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Lee Moran
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Lee commented on the article |You forgot a biggie!
DOTS - Directly Observed Therapy, Short-course. The gold standard in treating TB
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Lee commented on the article |Thanks for the post on this, Alanna! I think that my issue with investing in HSS is that a lot of it is simple infrastructure building - strengthening medical schools, building hospitals and clinics, building better roads - that are more of an economic deveopment issue than a health one. If a country has a thriving economy with sufficient tax revenue then it can build up this infrastructure.
I think int'l donors tend to shy away from HSS because they see it as an issue of development less than health, and as something that a country's government should be supplying. That doesn't mean that it isn't important or shouldn't get a portion of aid money, but that may explain the reluctance of donor countries to invest in HSS.
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Lee commented on the article |Fair enough on the GF for health systems.
But I still feel like your efficient vs. impactful dichotomy doesn't make sense. If an intervention delivers "impact for a relatively small cost" then how is it not having an "overall impact"?
Maybe I'm getting hung up on semantics, but it seems that there are some GH issues that cause a large share of the health burden in specific countries. So if you had a vertical program with interventions for that specific problem, then the overal health impact would still be substantial. It may not address every health issue, but it would still have a big impact.
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Lee commented on the article |
Alanna, I have to agree with Robert on this and say that you are contradicting yourself.
In your comment you say that a fund for maternal health focused on health systems would be wasted effort and "lose a percentage off the top to the fund administration." ...but then in the VERY next sentence say that a fund for health systems is interesting. You can't have it both ways. Either "global funds" are effective and efficient ways of raising and administering donor funds, or they aren't.
I also don't see how a maternal health fund with a narrow approach could be both "efficient" and "lack overall impact." If it doesn't have a large impact, then it isn't very efficient at solving maternal health issues.
To be honest, (I'm sure you'll disagree with me here) I don't think anyone has really been able to define concretely what a health system is and how to strengthen it. In fact, I would welcome a post on the topic. In my mind, a "health sytem" is an amorphous idea - the sum of anything effecting health in a country. And an amorphous idea can hardly be strengthened.
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Lee commented on the article |
Alanna, can you please clarify who this interview is with and where they work? Apologies if I missed it somewhere.
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Lee commented on the article |Connor says: "Show me the study and I will show you the flaws."
Ok, so you admit that you've never even read the studies in the first place!!! How can you pass judgement without even reading the evidence? -
Lee commented on the article |
Actually, the U.S. does not have a very high rate of HIV infection. Washington D.C. has a high infection rate - the CDC released a report about it earlier this year - but compared to Sub-Saharan Africa, the U.S. has extremely low incidence. This is from the CDC website:
"Incidence is the number of new HIV infections that occur during a given year. In 2008, CDC estimated that approximately 56,300 people were newly infected with HIV. in 20061 (the most recent year that data are available). Over half (53%) of these new infections occurred in gay and bisexual men. Black/African American men and women were also strongly affected and were estimated to have an incidence rate than was 7 times as high as the incidence rate among whites."
The African American community traditionally has much lower rates of circumcision. I am NOT saying that the high rate of new infections among the black population is due to low circumcision rates. I am only pointing out that if you want to talk about the U.S., the data does not support your assertions. Ditto with the gay community, since the studies only applied to heterosexual men. -
Lee commented on the article |
What exactly do you think was done incorrectly in the studies? What were these "huge" flaws. I have read the published results of the studies and cannot see what you think was mishandled. They were well planned and executed studies. Many commenters on this post make accusations that the studies were tainted somehow, yet no one has said how. And please, tell me in your own words - don't just post a link to someone else's.
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Lee commented on the article |
Putting aside the issue of infant circumcision for a moment (so please do not reply to this comment about it!), I still do not see any good reason why you should oppose voluntary adult male circumcision.
If a consenting adult man decides that he wants to be circumcised to help cut his risk of contracting HIV, there is no reason he should be forbidden from doing so. If you feel that circumcision is "mutilation" and should be outlawed, then what about piercings? When you pierce yourself, you are cutting holes in your body and sticking foreign objects (earrings) inside those holes. Would you also argue that it should be illegal to get piercings?
It has been scientifically proven that male circumcision reduces the risk of contracting HIV among heterosexual men (note that the study did not look at homosexual populations). Before arguing that the studies were bull, I suggest you take a look at Alanna's second post on MC (http://globalhealth.change.org/blog/view/circumcision_part_ii).
Circumcision alone will not end the epidemic, but it is one more tool to help slow the rate of new infections. Yes, comdons are FAR more effective, but the fact is, that even when men know that they should use a condom, they often won't. In parts of South Africa, there is a stigma that if you're using a condom, it means you already have HIV, so many men refuse to wear them even though they know it could save their life. education is important, but it alone will not end the epidemic either. Neither will teaching abstinence and faithfulness. If one partner in a relationship is faithful, that doesn't mean the other will be.
The only way to end the HIV epidemic is to use a combination approach to prevention - utilize all the available tools in our toolbox. Yes, this means making safe, affordable circumcision services available to men. I am not advocating for forced mass circumcision. Nor am I advocationg for infant circumcision. I am advocating for providing the option to adult men at affordable prices so that they can make the decision for theselves. It's important that these services be offered in sterile, safe facilities, with trained physicians, and that patients receive all the necessary warnings to ensure that they wait until fully healed before having sex. But if those criteria are met, circumcision has the potential to help drastically cut HIV infection rates. -
Lee commented on the article |
If you don't "buy into" the scientifically executed studies with strong scientific designs, control groups, and replicable results, then there is no point in anyone ever trying to reason with you.
The scientific method is ths the only sure way to prove a theory, and all ideas and beliefs are just that - theories - until they can be proven. If you don't allow yourself the opportunity to be proven right or wrong, then you are not actually willing to have a discussion. You're only willing to lecture.
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