Biden’s PEPFAR mixed messages

From: POLITICO Future Pulse - Thursday Mar 16,2023 06:02 pm
Presented by Guardant Health: The ideas and innovators shaping health care
Mar 16, 2023 View in browser
 
Future Pulse

By Carmen Paun, Ben Leonard, Erin Schumaker and Ruth Reader

Presented by Guardant Health

WASHINGTON WATCH

A patient, back left, is wheeled for treatment at the AIDS Care Training and Support Initiative (ACTS) at White River Junction, South Africa, Monday Dec 15, 2008. The center, partly funded by the President's Emergency Plan for AIDS Relief (PEPFAR) supports the development of a community-based palliative care unit which provides care, education and training for staff and community caregivers, volunteer counseling and testing facilities. (AP Photo/Denis Farrell)

President Biden's administration is touting PEPFAR's successes, while also calling for a budget cut. | AP

As the President’s Emergency Plan for AIDS Relief celebrates its 20th anniversary this year, the Centers for Disease Control and Prevention is touting PEPFAR’s accomplishments.

But President Joe Biden’s budget proposal throws some shade on the parade.

Biden wants to reduce PEPFAR funding in fiscal 2024 by $25 million compared with the amount enacted for this fiscal year, prompting one advocate, Chip Lyons, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, to charge that Biden was willing to “put the hard-won gains in the global HIV response at risk.”

Specifically, Lyons said the funding would make it impossible to reach the United Nations goal of ending the public health threat posed by HIV and AIDS by 2030.

The Biden budget proposal, though unlikely to be adopted by Congress, comes as lawmakers work on reauthorizing the program.

The public health gains from PEPFAR are impressive, according to the CDC:

— Approximately 20 million persons with HIV in 54 countries have received antiretroviral drugs, a 300-fold increase.

— PEPFAR has saved an estimated 25 million lives.

— Between 2015 and 2022, the percentage of people with HIV, the virus that causes AIDS, who achieved viral load suppression where the virus is undetectable, increased from 80 to 95 percent.

Next steps: HIV remains a health threat, and PEPFAR needs to focus on groups that haven’t achieved similar high rates of viral load suppression, the CDC said.

Those groups include people who are pregnant or breastfeeding, inmates and people younger than 20, according to the report.

“Stigma and discrimination remain important barriers to health equity,” the CDC said.

More than 30 million people worldwide still live with HIV, and about 10 million of them hadn’t received antiretroviral therapy in 2021, according to the CDC.

 

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LAGOS, PORTUGAL - MAY 22: Kate McCann holds a cuddly toy of her missing daughter Madeleine while dropping off her children at the local nursery on May 22, 2007 in Praia da Luz, Portugal. Kate's 4-year-old daughter Madeleine was abducted May 3 from the resort apartment where she was on vacation. (Photo by Denis Doyle/Getty Images)

Kids are experiencing high levels of anxiety and depression. | Getty Images

Kids’ mental health is the most pressing patient-safety concern for 2023, warns nonprofit ECRI in its annual report.

The safety-focused group pointed to an HHS study finding that anxiety and depression among kids ages 3 to 17 jumped close to 30 percent between 2016 and 2020.

Marcus Schabacker, ECRI’s president, told Ben that the rise of social media, a dearth of pediatric behavioral health providers and gun violence have all exacerbated the problem.

And then the pandemic hit, making things even worse.

These four issues followed kids’ mental health in ECRI’s list of safety concerns:

— Violence against health care workers

— Clinician needs post-Roe v. Wade

— Providers working outside their scope of practice

— Failure to detect and treat sepsis in a timely way

Workforce shortages are a crosscurrent in the top patient-safety concerns, Schabacker said.

“There’s no silver bullet to fix it,” he said. “It needs a will to solve it, and we don't see that.”

 

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TECH MAZE

QTrobot and Misty II

QTrobot and Misty II | University of Cambridge

Turns out looks do matter, at least for robot wellness coaches.

Findings from a small University of Cambridge study presented at a human-robot interaction conference suggest that employees had a higher opinion of a toylike robot coach than they did of a robot with human features.

With workers facing increasing stress and mental illness, amid a shortage of mental health practitioners, the findings could provide guidance on how to provide cost-effective care.

How the study worked: Twenty-six people between ages 18 and 55 were assigned to one of two robot wellness coaches for four weekly sessions.

Meet the bots: 

QTrobot: 90 centimeters tall. QT’s face is a white screen with green eyes and a black-line mouth, embedded in a robot head. QT has a human-looking upper and lower body with shoulders, elbows, hands and legs.

Misty II: 36 centimeters tall. Misty’s face is a black screen with green eyes and a white-line mouth embedded in a robot head. Misty has an upper chest but no elbow or hands. Misty’s lower half is a navigation base.

“The robots were programmed to have the same personality, the same facial expressions and the same voice, so the only difference between them was the physical robot form,” Minja Axelsson, co-author of the study, which hasn’t yet undergone peer review, said in a statement.

The results: Participants rated Misty, the toylike robot, more favorably than QT, the humanoid.

They criticized QT’s coaching style, noting that the robot was “not showing any care” and “didn’t add any value.” By contrast, participants said Misty made them feel “a lot more engaged” and had “a calming presence.”

The takeaway: “It could be that since the Misty robot is more toy-like, it matched their expectations,” Micol Spitale, lead study author, said in a statement. "Since QT is more humanoid, they expected it to behave like a human, which may be why participants who worked with QT were slightly underwhelmed.”

 

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