- Email: [email protected]
The Global Fund: growing pains
Reflection and Reaction
Genetics and Developmental Biology, University of Connecticut Health Center, Farmington, CT, USA (JDR) [email protected]
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We declare that we have no conflicts of interest. 1
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Zeidner NS, Brandt KS, Dadey E, Dolan MC, Happ C, Piesman J. Sustainedrelease formulation of doxycycline hyclate for prophylaxis of tick bite infection in a murine model of Lyme borreliosis. Antimicrob Agents Chemother 2004; 48: 2697–99. Moody KD, Adams RL, Barthold SW. Effectiveness of antimicrobial treatment against Borrelia burgdorferi infection in mice. Antimicrob Agents Chemother 1994; 38: 1567–72. Hollander DH, Turner TB, Nell EE. The effect of long continued subcurative doses of penicillin during the incubation period of experimental syphilis. Bull Johns Hopkins Hosp 1952; 90: 105–20. Eagle H, Fleischman R, Musselman AD. Effect of schedule of administration on the therapeutic efficacy of penicillin. Importance of aggregate time penicillin remains at effectively bactericidal levels. Am J Med 1950; 9: 280–99. Nadelman RB, Nowakowski J, Fish D, et al. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med 2001; 345: 79–84. Costello CM, Steere AC, Pinkerton RE, Feder HM. A prospective study of tick bites in an endemic area for Lyme disease. J Infect Dis 1989; 159: 136–39. Shapiro ED, Gerber MA, Holabird ND, et al. A controlled trial of antimicrobial prophylaxis for Lyme disease after deer-tick bites. N Engl J Med 1992; 327: 1769–73.
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Agre F, Schwartz R. The value of early treatment of deer tick bite for the prevention of Lyme disease. Am J Dis Child 1993; 147: 945–47. Korenberg EI, Vorobyeva NN, Moskvitina HG, Gorban L Ya. Prevention of borreliosis in persons bitten by infected ticks. Infection 1996; 24: 187–89. Schroeter AL, Turner RH, Lucas JB, Brown WJ. Therapy for incubating syphilis: effectiveness of gonorrhea treatment. JAMA 1971; 218: 711–13. Takafuji ET, Kirkpatrick JW, Miller RN, et al. An efficacy trial of doxycycline prophylaxis against leptospirosis. N Engl J Med 1984; 310: 497–500. Hasin T, Davidovitch N, Cohen R, et al. Postexposure treatment with doxycycline for the prevention of tick-borne relapsing fever. N Engl J Med 2006; 355: 148–55. Magnuson HJ, Eagle H. The retardation and suppression of experimental early syphilis by small doses of penicillin comparable to those used in the treatment of gonorrhea. Am J Syph Gonorrhea Vener Dis 1945; 29: 587–96. Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2006; 43: 1089–1134. Zoschke DC, Skemp AA, Defosse DL. Lymphoproliferative responses to Borrelia burgdorferi in Lyme disease. Ann Intern Med 1991; 114: 285–89. Aguero-Rosenfeld M, Wang G, Schwartz I, Wormser GP. Diagnosis of Lyme borreliosis. Clin Microbiol Rev 2005; 18: 484–509. Molloy PJ, Persing DH, Berardi VP. False-positive results of PCR testing for Lyme disease. Clin Infect Dis 2001; 33: 412–13.
The Global Fund: growing pains that pledges will move towards the higher needs estimate of $18 billion, if strong demand for Global Fund financing by developing countries is shown over the coming years. It is also notable that the Global Fund’s seventh round of financing, which was approved by the Board at its meeting in November, 2007, is the largest yet, with grants commitments of $1·1 billion. This round is fully financed.
CC Studio/Science Photo Library
In a Leading Edge editorial,1 you stated that in the latest replenishment round of the Global Fund to Fight AIDS, Tuberculosis and Malaria, “many governments pledged substantially less than they had previously committed to”. This is not correct. The large majority of donors substantially increased their contributions, while a few donors provided smaller increases. Canada, Japan, and the USA were three large donors who did not announce substantial increases at the meeting, but these countries clearly indicated that this was because of internal budgetary cycles, and announcements of new pledges to the Global Fund would come at a later date. Given this situation, the Global Fund is confident it will reach at least the lower end of its funding needs range for 2008–10 of US$12 billion. We are hopeful
Jon Lidén The Global Fund to Fight AIDS, Tuberculosis and Malaria, 1214 Vernier, Geneva, Switzerland [email protected] I declare that I have no conflicts of interest. 1
The Lancet Infectious Diseases. The Global Fund: growing pains. Lancet Infect Dis 2007; 7: 695.
HIV exclusion does not mitigate risk The Lancet Infectious Diseases has provided a great service by recognising the crucial role that the private sector has to play in combating the global HIV/ AIDS epidemic.1 Recent years have seen increasing momentum in the global business community’s mobilisation against the virus. However, as death tolls http://infection.thelancet.com Vol 8 March 2008
and infection rates continue to increase around the world, opportunities abound for further and deeper business engagement. However, one statement from the editorial1 caught my attention as potentially misleading. Although condemning the policy of pre-employment HIV testing, 147
Genetics and Developmental Biology, University of Connecticut Health Center, Farmington, CT, USA (JDR) [email protected]
8 9
We declare that we have no conflicts of interest. 1
2
3
4
5
6 7
Zeidner NS, Brandt KS, Dadey E, Dolan MC, Happ C, Piesman J. Sustainedrelease formulation of doxycycline hyclate for prophylaxis of tick bite infection in a murine model of Lyme borreliosis. Antimicrob Agents Chemother 2004; 48: 2697–99. Moody KD, Adams RL, Barthold SW. Effectiveness of antimicrobial treatment against Borrelia burgdorferi infection in mice. Antimicrob Agents Chemother 1994; 38: 1567–72. Hollander DH, Turner TB, Nell EE. The effect of long continued subcurative doses of penicillin during the incubation period of experimental syphilis. Bull Johns Hopkins Hosp 1952; 90: 105–20. Eagle H, Fleischman R, Musselman AD. Effect of schedule of administration on the therapeutic efficacy of penicillin. Importance of aggregate time penicillin remains at effectively bactericidal levels. Am J Med 1950; 9: 280–99. Nadelman RB, Nowakowski J, Fish D, et al. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med 2001; 345: 79–84. Costello CM, Steere AC, Pinkerton RE, Feder HM. A prospective study of tick bites in an endemic area for Lyme disease. J Infect Dis 1989; 159: 136–39. Shapiro ED, Gerber MA, Holabird ND, et al. A controlled trial of antimicrobial prophylaxis for Lyme disease after deer-tick bites. N Engl J Med 1992; 327: 1769–73.
10 11 12
13
14
15 16 17
Agre F, Schwartz R. The value of early treatment of deer tick bite for the prevention of Lyme disease. Am J Dis Child 1993; 147: 945–47. Korenberg EI, Vorobyeva NN, Moskvitina HG, Gorban L Ya. Prevention of borreliosis in persons bitten by infected ticks. Infection 1996; 24: 187–89. Schroeter AL, Turner RH, Lucas JB, Brown WJ. Therapy for incubating syphilis: effectiveness of gonorrhea treatment. JAMA 1971; 218: 711–13. Takafuji ET, Kirkpatrick JW, Miller RN, et al. An efficacy trial of doxycycline prophylaxis against leptospirosis. N Engl J Med 1984; 310: 497–500. Hasin T, Davidovitch N, Cohen R, et al. Postexposure treatment with doxycycline for the prevention of tick-borne relapsing fever. N Engl J Med 2006; 355: 148–55. Magnuson HJ, Eagle H. The retardation and suppression of experimental early syphilis by small doses of penicillin comparable to those used in the treatment of gonorrhea. Am J Syph Gonorrhea Vener Dis 1945; 29: 587–96. Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2006; 43: 1089–1134. Zoschke DC, Skemp AA, Defosse DL. Lymphoproliferative responses to Borrelia burgdorferi in Lyme disease. Ann Intern Med 1991; 114: 285–89. Aguero-Rosenfeld M, Wang G, Schwartz I, Wormser GP. Diagnosis of Lyme borreliosis. Clin Microbiol Rev 2005; 18: 484–509. Molloy PJ, Persing DH, Berardi VP. False-positive results of PCR testing for Lyme disease. Clin Infect Dis 2001; 33: 412–13.
The Global Fund: growing pains that pledges will move towards the higher needs estimate of $18 billion, if strong demand for Global Fund financing by developing countries is shown over the coming years. It is also notable that the Global Fund’s seventh round of financing, which was approved by the Board at its meeting in November, 2007, is the largest yet, with grants commitments of $1·1 billion. This round is fully financed.
CC Studio/Science Photo Library
In a Leading Edge editorial,1 you stated that in the latest replenishment round of the Global Fund to Fight AIDS, Tuberculosis and Malaria, “many governments pledged substantially less than they had previously committed to”. This is not correct. The large majority of donors substantially increased their contributions, while a few donors provided smaller increases. Canada, Japan, and the USA were three large donors who did not announce substantial increases at the meeting, but these countries clearly indicated that this was because of internal budgetary cycles, and announcements of new pledges to the Global Fund would come at a later date. Given this situation, the Global Fund is confident it will reach at least the lower end of its funding needs range for 2008–10 of US$12 billion. We are hopeful
Jon Lidén The Global Fund to Fight AIDS, Tuberculosis and Malaria, 1214 Vernier, Geneva, Switzerland [email protected] I declare that I have no conflicts of interest. 1
The Lancet Infectious Diseases. The Global Fund: growing pains. Lancet Infect Dis 2007; 7: 695.
HIV exclusion does not mitigate risk The Lancet Infectious Diseases has provided a great service by recognising the crucial role that the private sector has to play in combating the global HIV/ AIDS epidemic.1 Recent years have seen increasing momentum in the global business community’s mobilisation against the virus. However, as death tolls http://infection.thelancet.com Vol 8 March 2008
and infection rates continue to increase around the world, opportunities abound for further and deeper business engagement. However, one statement from the editorial1 caught my attention as potentially misleading. Although condemning the policy of pre-employment HIV testing, 147