest G-FINDER report finds that annual investment in neglected disease research and development (R&D) from donors worldwide has been in the decline in recent years. And while the report finds that the United States has maintained its position as the top funder of neglected disease R&D, US funding still decreased in 2011 by $30.6 million. A treatment for sleeping sickness has entered clinical trials in the Democratic Republic of the Congo, and trials will start soon in Central African Republic. The study was initiated by the Drugs for Neglected Diseases initiative (DNDi) and its partners. A new opinion piece argues that sequestration “would significantly delay new, life-saving medical treatments. But what many people don’t realize is that the massive cuts also would put a chokehold on the creation of high-tech jobs and threaten US global competitiveness.” The US Food and Drug Administration approved 35 new medicines in its fiscal year 2012, which ended in September, according to a new report. That number is one of the highest levels in years. Senators Patrick Leahy (D-VT) and Christopher Coons (D-DE) have introduced legislation that aims to bolster the US Patent and Trademark Office’s Patents for Humanity initiative by making certificates awarded through the program transferable to third parties.

With the results of the presidential and congressional elections now almost two days behind us, there has been increasing reaction and speculation about what President Barack Obama’s second term and new congressional leadership could mean for foreign policy, international development, and global health. Below, we provide a round-up of some of the most interesting reads in the wake of the election results. Devex examines if Obama’s re-election is a “boon for US foreign aid.” While “Obama’s win is good news for the US Agency for International Development (USAID), which could have faced deep budget cuts in a Republican administration,” questions still “linger” over leadership. “Secretary of State Hillary Clinton is not expected to stay for more than a few months into Obama’s second term, if at all. Some Washington insiders also suggest that USAID Administrator Rajiv Shah is interested in pursuing a political career sooner rather than later.” According to the US Global Leadership Coalition (USGLC), the election has resulted in “broad bipartisan support for America’s global leadership and the International Affairs Budget,” although there are “challenges ahead to reconcile commitments to development and diplomacy with the need to address America’s fiscal crisis.” USGLC provides a detailed look at the new players in Washington and the likely playing field for the 113th Congress. The Center for Global Development identifies the “five things that should be at the top of the President’s global health agenda for the next four years.” These priorities include the President’s Emergency Plan for AIDS Relief, strengthening global health partnerships, and sustainability. Both National Journal and Foreign Policy examine how Rep. Howard Berman’s (D-CA) loss and a new Republican chair of the House Foreign Affairs Committee will shake up the foreign policy leadership in Congress. National Journal reports that one day “after the election ensured Republicans will keep their majority in the next Congress, Rep. Ed Royce (R-CA) made his first public play to secure the chairmanship of the House Foreign Affairs Committee.” And according to Foreign Policy, “Berman will be remembered for his decades of tireless work on foreign policy and his reputation as a legislator who sought to build consensus to push forward a bipartisan agenda.” Pharmalot looks at what the US Food and Drug Administration (FDA) will look like after the election results have settled. “Apart from an occasional reference, the agency is not part of the campaign dialogue.” However, the FDA will still be affected by the looming sequester, which would leave the agenda with about $320 million less to spend in Fiscal Year (FY) 2013 than it did in FY 2012. Pharmalot also examines what could happen to FDA leadership in the coming months.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Secretary of State Hillary Rodham Clinton unveiled a blueprint for achieving an AIDS-free generation, which recognizes the need for research to develop new HIV and AIDS treatment and prevention tools. A new tuberculosis vaccine candidate has been given regulatory approval to begin clinical trials in Europe, making it the first of its kind to do so. An experimental vaccine based on a molecule that protects animals against influenza may one day offer a faster way to develop new vaccines for humans. At a recent World Health Organization meeting, member states agreed to focus on strengthening national regulatory capacities as part of a plan to promote the prevention and control of substandard medical products worldwide. In related news, WHO member states have also agreed to endorse a strategic work plan for global health research that includes proposals on the coordination, financing, and monitoring of research expenditures. A new report from the Milken Institute explores possible incentives and innovative financing mechanisms to develop treatments for diseases that primarily affect the developing world.

It’s not much of a surprise that Monday night’s presidential debate, which focused on foreign policy, was consumed by a discussion of defense spending, and security and trade policies regarding the Middle East, North Africa, and China. While not unexpected, it’s still disappointing that both Barack Obama (D) and Mitt Romney (R) were relatively silent on issues like global health, research, and international aid. We’ve written previously about how critical it is for the candidates to address these issues, given the impact of presidential policies on funding for global health research and other development programs. While there have been some brief mentions during the debate season of the role of science and technology—both candidates have discussed how science and technology can help create domestic jobs and tackle issues like energy and climate change—it’s critical to also address the role of science in international health and development. Indeed, there’s been some reaction from the international development community regarding the lack of foreign aid and assistance in Monday night’s debate. Devex provides a summary of some clues offered up by both Romney and Obama regarding foreign aid and development in Pakistan, the Middle East, North Africa, and South Asia. But as this word cloud from the US Global Leadership Coalition indicates, health, research, and science—among a host of other topics—were missing from the debate. Perhaps Josh Barro from Bloomberg puts it most succinctly: “The biggest problem with this debate, as with the previous ones, is what wasn’t discussed. There was no discussion of Europe or sub-Saharan Africa and only a brief mention of Latin America by Romney (who, as Matt Yglesias notes, got his key factoid wrong). The candidates did not discuss immigration, the drug war, global health, climate change or the international financial system.” He adds that “apparently ‘foreign policy’ has come to mean ‘places in the Middle East and North Africa where we are or might be bombing people, plus some really stupid and demagogic discussion of trade with China.’” With the election now less than two weeks away—and domestic issues such as jobs and the economy taking center stage—it seems increasingly unrealistic that either candidate will offer up much on global health, research, or other development topics soon. But no matter what the outcome is in two weeks, the next president must demonstrate more support for global health and foreign aid than the candidates displayed during Monday night’s debate.