Some members of Congress “are advocating deep cuts to funding for domestic programs such as [the Ryan White CARE Act] and international programs such as the Global Fund [to Fight AIDS, Tuberculosis and Malaria] and PEPFAR,” but “[w]hat these critics fail to realize is that though we have won a multitude of battles, we are still losing the war in many communities,” Rep. Michael Honda (D-Calif.) writes in a U.S. News & World Report opinion piece. “We must continue to find innovative, targeted solutions in the fight against this dreaded disease,” he continues, adding, “There are many of us in Congress who recognize this important fact, chief among those are my dear friend Rep. Barbara Lee [D-Calif.], whose upcoming ‘Ending the HIV/AIDS Epidemic Act of 2012’ targets at-risk populations both domestically and internationally.” Honda concludes, “From legislative action on the federal level to grassroots efforts in state communities, we need to make targeting these communities a top priority in order to move forward. This requires advocacy, this requires commitment, and most importantly, it requires more investment” (7/27).
Access to Health Services
Noting “the total clinic-level cost of providing a year’s worth of antiretroviral drugs … ha[s] dropped” in some countries, Charles Kenny, a fellow at the Center for Global Development and the New America Foundation, discusses “disagreement over the effectiveness of the global AIDS response” in this Bloomberg Businessweek opinion piece. Kenny highlights a debate that took place last week on the sidelines of the XIX International AIDS Conference (AIDS 2012) that “focused on the question: should we use resources for antiretrovirals at a cost (including overhead) of perhaps $350 per patient per life year saved if we could use those resources to provide a course of drugs to cure victims of tuberculosis at a cost of $5 to $50 per life year, or of extending childhood immunizations at the cost of $2 to $20 per life year?” He writes, “Simply, millions of people are dying unnecessarily, for lack of $350 a year or less. It may be those who don’t get AIDS treatment, or those that don’t get other treatments because the available money is being used to buy antiretrovirals.” He continues, “If anything could open treasury accounts in the rich world to provide a larger flow of resources to global health, perhaps it is to get policymakers in those countries to think through these gut wrenching decisions that limited funding (and lack of funding flexibility) forces doctors and ministers and activists alike to make every day” (7/27).
Noting that “[t]he XIX International AIDS Conference [AIDS 2012] has just come to a close amid much talk of the beginning of the end of AIDS, turning the tide on HIV and even a potential cure,” Julio Montaner, former president of the International AIDS Society (IAS) and director of the B.C. Centre for Excellence in HIV/AIDS, writes in a Globe and Mail opinion piece, “It is now more certain than ever that we have the tools, medicines and expertise to stop this epidemic.” He continues, “However, without the political will to expand antiretroviral treatment to everyone in need, the audacious goals set before us in Washington last week will never be met and infection may spiral out of control once again.” He writes, “Politicians have paid little more than lip service to supporting the rollout of antiretroviral treatment in their home countries and around the globe,” and concludes, “Treatment as prevention represents the fundamental building block to achieve our goal. We must find the resolve to deliver on the promise of an ‘AIDS-free generation'” (7/30).
“The XIX International AIDS Conference [AIDS 2012] drew to a close Friday without the physical presence of President Obama but with a full cast of other high-profile U.S. politicians who expressed their commitment to ending the disease,” CQ HealthBeat reports (Norman, 7/27). The conference closed “with the message that getting treatment to more of the world’s 34 million people with HIV is key to curbing the epidemic, short of a vaccine and cure that still are years away,” the Associated Press adds (Neergaard, 7/27). “Presenters at AIDS 2012, from senior government officials and heads of international organizations to civil society leaders and scientists, all echoed that for the first time in the history of AIDS, an end to the epidemic is on the horizon,” an UNAIDS feature article writes, adding, “However, speakers cautioned that there are still numerous challenges that must be addressed before the international community reaches zero new HIV infections and zero AIDS-related deaths” (7/27).
“[M]any health systems are not ready to cope with th[e] relatively new phenomenon” of people living with HIV (PLHIV) growing older, PlusNews reports. “Data on aging with HIV is largely restricted to the developed world and very little is known about older Africans living with virus, despite the high caseload in this region,” the news service writes, adding, “A July 2012 supplement of the medical journal, AIDS, notes that an estimated three million people in sub-Saharan Africa aged 50 and older are HIV-positive — 14 percent of all infected adults (7/26). In the U.S., people aged 50 and older accounted for 17 percent of new HIV diagnoses in 2009, according to the CDC, the Associated Press adds. The news service notes about one-third of the nearly 1.2 million PLHIV in the U.S. are older than 50, and that proportion will rise to one half by 2020, according to Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), who spoke at one of several sessions on aging at the XIX International AIDS Conference (AIDS 2012) (Neergaard, 7/26).
“Excitement about turning the tide in the fight against HIV is being tempered by researchers who worry some of the most vulnerable populations will miss out on medical advances,” delegates of the XIX International AIDS Conference (AIDS 2012) heard at Thursday’s plenary session, VOA News reports (Seldin, 7/26). Ugandan physician Paul Semugoma, who works with homosexual and transgender patients, told the session that one of the biggest challenges is reaching people at risk of HIV infection with prevention information, especially when stigma and discrimination are prevalent, VOA says in another article (7/26). “Semugoma says too many physicians fail to ask their patients about their sexual histories in a misguided effort not to discriminate,” VOA writes (7/26). Researcher Cheryl Overs of Australia’s Monash University spoke about how discrimination and stigma hinder the AIDS response among sex workers, VOA reports in yet another article (Seldin, 7/26). Speaking about new HIV prevention methods, Overs said, “The risk to sex workers of all genders will be enormous if condoms are replaced by partially effective HIV methods that do not protect against STIs [i.e., sexually transmitted infections] or unwanted pregnancies,” according to the news service.
NPR continues its coverage of issues being discussed at the XIX International AIDS Conference (AIDS 2012) with several stories on its health blog and radio programs. On Thursday, “Tell Me More” host Michel Martin spoke with Teguest Guerma, the first woman director general of the African Medical and Research Fund (AMREF) about how African nations are responding to the HIV/AIDS epidemic and how they are working “to find the solutions ourselves, with the support of the international community,” Guerma said, according to the program’s transcript (7/26). On “All Things Considered,” correspondent Jason Beaubien reports on how South Africa’s Kwa-Zulu Natal province is responding to high rates of HIV and tuberculosis (7/26). NPR’s “Shots” blog reports on Alexandra Volgina, who won a Red Ribbon Award for her efforts to raise awareness about drug shortages in Russia and prompting the Ministry of Health to respond (Doucleff, 7/26).
As the XIX International AIDS Conference concludes in Washington, D.C., “[t]his is a moment for all Americans to be proud of the best thing George W. Bush did as president: launching an initiative to combat AIDS in Africa that has saved millions of lives,” Washington Post columnist Eugene Robinson states in an opinion piece in the newspaper. PEPFAR “deserves accolades,” he writes, adding that the Bush administration ignored dissenting opinions stating that treatment in Africa posed a risk because of potential drug resistance and was motivated “by altruism” to create the program. Robinson notes that the Obama administration has proposed shifting funds from PEPFAR to “complementary programs” and that officials say “that overall HIV/AIDS funding will rise to an all-time high.” He also notes that Obama ended restrictions on allowing visas for people living with HIV to enter the country during his first year in office. “But if Africa is gaining ground against AIDS, history will note that it was Bush, more than any other individual, who turned the tide. The man who called himself the Decider will be held accountable for a host of calamitous decisions. But for opening his heart to Africa, he deserves nothing but gratitude and praise,” Robinson concludes (7/26).
“It is outrageous that, in 2012, when we have everything we need to beat AIDS, we are still fighting prejudice, stigma, and exclusion,” UNAIDS Executive Director Michel Sidibe writes on the Human Rights and HIV/AIDS “Now More Than Ever” blog, adding, “It is my daily reminder that the AIDS response is not just about an epidemic; the AIDS response is, has been, and must be, an instrument to fight for social justice.” He concludes, “[O]ur common aspiration is clear: a world where no one gets infected with a preventable virus, no one dies of a treatable disease, and no one faces discrimination for a health condition. We have tools to stop HIV transmission, deaths and discrimination. Human rights demand that we deliver these tools to every community and person affected. By doing so, we help to transform societies into the inclusive places they should be” (7/25).
The Economist on Friday published two articles from Saturday’s print edition regarding the XIX International AIDS Conference (AIDS 2012). One article states that “[f]ew areas of international affairs have seen more recent success than the fight against AIDS,” and discusses advancements in HIV treatment research and availability (7/28). A second article provides a recap of several studies presented at the conference, notes “some people are starting to look beyond [current] antiretroviral (ARV) drugs,” and writes, “Several clues suggest a cure may be possible” (7/28). In a related post, the Economist’s “Babbage” blog reports on new tuberculosis (TB) research presented at the conference on Monday, which “found that a combination of one experimental drug, one drug approved for other infectious diseases and one existing TB drug had a comparable effect to standard TB treatment,” suggesting “the combination may fight some TB strains resistant to other drugs — and do so quite quickly” (7/26).