NEWSBYANDREW GREEN

What’s on your résumé? Activism? Project management? Research skills? Turns out, the experience you have, whether from a book or in the field, can help save lives. And Healthcare Information for All by 2015 gives you the opportunity.

HIFA2015’s tagline “People are dying for lack of knowledge” is borne out in the statistics they cite: four in 10 mothers in India believe they should withhold fluids if a child suffers from diarrhea, seven in 10 children treated at home for malaria are mismanaged, eight out of 10 caregivers in developing countries don’t recognize the two key symptoms of childhood pneumonia.

There’s an obvious need for better basic health care knowledge in many low-income settings. But it's not just information and training - a broader range of support for health care workers is required. This is why HIFA2015 exists. The organization’s ultimate goal (belied in the name): that every person, worldwide, should have access to an informed health provider by 2015.

Thousands of AIDS patients across the developing world could lose access to affordable antiretrovirals if one specific clause makes its way into a pending trade agreement between India and the EU.

Let’s help make sure that doesn’t happen.

Cheap, generic antiretrovirals have been critical in prolonging the lives of HIV/AIDS patients in resource-poor settings. Such generic meds make up 80 percent of the drugs distributed by organizations like Doctors Without Borders across communities that are not able to afford the full-priced alternative. Even the President’s Emergency Plan for AIDS Relief incorporates generics into its programs.

India is the world’s leading producer of generics. But if the “data exclusivity” passage, seen in a leaked draft obtained by the Associated Press, makes its way into the final version of a pending trade agreement between India and the EU, it could stymie India’s generic pharmaceutical industry, especially in the development of new medicines coming online. The result could be a return to the days when patients had to choose between full price meds or no meds at all.

The long-prophesied integration of mobile technology and public health coverage is no longer a fantasy. It’s happening, it’s successful and you can help facilitate its spread.

The Weltel Project launched in 2006 to help health care providers in rural areas of Kenya use mobile technology to keep in better touch with patients taking antiretroviral drugs. According to PlusNews, a simple text message of “Mambo?” (“How are you?” in Swahili), allowed clinic nurses to check in on far-flung patients. Those patients who either didn’t respond or responded that they were in trouble received a follow-up call from the nurse to assess problems.

The approach makes sense. Cell technology is widespread in Africa and, as a coordinator explained to PlusNews, a phone call provides a sense of privacy that a visit to the clinic does not. Suddenly patients unable or unwilling to access health care have a private channel to communicate problems and easily follow up. A study published in The Lancet proves that the Weltel approach is working. Researchers found that patients who received text messages had higher adherence rates to their antiretroviral treatment and better rates of viral suppression, compared to a control group.

So, World AIDS Day has come and gone, and what’s the takeaway?

Inspired? Definitely. There were myriad examples of people coming together around the world to show that AIDS is still a critical issue that needs to be addressed.

Depressed? Also that, considering the litany of articles about the funding that’s missing for key projects and interventions to continue and flourish.

It’s the latter point that’s particularly galling, because it often feels as if public health needs - and particularly something so overwhelming as the AIDS pandemic - get the budgetary short shrift, especially in the midst of an economic downturn. What’s a concerned citizen to do, except continue to put pressure on elected officials and keep calling attention to the issue?

There’s plenty you can do and it doesn’t have to be launching a major national or international campaign. Not that national and international campaigns aren’t important, but impact can be measured outside of funding dollars and congressional legislation.

It can happen in your home.

First came the announcement: Pope Benedict XVI says condom use might be justified in some situations (like for male prostitutes). Then there was much rejoicing, especially in the public health communities.

But then came the confusion. Among members of the Catholic clergy, you have leaders like Botswana’s Bishop Valentine Seane, who told the AP he was amenable to the idea of condom use. At the same time, though, you also have clergy like Tanzania’s Auxiliary Bishop Methodius Kilaini, who announced that he will continue to advise his flock not to use condoms.

So, where does that leave us? The Pope may have floated the condom trial balloon, but he has not offered a clear path forward for his followers.

The calender for a committed global health activist can be quite full. There’s World Malaria Day in April, World AIDS Day in December, World Tuberculosis Day in March. The Department of Health and Human Services tallies at least 14 more international public health awareness days.

That might provide some solace if, like me, you missed World Pneumonia Day on Nov. 12.

The scourge of pneumonia needs all the attention it can get. Pneumonia is responsible for killing more children each year than any other disease. In 15 of the most severely affected countries - all in Asia and Africa - more than 1.16 million children died from pneumonia or related causes in 2008, according to the World Health Organization (WHO).

But unlike diseases that get more media and celebrity attention, there were no large-scale efforts to set prevention standards based on proven interventions until relatively recently. This is especially confounding given that relatively straightforward steps could reduce pneumonia mortality by more than half, among them: encouraging breastfeeding, consistent tracking and case management of patients and, most critically, the consistent use of relevant vaccines.

Fairly early into the first day of the Clinton Global Initiative, New York Times columnist Nick Kristof issued a tweet that this year’s conference seemed “focused on investing in girls as a cost-effective strategy to fight poverty.” He was only part of the way there.

If there was a theme to the day, it was that improvement in any field -- education, global health, poverty -- depended on recognizing and removing detriments to the health, safety and success of girls and women.

A quick rundown of some of the highlights:

A modestly successful human trial in Thailand and the announcement of new antibodies that kill more than 90 percent of all strains of the AIDS virus brought new momentum to the search for an HIV vaccine. Now an international consortium of HIV researchers and activists has issued guidelines for how the AIDS community can best leverage that momentum and it’s worth taking a look.

The Global HIV Vaccine Enterprise — a seven-year-old alliance of AIDS organizations — issued its Scientific Strategic Plan for HIV vaccine development last week. The headliner was a call for more and speedier human clinical trials of potential vaccines, like the 2009 effort in Thailand.

As the authors explain, human trials offer a chance to gauge the immune system’s response to vaccines as part of the development process, rather than saving it as a last step.

Or, as the vaccine enterprise’s executive director, Alan Bernstein, told Voice of America, human trials aren’t the “culmination of a series of basic science experiments,” but an “integral part of the discovery process.”

When United Nations Secretary General Ban Ki-moon called the Millennium Development Goals (MDGs) “ambitious but feasible,” I wonder if he had recently looked at MDG 6.

It had been a while since I dove into the specifics of that goal, which deals with fighting the spread of HIV/AIDS, malaria, and other diseases. I was familiar enough with the overall purpose, but it wasn’t until I started looking at the fine print in drafting this evaluation that I remembered just how “ambitious” this goal is.

Consider: By 2015 we are supposed to have halted and begun to reverse the spread of HIV/AIDS. At the same time, we also need to have halted and begun to reverse the incidence of malaria and other major diseases, including tuberculosis.

But more pressingly, by the end of this year, everyone who needs access to treatment for HIV/AIDS is supposed to have it.

So where do we stand? Starting from the top:

President Obama is coming in for a very public flogging over a perceived lack of action on the global AIDS pandemic. Is it deserved?

In Washington, D.C., bus stop posters earlier this summer compared Obama to former president Bush and asked, “Who’s better on AIDS?” (Hint: You’re supposed to conclude it’s Bush, who launched the President’s Emergency Plan for AIDS Relief -PEPFAR.) Now a new campaign is up, illustrating the disparity between the money being spent to fight the war in Afghanistan and the dollars flowing to AIDS prevention and treatment worldwide. It’s a stark comparison.

The criticism reached a climax at the International AIDS Conference in Vienna, where one observer described the mood toward the Obama administration as “rage.”

Rage, led by organizations like the Global AIDS Alliance, over what they see as broken promises from a candidate who was supposed to be a champion for the cause. Before he was elected, Obama co-sponsored PEPFAR’s reauthorization. And on the campaign trail he committed to spend more than $50 billion by 2013 on the fight against AIDS.

Instead, his administration has basically flat-funded U.S. financing of international AIDS programming. Exact numbers are still being debated, but U.S. funding for AIDS relief was, at best, only slightly up in 2009 compared to 2008. And, as The Washington Post reports, the administration’s funding request for the next fiscal year is only about two percent higher than this year.