The Associated Press on Saturday examined the HIV/AIDS epidemic in Uganda, where “[a] new government report says the prevalence of HIV in this East African nation increased from 6.4 percent in 2004 to 7.3 percent in 2011, a shocking statistic for a country once praised for its global leadership in controlling AIDS.” The news service highlights PEPFAR’s contributions to fighting the epidemic in Uganda, noting that “[a]t least half of the 600,000 Ugandans in need of AIDS treatment are able to access the drugs, mostly through PEPFAR.” According to the AP, “U.S. government officials have been pressing Uganda to devote more resources to AIDS and issues such as maternal health, saying dependency on foreign support is unsustainable in the long term.” On a recent trip to the country, Rep. Barbara Lee (D-Calif.) said meeting patients benefitting from PEPFAR-funded treatment “was confirmation of the fact that United States foreign aid works,” the AP writes (Muhumuza, 7/21).
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“An international group of scientists on Sunday called for all adults who test positive for HIV to be treated with antiretroviral drugs right away rather than waiting for their immune systems to weaken,” Agence France-Presse reports. The guidelines, issued by the International Antiviral Society-USA, “are based on new trial data and drug regimens that have become available in the last two years which warrant an ‘update to guidelines for antiretroviral treatment in HIV-infected adults in resource-rich settings,'” the news agency writes (7/22). “In addition, data have shown that suppressing HIV reduces the risk of an infected person passing the virus to another person,” according to Reuters. The guidelines, which “echo those issued in March by the U.S. Department of Health and Human Services,” were published in the Journal of the American Medical Association at the start of the International AIDS Society’s 2012 conference, the news service notes (Beasley, 7/22).
“Lack of money can no longer be considered a reason — or an excuse — for failing to treat all those with HIV who need drugs to stay alive, following game-changing work about to be published by the Clinton Foundation that shows the real cost is four times less than previously thought,” the Guardian reports. “The striking findings of a substantial study carried out in five countries of sub-Saharan Africa are hugely important and will set a new hopeful tone for the International Aids Conference in Washington, which open[ed] on Sunday,” the news service writes.
The XIX International AIDS Conference opened in Washington, D.C., on Sunday and “is expected to draw 25,000 people, including politicians, scientists and activists, as well as some of the estimated 34 million people living with HIV who will tell their stories,” Agence France-Presse reports (Sheridan, 7/22). “Researchers, doctors and patients attending the world’s largest AIDS conference are urging the world’s governments not to cut back on the fight against the epidemic when it is at a turning point,” the Associated Press writes, adding, “There is no cure or vaccine yet, but scientists say they have the tools to finally stem the spread of this intractable virus — largely by using treatment not just to save patients but to make them less infectious, too” (Neergaard, 7/22). “New breakthroughs in research will be announced, as will new efforts by governments and organizations to reduce the spread of HIV, to treat those who have it, and to work, eventually, toward a vaccine and a cure,” the Seattle Times writes (Tate, 7/22). According to the Washington Post’s “Blog Post,” three remaining challenges to be addressed at the conference include: “More research into treatment and prevention, and more ways to deliver treatments”; reaching marginalized populations, such as men who have sex with men and sex workers; and “[i]ncreasing funding for PEPFAR and other anti-AIDS programs” (Khazan, 7/20).
Though South Africa has made progress against HIV/AIDS over the past few years, the country’s “health minister says much more needs to be done,” VOA News reports. Health officials from South Africa’s Medical Research Council on Thursday said the mother-to-child transmission rate dropped from 3.5 percent in 2010 to 2.7 percent in 2011, getting the country closer to its goal of reaching a two percent rate by 2015, the news service notes. But Health Minister Aaron Motsoaledi “told reporters Thursday in Johannesburg that 60 percent of HIV/AIDS patients are female and they must be the focus to stem the epidemic in the country,” VOA writes, adding, “Motsoaledi is urging everyone to seek regular HIV testing in an effort to reduce the epidemic and diminish the disease’s stigma” (Powell, 7/19).
Ahead of the XIX International AIDS Conference next week, UNAIDS on Wednesday launched a new report, titled “Together we will end AIDS” (.pdf), “that shows that a record eight million people are now receiving antiretroviral therapy [ARVs], and that domestic funding for HIV has exceeded global investments,” the U.N. News Centre reports (7/18). “In all low- and middle-income countries, the availability of antiretroviral drugs grew by more than 20 percent in just one year, compared to the latest figure of 6.6 million people covered in 2010, said the report,” Agence France-Presse writes (Sheridan, 7/19). “At that rate, the world should meet a U.N. goal of having 15 million people [in low- and middle-income countries] on treatment by 2015, the report found,” the Associated Press adds (Neergaard, 7/18). “Fewer people infected with HIV globally are dying as more of them get access to” ARVs, “particularly in sub-Saharan Africa,” Reuters notes (Beasley/Miles, 7/18). AIDS-related deaths “dropped 5.6 percent to 1.7 million in 2011 from the previous year,” Bloomberg writes, adding that deaths “peaked in 2005 and 2006 at 2.3 million and have been going down since then, according to the report” (Pettypiec/Langreth, 7/18).
More widespread use of antiretroviral drugs (ARVs) to treat HIV infection has led to drug resistance in low- and middle-income countries, but the level “is not steep enough to cause alarm, said a survey released by the World Health Organization on Wednesday,” Agence France-Presse reports. “In low- and middle-income countries, drug resistance stood at 6.8 percent in 2010, the WHO said in its first-ever report on the matter,” the news agency writes, adding, “High-income countries, many of which began widescale treatment for HIV years earlier and used single or dual therapies that can also encourage resistance, face higher rates of resistance, from eight to 14 percent, said the study” (Sheridan, 7/18).
The goal of an “AIDS-free generation” “requires an ambitious implementation-science agenda that improves efficiency and effectiveness and incorporates strategies for overcoming the stigma and discrimination that continue to limit the uptake and utilization of [treatment, prevention and care] services,” AIDS 2012 Co-Chair Diane Havlir of the University of California-San Francisco School of Medicine and Chris Beyrer of the Johns Hopkins Center for AIDS Research write in a New England Journal of Medicine opinion piece. They note that “[r]esearch efforts on HIV vaccines will also probably be key, and the field has been reinvigorated” by recent study results. “A combination approach to prevention that includes HIV treatment can generate tremendous gains in the short term by curtailing new HIV infections, but ending the AIDS epidemic will probably require a vaccine, a cure, or both,” they write.
Jennifer Furin, an infectious diseases physician and medical anthropologist who specializes in the management of tuberculosis (TB) and HIV in resource-poor settings, writes in a post in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog that “when it comes to the great advancements made in global HIV and TB care, children are being left behind.” She continues, “All children with HIV and TB deserve access to diagnosis and treatment, and the death of even a single child from either one of these diseases signifies a global failure. … It is time to require that pediatric formulations of TB and HIV medications be developed.” She notes that StopTB.org will host a talk show on July 22 featuring women and young people who have been affected by TB and HIV (7/17).
As part of its “AIDS Turning Point” series, GlobalPost examines how the United States and its African partners are designing clinical trials at four African sites to test whether a combination of prevention methods and strategies — “notably the vaccine-like preventative effect on transmission when someone starts taking AIDS drugs, as well as the life-long protection afforded to many due to male circumcision” — could “put them on the road to a Holy Grail: the numbers of HIV infections tumbling down.”