10 intersecting facts about HIV -AIDS

Despite major advances, HIV/AIDS remains one of the world's most significant public health challenges, particularly in low and middle income countries, with new diagnoses every year and young women in sub-Saharan Africa seen as being particularly at risk.

World AIDS Day on Dec. 1 is used to unite people in the fight against HIV, the human immunodeficiency virus first identified in 1984, to show their support for people living with HIV and commemorate those who have died.

The member countries of the United Nations agreed in September in a new set of global goals to end the AIDS epidemic by 2030.

Here are some facts about AIDS in 2015 with data from the World Health Organisation, the United Nations children's agency UNICEF, and UNAIDS:

1. Globally about 36.9 million people are living with HIV including 2.6 million children

2. An estimated 2 million were infected in 2014

3. An estimated 34 million people have died from HIV or AIDS, including 1.2 million in 2014

4. The number of adolescent deaths from AIDS has tripled over the last 15 years

5. AIDS is the number one cause of death among adolescents in Africa and the second among adolescents globally

6. In sub-Saharan Africa, the region with the highest prevalence, girls account for 7 in 10 new infections among those aged 15-19

7. At start of 2015, 15 million people were receiving antiretroviral therapy compared to 1 million in 2001

8. Despite widespread availability of HIV testing, only an estimated 51 percent of people with HIV know their status

9. The global response to HIV has averted 30 million new HIV infections and nearly 8 million deaths since 2000

10. In 2015, Cuba was the first country declared to have eliminated mother-to-child transmission of HIV

Congress Passes Tweak To ACA’s Small Business Rules

The AP (10/2) reports that Congress yesterday approved “legislation aimed at preventing premium increases that some smaller businesses were expecting next year under President Barack Obama’s health care law.” Currently, the ACA defines small businesses as having up to 50 workers. That number increases to 100 on Jan. 1, 2016. The bill approved Thursday “would keep the small business definition at 50 workers but let states increase the number if they choose.”

        The New York Times (10/2, Pear, Subscription Publication) reports a White House “spokeswoman confirmed that Mr. Obama would sign the bill, but she declined to discuss its substance.” According to the Times, recent comments “by administration officials suggested that they did not particularly like the legislation but could not stop the growing wave of bipartisan support for it.”

        According to National Journal (10/2, Subscription Publication), the Senate version was authored by Sens. Jeanne Shaheen (D-NH) and Tim Scott (R-SC). Shaheen said in a statement after the bill’s passage, “This bill is a win for businesses across this country, a win for bipartisanship and I’m very pleased it’s headed to the President’s desk.”

        In an analysis piece, meanwhile, The Hill (10/2, Sullivan) notes the bill’s “drama-free” passage and considers whether it marks “a shift in the legislative debate” over the ACA. Rep. Tony Cárdenas (D-CA) stated, “I do believe that this hopefully is the beginning of a lot of little fixes to a big, big law that’s not perfect.” According to the Wall Street Journal (10/2, Radnofsky, Subscription Publication), the bill’s passage could increase the likelihood that other changes to the law will be approved, such as a “Cadillac tax” repeal.

Economists Defend “Cadillac Tax” In Letter To Congress

The Washington Post (10/2, Johnson) reports in its “Wonkblog” that as Democratic presidential candidates Hillary Clinton and Bernie Sanders “add to the chorus calling” for the repeal of the Affordable Care Act’s so-called Cadillac tax on high-cost health plans, “a group of 101 economists from both sides of the aisle sent a letter [PDF] to Congressional leaders Thursday making an impassioned case for the law.” The economists argue that the tax, set to go into effect in 2018, will increase wages and other benefits as employers move away from compensating workers through overly generous health plans. The Post says economists have been “have been objecting to the unlimited exclusion of health benefits from taxation for decades,” and they see the Cadillac tax as a “necessary, if unpopular, step toward controlling health care spending.”

        CNBC (10/2) reports that the letter, sent to the Ways and Means and Finance committees of both chambers, “noted that the tax was included in the Affordable Care Act to address the ‘economically inefficient and regressive’ tax policy that allows the ‘unlimited exclusion of employer-financed health insurance from income and payroll taxes.’” The economists also warned that repealing the levy would add an estimated $91 billion to the deficit over the next decade.

        Meanwhile, the Wall Street Journal (10/2, Armour, Radnofsky, Subscription Publication) reports that while there is significant bipartisan support for scrapping the Cadillac tax, divisions among lawmakers could hinder efforts to change or eliminate the levy. Opponents of the tax remain at odds over how to offset revenue losses if it is repealed, and some Democrats are reluctant to support a measure that could be seen as an attack on the health law.

Karma( The Four Fives)

There was a man with four wives. He loved his fourth wife the most and took a great care of her and gave her the best.
He also loved his third wife and always wanted to show her off to his friends. However, he was always had a fear that she might runaway with some other man.
He loved his second wife too. Whenever he faced some problems, he always turned to his second wife and she would always help him out.
He did not love his first wife
though she loved him deeply, was very loyal to him and took great care of him. One day the man fell very ill and knew that he is going to die soon.
He told himself, "I have four wives with me. I will take one of them along with me when I die to keep company in my death."
Thus, he asked the fourth wife to die along with him and keep company. "No way!" she replied and walked away without another word.
He asked his third wife. She said "Life is so good over here. I'm going to remarry when you die".
He then asked his second wife. She said "I'm Sorry. I can't help you this time around. At the most I can only accompany you till your grave."
By now his heart sank and turned cold.
Then a voice called out: "I'll leave with you. I'll follow you no matter
where you go." the man looked up and there was his first wife. She was so skinny, almost like she suffered from malnutrition. Greatly grieved, the man said, "I should have taken much better care of you while I could have!"

Actually, we all have four wives in our lives.

a. The fourth wife is our body. No matter how much time and effort we
lavish in making it look good, it'll leave us when w die.

b. The third wife is our possessions, status and wealth. When we die, they
go to others.

c. the second wife is our family and friends. No matter how close they
had been there for us when we're alive, the furthest they can stay by us is
up to the grave.

d. the first wife is our soul, neglected in our pursuit of material
wealth and pleasure. It is actually the only thing that follows us wherever we go!

CMS: States Can Continue Using SNAP Data To Identify Eligible Medicaid Recipients

Modern Healthcare (9/3, Subscription Publication) reports that the Centers for Medicare and Medicaid Services “is making permanent a fast-track avenue for Medicaid enrollment through the federal program that provides food assistance for low-income Americans.” The agency said in a letter to Medicaid directors that states facing backlogs in enrolling Medicaid beneficiaries will be able to continue using data from the Supplemental Nutrition Assistance Program (SNAP) to identify eligible individuals. “We are pleased to be able to provide states with additional opportunities to facilitate enrollment of eligible individuals in Medicaid, and encourage states that have not adopted any of these options, as well as states that need additional assistance, to contact us,” CMS said.

Researchers Say They Have Developed A Flu-Prediction App

The Triangle (NC) Business Journal (8/24, Ohnesorge, Subscription Publication) reported in “Techflash” that researchers from Duke University and the University of North Carolina-Chapel Hill “say they’ve developed a flu-prediction app.” Investigators partnered “to develop a model that would allow them to predict the spread of influenza from one person to the next over time.” In theory, “health care providers could use the data to alert at-risk patients before they get sick – even encouraging them to stay at home to avoid passing the germs forward.”

CDC Debuts New Tool To Track Antibiotic Resistance

TIME (8/21, Sifferlin) reports that the Centers for Disease Control and Prevention (CDC) on Wednesday “rolled out a new interactive tool,” called the National Antimicrobial Resistance Monitoring System (NARMS), that “allows users to follow the spread of antibiotic resistant bugs nationwide.” CDC data reveals that of the two million illnesses reported every year, “23,000 deaths” are “associated with antibiotic resistant bacteria.” The tool has been useful in tracking “down trends in resistance.” For example, “the FDA withdrew approval for Enrofloxacin (a fluoroquinolone) in chickens after NARMS data revealed growing fluoroquinolone-resistant bacterial infections among Americans.” TIME notes that the tool is now available to the public for free.

Hospitals Using Technology To Reduce Readmissions

FierceHealthIT (8/21, Dvorak) reports “high readmissions continue to be a thorn in the side of the healthcare industry, with the Centers for Medicare and Medicaid Services announcing earlier this month that most hospitals will face some sort of Medicare penalty for excessive 30-day readmissions.” As a result, “as penalties continue to come down and costs continue to rise, providers are using all the tools at their disposal to combat the problem, with the goal of keeping patients healthy the most important of all.” Hospitals such as Cleveland Clinic are using technology to help “in this effort through initiatives such as a discharge readiness tool, a big data approach to identify patients at high risk for admissions and an effort engage them in their own care through patient portals, added Cynthia Deyling, Cleveland Clinic’s chief quality officer.”

Majority Of Americans Find Cost Of Drugs Unreasonable, Support Government Intervention, Survey Reveals

The AP (8/21) reports that a new poll by the Kaiser Family Foundation finds that 72% of Americans found the cost of prescriptions drugs to be “unreasonable,” with large majorities supporting government intervention to control drug costs, “regardless of party affiliation.” Overall, 73% said pharmaceutical companies make too much profit.

        Politico (8/21, Norman) calls the results “striking,” noting that the agreement across party affiliation was a “rare point of accord in politics.” Also covering the story are the Kaiser Health News (8/21), National Journal (8/21, Owens, Subscription Publication), and theWashington Times (8/21, Howell).

        Meanwhile, The Hill (8/21, Sullivan) reports that Rep. Elijah Cummings (D-MD), “the top Democrat on the House Oversight Committee, is calling out his Republican counterparts for declining his requests to act on high prescription drug prices, in the wake of a new poll on the issue.” Cummings claimed that Republicans have ignored his calls for a congressional investigation into rising drug prices, citing the Kaiser Family Foundation poll.

ACA Not To Blame For Healthcare Bankruptcies, Analysis Suggests

Modern Healthcare (8/21, Subscription Publication) reports that bankruptcy filings suggest the healthcare industry “has recovered more slowly than the improving economy would suggest.” According to the article, it’s not the ACA “by itself that’s pushing healthcare providers into bankruptcy, but a combination of forces including litigation, payment delays and even bad merger agreements.” The law firm Posinelli conducted an analysis of healthcare providers in distress, finding that tort litigation and payment delays topped the list of reasons for bankruptcy. “We did not see the Affordable Care Act being mentioned very much,” said healthcare attorney Bobby Guy.

Attorneys Say House ACA Lawsuit Has Better Chance Of Proceeding

According to the Los Angeles Times (8/21, Savage), “attorneys agree” that “an amended complaint and a recent Supreme Court ruling” have given the House’s lawsuit against the Obama Administration over the implementation of the Affordable Care Act a “much better” chance of proceeding. The lawsuit alleges that the Administration overstepped its authority by sending billions of dollars to health insurers under the ACA because that money was not appropriated by Congress. The Administration initially submitted a request for an annual appropriation, but officials including HHS Secretary Sylvia Burwell later “decided the so-called cost-sharing payments to insurers were mandatory and were akin to an entitlement written into law, so there was no need to seek additional approval from Congress.” House Republicans disagree, and a Federal judge is expected to soon decide on whether the complaint can proceed.

More Than 2M Eligible ACA Customers Not Receiving Subsidies, Analysis Finds

The Washington Examiner (8/20) reports that of the 8.1 million individuals who enrolled in 2015 coverage through the ACA exchanges “and were eligible for subsidies, only 5.9 million are actually getting a subsidy, according to the health research firm Avalere Health.” Avalere CEO Dan Mendelson said that many consumers are selecting plans based on premiums rather than out-of-pocket costs and, as a result, “some patients may be paying more than they need to for care.” For example, “some consumers are likely enrolling in the low-premium bronze plan, but need to be in the slightly more expensive silver plan to qualify for subsidies, Avalere said.”

UK Study Finds E-Cigarettes Reduce Smoking Risks

The New York Times (8/20, Meier, Subscription Publication) continues coverage of Public Health England’s study which concluded “that the use of electronic cigarettes can reduce the health risks of smoking by 95 percent and may also help smokers quit the habit,” although it said the products were not risk-free. Additionally, the Times notes that the study also “found little evidence that consumers who had never smoked before were adopting e-cigarettes in large numbers,” despite concerns that e-cigarettes could act as a “gateway” to smoking. Public Health England also said any British regulations on e-cigarettes should underscore the health benefits to the public.

        BBC News (8/20) quotes Prof. Kevin Fenton, Public Health England’s director of health and well-being, as saying, “E-cigarettes are not completely risk-free but when compared to smoking, evidence shows they carry just a fraction of the harm. The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting.”

Arkansas Governor Favors Keeping Medicaid Expansion, With Changes

The New York Times (8/20, Goodnough, Subscription Publication) reports that yesterday, Arkansas Gov. Asa Hutchinson (R) “told an advisory group weighing the future of the state’s alternative Medicaid expansion that he favored keeping it — but only if the federal government allowed changes that seemed intended to appeal to conservative legislators who continue to oppose the program.” While Hutchinson created the panel “to recommend whether to change or replace the state’s ‘private option’ version of Medicaid expansion,” the fate of the program “will ultimately be decided by the Republican-controlled legislature, which is likely to meet in a special session this year to vote on it.”

        The AP (8/20) reports that the changes that the Federal government would need to approve involve requiring recipients to participate in employer-sponsored plans, if available, and to pay a portion of their premium.

        Also covering the story are the Arkansas News (8/20, Lyon), the Fort Smith (AR) City Wire (8/20), the Fort Smith (AR) Times Record(8/20, Lyon), and the Arkansas Democrat Gazette (8/20, Lesnick).

Alaska Republicans Move To Block Governor’s Medicaid Expansion Plans

The Washington Times (8/20, Howell) reports that Republican legislative leaders in Alaska “have retained a pair of law firms and will ask the state Superior Court to issue an injunction” to “block Gov. Bill Walker’s unilateral plans to expand Medicaid under Obamacare” before Sept. 1. In July, Walker announced that he would “make an end run around the legislature and accept federal funds to extend government-sponsored insurance to 20,000 more low-income Alaskans.” Alaska’s Legislative Council voted 10-1 Tuesday “to sue the governor, with one Democrat joining nine Republicans in favor of the motion and one Democrat dissenting.”

GOP Proposals For High-Risk Pools Could Face Conservative Opposition

Bloomberg Politics (8/20) reports that Wisconsin Gov. Scott Walker (R) and Sen. Marco Rubio (R-FL) this week rolled out ACA replacement plans, both of which endorse the idea of using state-based high-risk pools to cover people with pre-existing conditions. However, a “major problem” with this idea is that congressional Republicans “have refused to spend even a fraction of the money that conservative experts say is necessary to make the plan work.” In fact, a 2013 effort by House GOP leaders to fund high-risk pools was stymied by “strong opposition from conservative lawmakers.” The article notes a 2010 paper “by conservative health-policy experts James Capretta and Tom Miller in National Affairs estimated that it would cost $15 to $20 billion per year for a ‘comprehensive set of high-risk pool programs’ aimed at covering between 2 and 4 million people.”

Clinics, Hospitals, Practices Compete For New Hires As ACA Expands Coverage

The Denver Business Journal (8/20, Subscription Publication) reports that as more people gain health insurance under the ACA, “hospitals, health clinics and physicians’ practices all are dealing with a hiring crunch as they try to staff up and take care of the new flow of customers.” The “various sectors” are offering new incentives as they compete against each other for advanced-practice nurses, primary care physicians, and physician assistants. Community health clinics, for example, “are offering participation in government-backed educational-loan repayment programs and paying competitive wages with deeper-pocketed hospitals.” Rural hospitals, meanwhile, “are wooing providers with bonuses, while urban hospitals have a new tendency with specialty nurses in particular to offer to repay student debt.”

Critics Say FDA Not Scrutinizing Misleading Health Ads Equally

Modern Healthcare (8/19, Rice, Subscription Publication) reports that since launching in 2010, the Food and Drug Administration’s “Bad Ad” campaign has received “nearly 800 complaints” regarding “potentially misleading or imbalanced drug advertisements.” The actions taken in response to complaints are unclear, and an FDA spokesperson said: “We don’t track this metric, as the goal of the program is to raise awareness of misleading advertising and not to increase enforcement actions.” Meanwhile, clinicians and policy leaders “say there’s far less scrutiny for medical devices and other health services” than drugs. The FDA “says complaints about medical devices are forwarded to the Center for Devices and Radiological Health, which enforces violations against federal ad regulations” and the Federal Trade Commission “may also take actions separately based upon its own jurisdiction.”

Scientists Say They Have Figured Out How Key Gene Tied To Obesity Makes People Fat

The AP (8/20, Marchione) reports that in a study published in the New England Journal of Medicine, scientists claim to “have finally figured out how” FTO, “the key gene tied to obesity, makes people fat, a major discovery that could open the door to an entirely new approach to the problem beyond diet and exercise.” Working with genetically engineered mice and with human cells, researchers found that “a faulty version” of the FTO gene “causes energy from food to be stored as fat rather than burned.”

        TIME (8/20, Park) reports that “by manipulating the genes in question in mice,” investigators discovered that “they could adjust the amount of obesity or leanness by reformulating the proportions of white and beige fat cells.” They found they could even “reduce the amount of white fat by a factor of seven, give or take.” The study authors’ “next step will be to manipulate these genes and this pathway in human patients...to see if the intervention has an effect on their weight and fat composition.” The Telegraph (UK) (8/20, Knapton) also covers the story.

Longer Work Hours Tied To Increased Risk For Stroke

The Los Angeles Times (8/20, Kaplan) reports in “Science Now” that people “who put in long hours at the office were 33% more likely to suffer a stroke than their colleagues who clocked out earlier,” according to study findings published online yesterday in The Lancet. The study also found that even people “who worked just over 40 hours per week saw a significant increase in stroke risk.”

        The New York Times (8/20, Saint Louis) “Well” blog points out that the “new analysis includes data on more than 600,000 individuals in Europe, the United States and Australia, and is the largest study thus far of the relationship between working hours and cardiovascular health.” Included in the analysis were 17 “studies of stroke” that “included 528,908 men and women who were tracked on average 7.2 years,” as well as 25 studies of “coronary heart disease among workers” that involved some “603,838 people.”

        TIME (8/20, Basu) reports that the study authors are not sure why longer work hours appear to be linked to an increased risk for stroke, but posited that “working long hours tends to be correlated with risky health behaviors, like drinking more alcohol or sitting for hours at a time.” Such behaviors, in combination “with the stress associated with working overtime, could be a perfect recipe for a stroke or cardiovascular strain.” The Telegraph (UK) (8/20, Knapton) also covers the study.