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States Consider Scaling Back Funding For Medicare Drug Benefit Amid Economic Crisis
At least six states have considered eliminating or reducing financial assistance for those enrolled in the Medicare prescription drug benefit program who are affected by the "doughnut hole," or gap in coverage, the AP/Boston Herald reports. According to the AP/Herald, the governors of Rhode Island and Vermont and lawmakers in South Carolina have proposed plans to eliminate such financial assistance programs, while Massachusetts has reduced funding for its program. Meanwhile, proposals in New York and Connecticut to limit financial help have been dismissed.Beneficiaries enrolled in the drug benefit have coverage until total spending reaches $2,700 and then must pay out-of-pocket for their medications until the total spending reaches $4,350, after coverage. At least 16 states provide financial help to beneficiaries who have reached the coverage gap (AP/Boston Herald, 5/27).

Study Suggests TB Screening Needs To Be Targeted For Maximum Public Health Benefit
New estimates of the likelihood that a latent case of tuberculosis (TB) will become active have resulted in a roughly 50 percent increase over previous estimates of the number of people needed to be screened (NNS) to prevent an active infection, limiting the cost effectiveness of screening in many Center for Disease Control and Prevention (CDC)-defined risk groups, according to an analysis conducted by experts in the epidemiology of the disease.
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When Children Have Breathing Problems
Increasing numbers of children around the world are suffering from respiratory problems - coughing, wheezing and asthma attacks. Although the key external causes of these diseases were identified a long time ago (traffic and industrial air pollution), it had not previously been possible to distinguish clearly between these two factors so as to have a targeted impact on them. Researchers at the Helmholtz Centre for Environmental Research (UFZ) and the University of Leipzig carried out research in this area together with colleagues from the University of La Plata and can now confirm that air pollution caused by industry has even more grave effects than vehicle exhaust fumes.
Mental Health

Piecing Together The HIV Prevention Puzzle

"It"s an exciting time in HIV prevention research. We will see results from a number of critically important HIV prevention research trials this year, as well as see the start of new trials around the world that will yield important answers in the years to come," said Mitchell Warren, AVAC executive director, at the release of AVAC"s 13th annual report of the field. "But scientific, community and political leaders must act now to plan for continued research and implementation of effective strategies, or this excitement will be wasted," Warren added. The report - Piecing Together the HIV Prevention Puzzle - looks at AIDS vaccine research, where there is an energized focus on discovery, innovation and basic science and looks at the broader HIV prevention field, particularly the implications of pre-exposure prophylaxis (PrEP) and other strategies in efficacy trials today. This analysis of the HIV prevention field comes in a year that has already brought disappointment as well as intriguing results from various prevention studies. At the same time, even trials that failed to show overall benefit, such as the Step Study of the Merck HIV vaccine candidate, have continued to generate new, valuable information and questions that would not otherwise exist. These trials have succeeded as a result of increasingly robust partnerships between researchers and communities grappling with HIV, including gay men around the world and heterosexual women in Africa. These partnerships, along with the persistently high rates of new infections, are a continual reminder of the global commitment to and need for continuing the search for new prevention for as long as it takes. "We hope to have new prevention intervention pieces to add to the puzzle in the next few years," said Warren. "But as the slow implementation of male circumcision to reduce heterosexual men"s risk of HIV infection reminds us, we need extensive planning and guidance to ensure research results are translated into real impact against the epidemic. We can"t afford to wait for efficacy results before we begin to plan. We must anticipate and tackle the major hurdles for implementation now." The Report identifies major issues for implementation of new prevention options, including: -- Ongoing global failures to scale up access to HIV testing and counseling services. -- Persistent inattention to the needs of gay men and other men who have sex with men around the world. -- Gaps in health care infrastructure that will complicate introduction of any new strategy. In the Report, AVAC also underscores the importance of WHO and UNAIDS getting involved in planning for the results from PrEP trials before data are available. "WHO and UNAIDS, along with other stakeholders, need to combine their strengths now to provide leadership and coordination so that the world is ready to work with results from the many ongoing PrEP trials," said Warren. Positive results from current vaccine, PrEP and microbicide trials will also present challenges and opportunities for other ongoing and planned HIV prevention trials. "There has been concern that positive results from PrEP trials would require vaccine or microbicide trials to become larger, longer and more expensive, as PrEP could become a standard of prevention in these trials," said Warren. "But we believe that success in one trial will open up possibilities and options for research that could combine AIDS vaccines and other interventions as they emerge." To help guide efforts in new areas of research and sustain ongoing research, AVAC calls for researchers and trial sponsors to begin planning on how combination strategies can be evaluated. As the field looks to fit the puzzle pieces together, the AVAC Report also identifies a number of big questions in AIDS vaccine research for 2009 and beyond, focusing on issues such as cell-mediated viral control, HIV genetic diversity, the role of animal models, immune activation, antibodies and adjuvants. In its analysis of the vaccine field, AVAC also assesses the progress and future potential of the Global HIV Vaccine Enterprise and considers the impact of results from the Thai prime-boost vaccine trial that are expected in September. With over 16,400 participants, this is the largest AIDS vaccine trial ever undertaken. "In AIDS vaccine and HIV prevention research today, we see a fertile mix of big science and individual efforts, of product-oriented work and of slow and steady basic science," Warren added. "What we need now is a quick, strategic, scientific analysis of all the efforts underway, with a goal of identifying gaps and opportunities for synergy both within the AIDS vaccine field and across the vaccine, PrEP, and microbicide fields. AVAC is excited to help move the HIV prevention field toward a collaborative agenda and to prepare now for implementing potential new prevention options." About AVAC Founded in 1995, the international non-profit AIDS Vaccine Advocacy Coalition (AVAC) seeks to create a favorable policy and social environment for accelerated ethical research and eventual global delivery of AIDS vaccines and other HIV prevention options as part of a comprehensive response to the pandemic. AIDS Vaccine Advocacy Coalition


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