According to a new report released by the Joint United Nations Programme on HIV/AIDS (UNAIDS), a record 8 million people are now receiving antiretroviral therapy, thanks to increased domestic investment by low- and middle-income countries. The report, Together we will end AIDS, found that in 2011 there were 34.2 million people worldwide living with HIV, and AIDS-related deaths had fallen to 1.7 million—significantly down from a peak of 2.3 million in 2005.

A primary reason for the drop in deaths is the increase in access to treatment, which has prolonged the lives of HIV-positive individuals and reduced rates of infection. In 2011, 8 million people—1.4 million more than in 2010—were receiving antiretroviral drugs. Latin America and the Caribbean have the highest rates of coverage, with 70 percent and 60 percent coverage, respectively. The total number of people living with HIV in Latin America and the Caribbean in 2011 was about 1.6 million, with the burden of disease disproportionately borne by the poor, the Indigenous and, in the Caribbean, women.

The increase in access to treatment has largely been a result of increased domestic public investments in the response to HIV/AIDS. In 2011, low- and middle-income countries invested $8.6 billion in HIV/AIDS—up 15 percent from 2010, and surpassing the amount of global investment, which has remained essentially flat at $8.2 billion since 2008. “Countries most affected by the epidemic are taking ownership and demonstrating leadership in responding to HIV,” said Michael Sidibé, executive director of UNAIDS. BRICS countries in particular have dramatically increased domestic spending; they now fund, on average, over 75 percent of their domestic AIDS responses.

The new UN report was launched ahead of the 19th International AIDS Conference in Washington DC next week—the first to take place in the U.S. since a 22-year travel ban on people living with HIV was lifted. As part of the conference, Latin American and Caribbean leaders have organized a series of events with prominent researchers, community leaders and experts to collaborate in confronting the epidemic in the region and within diaspora communities.

Soon after passage of the United States’ health care reform act, I wrote a charticle for Americas Quarterly describing the implementation of the law. Today the Supreme Court upheld the insurance reforms of the  Affordable Care Act in their entirety.  This means that the U.S. now in fact joins some of the other countries in the Americas (including Canada, Chile, Colombia, Costa Rica, and Mexico) that have sought to broaden access to health care for all—and is yet again proving how we are a leader in some of the most pressing issues confronting society in the twenty-first century.

From the beginning, it was clear that this was a political case.  It was brought by Republican attorneys general and governors as a challenge to the signature achievement of a Democratic Congress.  From the beginning, most legal scholars gave the lawsuit little chance of success.  The majority of federal appellate courts, including distinguished conservative judges, rejected the challenges.  The Supreme Court has—to its great credit—demonstrated that it remains committed to the rule of law.  It is troubling that the Court used this occasion to limit the ability of the federal government to condition participation in the Medicaid program on compliance with program requirements. 

The ramifications of this decision for many cooperative federal-state programs are far reaching and will be litigated for years, but may turn out to be quite limited.  But in the end, this is a great day for millions of Americans who will gain access to health care because of this decision.  It is time for the states and the federal government to move forward expeditiously with implementing the ACA.   Thousands of lives literally depend on it.

Timothy Jost holds the Robert L. Willett Family Professorship at the Washington and Lee University School of Law and writes about health policy and law.

“Soy Hugo López, uno de los pocos que sobreviví a los psicofármacos”, dice micrófono en mano un hombre grueso y de mirada bonachona, locutor habitual de la Radio la Colifata. “También conduzco aquí mi espacio llamado la Fogonera en donde hablo de todas las delicias gastronómicas que no podemos comer en este hospital”, agrega, con su habitual sentido del humor. Uno a uno pacientes internados, ambulatorios y externados del Hospital Mental José Tiburcio Borda se presentan en la ronda de introducción del programa. También lo hacen algunos invitados y curiosos que quieren ser partícipes de esta singular experiencia, única en Latinoamérica, en la que un medio de comunicación transmite desde un neuropsiquiátrico.

Todos los sábados desde una casita de colores en los predios del Borda, una institución que actualmente tiene alrededor de 900 camas psiquiátricas para pacientes de escasos recursos, este programa de cinco horas resulta irreverente y ejemplar. Desde hace casi 20 años decidieron que era una forma de comunicarse con el exterior sin que mediaran autoridades ni diagnósticos. No es, sin embargo la única experiencia al interior de este hospital de salud mental.

Just recently, I came across an article in the Harvard Business Review written by renowned professors Michael E. Porter and Mark R. Kramer.  The authors lament the increasingly negative views toward business and capitalism of recent years and argue that companies must lead the effort to bring business and society back together.  In their view, those who use corporate social responsibility to enhance reputations, recognition and respect miss the point.  Porter and Kramer claim that businesses will gain the most respect if they embrace the concept of shared value, in which the creation of economic value meets social progress.  Furthermore, this concept has the greatest potential for launching the next era of growth and innovation.

Porter and Kramer acknowledge that adherence to shared value is far from the norm in business today.  While they offer examples of companies moving in the direction of combining economic and societal progress in their business models, such as Wal-Mart, General Electric and Nestle, they argue there is still much to change with education in business schools.

Listening to the recent State of the Union speech by President Obama convinced me that preparing for—or as he says—“winning” the future will require more than short-term job stimulus and deficit/debt-reduction measures.  It will require a new mindset very much in line with the Porter-Kramer vision. 

At least one Haitian was killed in a clash with UN peacekeepers on the outskirts of Cap Haitien, Haiti, on Tuesday. The man was shot amid mass protests in response to the rapidly spreading Cholera epidemic that has killed more than 1,000 people and which many Haitians believe was spread by the mostly Nepalese UN forces. Haitians protesters in Cap Haitien and Hinche reportedly threw stones and set up burning barricades to which the UN troops responded by firing tear gas. According to the UN, the protestor who was shot had first fired at a UN soldier, who fired back in self defense.

The protesters were demanding the departure of peacekeepers and the end of the MINUSTAH stabilization mission, which has been a presence in Haiti since 2004. However, the confirmation of Cholera cases in Port-au-Prince and all of Haiti’s 10 provinces is largely responsible for the unrest. As Haiti nears the one-year anniversary of the devastating earthquake, many of its social services are provided, not by the government, but by the multitude of non-governmental organizations that are currently on the ground. Given the damaged and largely decentralized health care system, access to adequate care is still scarce.

Though fear and anger surrounding Cholera is no doubt the primary agitator behind this week’s protests, the UN believes violence and political manipulation surrounding the presidential elections could also be responsible. The Haitian elections commission may choose to postpone the elections, scheduled for November 28, given the heightened risk of Cholera contamination and Haitian people’s reluctance to leave their homes to vote.

This week Mayo Clinic announced the launch of a Center for Social Media. The first of its kind, the Center aims to deepen Mayo’s use of social media tools to promote better communication among health care professionals and improve patients’ quality of care. As discussed in depth in the newly released summer issue of Americas Quarterly, communications technology is revolutionizing the way patients receive health information and even services.

Long a pioneer in social media, Mayo Clinic has a popular channel on YouTube, active Twitter and Facebook accounts, and 12 blogs, the topics of which range from cancer to safe sex to patient anecdotes. While thus far it has primarily used these tools to enhance internal communication among employees—fostering collaboration on patient care, education, research and administration issues—it now seeks to accelerate adoption of them for health-related purposes. Patients will be able to research specific diseases, learn more about Mayo Clinic doctors and even access reference material from CNN Health.

The bottom line? “To help patients,” says center leader Lee Aese, by both providing information directly and integrating communication channels among the medical community.

Five months after the 8.8-magnitude earthquake, the Chilean Ministry of Health reports that the demand for antidepressants like Diazepam, Alprazolam and Clonazepam has increased by 33 percent compared to pre-earthquake levels. At the same time, according to the Unidad de Trauma, Estrés y Desastres de la Universidad Católica, 7.5 percent of the Chilean population is suffering from post-traumatic stress disorder (PTSD) as a result of the disaster.

Clearly, the earthquake is testing a system that Philip Musgrove describes in the newly released AQ as being increasingly “more complete and more equitable through reforms that are also politically acceptable.”

Besides, placing tremendous pressure on the system, the earthquake and resulting spike in antidepressant consumption also leads to problems of self-prescription and counterfeit medicine. According to Marv Shepherd, “Latin America currently rank second behind Asia as having the highest number of counterfeit drugs ‘incidents.’” If this trend continues, Chilean authorities will face the added challenge of cracking down on a growing black medicine market.

Yesterday’s election in Massachusetts to fill Ted Kennedy’s U.S. Senate seat had little to do with Latin America, but the implications of Scott Brown’s victory over Martha Coakley will nonetheless resonate across the region. That’s because the victory of the Republican candidate breaks the Democrats’ super majority of 60 votes in the Senate, and will likely require renewed negotiation and accommodation in order to pass the massive health care bill that has been the top priority of the White House and Congressional leaders since early 2009. Further delay on health care means that other agenda items will have to wait even longer for the political attention required to address them, and the mood on Capitol Hill could well become still more partisan and sour.

That’s doubly true for controversial legislation, particularly as we move further into 2010, which is a midterm election year. Since President Obama was inaugurated one year ago today, three out of the four special elections have been won by Republicans (the Massachusetts Senate seat and the Governorships of Virginia and New Jersey). Only an upstate New York Congressional seat was won by the Democratic candidate, and that was after the Republican vote split over two candidates. Looking ahead to the elections in November, many observers predict that Democratic losses will mount, which means the White House and Congressional leadership will do whatever they can to improve the midterm prospects by juicing the economy, creating jobs and strengthening the support of the Democratic base, particularly organized labor.

From the Americas Society/Council of the Americas. AS/COA Online's news brief examines the major—as well as some of the overlooked—events and stories occurring across the Americas. Check back every Wednesday for the weekly roundup.

Sign up to receive the Weekly Roundup via email.

Zelaya Sneaks Back into Honduras, Catapaults Brazil into Center of Crisis

Three months after the military forced him out of Honduras, deposed President Manuel Zelaya reentered the country and gained sanctuary in the Brazilian embassy on September 21. Since then—and at the time of this report—the country remains in a tense standoff. The interim government of Roberto Micheletti closed airports, declared a curfew, and cut water supplies and electricity to the embassy. Police forces broke up protests with tear gas, with some canisters falling inside the embassy’s compound.

Such moves did little to please Brasilia, where the House approved a motion repudiating Honduras’ blockade of the embassy. While Brazil said it did not play a role in bringing Zelaya back into Honduras, officials allowed him to take shelter and reiterated support for his reinstatement. President Luiz Inácio Lula da Silva, in New York for the UN General Assembly, urged an emergency meeting of the UN Security Council on the crisis and requested to be present at the meeting.

In a Christian Science Monitor article exploring Brazil’s role in the center of the crisis, COA’s Eric Farnsworth explains why Zelaya chose that country to turn to. “Seeking asylum with Brazil shows that [Zelaya] thinks Brazil is the neutral voice in the crisis, not the U.S., Costa Rica, [or] Venezuela. He's essentially throwing in his lot with the party he thinks has the best chance to get him restored to power,” said Farnsworth, “It's a tangible representation of a power shift in the region.”

From the Americas Society/Council of the Americas. AS/COA Online's news brief examines the major—as well as some of the overlooked—events and stories occurring across the Americas. Check back every Wednesday for the weekly roundup.

Sign up to receive the Weekly Roundup via email.

Clinton, Vázquez Worry over LatAm Arms Race

Uruguayan President Tabaré Vázquez met with U.S. Secretary of State Hillary Clinton in Washington September 15 where, during a press conference, they expressed concern about the possibility of a Latin American arms buildup. Clinton referred in particular to Venezuela’s announcement that it would purchase $2.2 billion worth of arms from Moscow, saying: “[W]e urge Venezuela to be transparent in its purchases, clear about its purposes. They should be putting in place procedures and practices to ensure that the weapons that they buy are not diverted to insurgent groups or illegal organizations, like drug trafficking gangs and other criminal cartels.” Vázquez added that, in a region marked by social inequality, resources should be devoted to poverty alleviation rather than weapons.

Read an AS/COA analysis of the South American arms spending, focusing in particular on recent arms deals forged by Venezuela and Brazil.