What the HIV Experience Can Teach the NCD Community

by Bob Meyers 0 comments

ROME – The AIDS Conference held here may have opened a window onto the next big story in public health issues – the benefit for the non-communicable disease community in building on the infrastructure that the HIV/AIDS community has spent 30 years putting into place.

The show-stoppers at the conference were the three trials that show that drugs like tenofovir and others, when used in certain combinations, can prevent the transmission of the AIDS virus (see a blog post I did after the conference that has many links to critical information).

But there was a great deal of buzz before and during the Rome conference on the anticipated attention about to be paid diseases other than AIDS.

“Chronic non-communicable diseases (NCDs), including diabetes, cardiovascular disease, cancers and chronic respiratory illnesses are now the world’s leading causes of mortality, with a significant and rapidly growing impact in low- and middle-income countries,”  states an article in the journal, Global Public Health (abstract is free; fee required to download the full piece).

 “… many LMIC [low- and middle-income countries] have already  established examples of effective chronic disease programmes as they have scaled up HIV/AIDS services over the past decade … Can the response to HIV, a chronic communicable  disease, be leveraged to expand access to high-quality services for other chronic non-communicable conditions?”

Just so you don’t miss the point, the article, by Miriam Rabkin and Wafaa M. El-Sadr of Columbia University, is titled, “Why Reinvent the Wheel? Leveraging the lessons of HIV scale-up to confront non-communicable diseases.” (Dr. El-Sadr spoke at an NPF AIDS conference several years ago, and Dr. Rabkin told me in Rome she focused on science communication as she was completing her medical degree.)

A kind of “natural history” of responses to the AIDS epidemic in sub-Saharan Africa is described in the July 2011 supplement of the Journal of the International AIDS Society and sets the focus on NCDs. One of the article’s points is that the health systems in that region were “historically geared towards the management of acute illnesses, and are not oriented to the management of chronic diseases,” in particular HIV/AIDS.

One of the very positive outcomes of successful ART therapy both in maintaining health and also (now) in preventing infection is that there will be more people living longer with HIV/AIDS. That will require the continuation and further development of health care systems, not only for HIV/AIDS but for non-communicable diseases as well.

In less than two months the United Nations will hold a special high level meeting on the subject of non-communicable diseases. The last time the UN put health care in such a prominent position was in 2001—and the subject was HIV/AIDS.

Organizations representing four of the most impactful non-communicable diseases have formed the NCD Alliance to bring attention, and funding, to these issues. The member groups, and their websites, are:

• The International Union Against Tuberculosis and Lung Disease
• The International Diabetes Federation
• The World Heart Federation
• The Union for International Cancer Control

Let’s face it: in a time of global economic weakness, but growing awareness of illness and disease, the ability to use an established blueprint to support a new approach to traditional diseases may be a pretty good idea.

If you want to see linkages between various kinds of diseases, check out this article from the open access journal, Globalization and Health. It looks at co-morbidities in Sub-Saharan Africa between TB and diabetes; HIV and metabolic syndrome, and the impact of globalization (a story in itself).

It is these further linkages between diseases that experts seem to be saying will become an important new part of the health care picture – and therefore fertile ground for journalists to explore.

NPF will do its part. In October we will collaborate with the International Union Against Tuberculosis and Lung Disease in our third consecutive training program for journalists. The deadline for applications is August 8 at 5 pm. If you want to apply, go to www.nationalpress.org and follow the instructions.

Finally, all drugs have side effects, regardless of their success in treating disease. Here is a link to Clinical Care Options, an online site that provides information about drugs and their side effects for medical professionals. Journalists can benefit from its information, too.

Posts in this series:

• Story Ideas for Journalists from the Rome 2011 IAS Conference
• What the HIV Experience Can Teach the NCD Community
• Lowering the Cost of AIDS Drugs While Searching for a Cure
• Three Exciting AIDS Trials