The Center for Strategic and International Studies (CSIS) on Thursday hosted a panel discussion focusing on the policy implications of findings published by the Lancet in a special series on HIV/AIDS and men who have sex with men (MSM), the Center for Global Health Policy’s “Science Speaks” blog reports (Barton, 9/7). Chris Beyrer, a professor of international health at the Johns Hopkins Bloomberg School of Public Health and a contributor to the Lancet series, explained two factors are affecting the expansion of the HIV epidemic among MSM worldwide, according to Inter Press Service. First, HIV “is far more efficiently transmitted through the gut, hence leading to a far higher transmission probability in anal sex, for either a man or a woman — around 18 times more likely than through vaginal transmission,” the news service writes. Second, “because gay men can switch sexual roles in a way that is impossible among heterosexual couples — acting as both the acquisition and transmission partner — the efficiency of transmission among MSM networks appears to be far higher than previously understood,” IPS adds, noting, “These two factors, the new research suggests, account for a full 98 percent of the difference between HIV epidemics among MSM and heterosexual populations.”
Following the XIX International AIDS Conference (AIDS 2012) in July, “delegates left Washington with a clear focus on achieving an AIDS-free generation,” Chip Lyons, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, writes in the Huffington Post’s “The Big Push” blog. “But in the weeks following, HIV/AIDS and global health have largely disappeared from our political dialogue,” he says, because “[n]ational attention is squarely focused on the November elections, and we haven’t seen the ‘post-conference’ bounce that these issues deserve.” He continues, “Although there was mention of support for PEPFAR and the Global Fund [to Fight AIDS, Tuberculosis and Malaria] at this summer’s conventions, this kind of high-level call to action was noticeably absent in Tampa and Charlotte.”
“Each year, nearly 400,000 children are born with HIV globally, and prevention of mother-to-child transmission (PMTCT) is a particular challenge in sub-Saharan Africa, an area characterized by weak health systems,” U.S. Global AIDS Coordinator Ambassador Eric Goosby writes in the State Department “DipNote” blog. “Last year PEPFAR and UNAIDS joined with other partners to launch the Global Plan, an initiative to eliminate new HIV infections among children and keep their mothers alive,” Goosby writes and reflects on a two-day mission to Nigeria with UNAIDS Executive Director Michel Sidibe last week. He concludes, “Preventing new HIV infections in children is a smart investment that saves lives, and the United States is proud to partner with Nigeria and other countries in this cause” (4/30).
Trade officials met last week at the U.N. World Intellectual Property Organization “to make progress on a proposal that would allow poor countries to provide inexpensive generic versions of lifesaving medications, rather than rely a single version of the same drugs under expensive patent monopolies,” but the U.S. “remained steadfast in rejecting proposals aimed at lowering the prices of existing medicines in poor countries,” the Huffington Post reports (Carter, 5/29). At the 18th session of the Standing Committee on the Law of Patents (SCP), delegates considered two proposals, according to Intellectual Property Watch. The news service notes that a South African proposal (.pdf), submitted on behalf of the African Group and the Development Agenda Group (DAG), would have assisted developing nations adapt their patent schemes “to make full use of the flexibilities available in the international patent system in the interest of public health,” and a U.S. proposal (.pdf) “warned against any weakening of patent protection as a solution to the lack of availability of medicine in developing countries” because, “the delegate said, less patent rights would be detrimental to innovation” (Saez, 5/25).
The Center for Global Health Policy’s “Science Speaks” blog notes that PEPFAR recently released its 8th annual report (.pdf) to Congress. “The five-page document outlines the program’s progress as of the end of fiscal year 2011 in various areas,” including the provision of antiretroviral treatment, care, and support; HIV testing and counseling for pregnant women; and prevention of mother-to-child transmission services, the blog notes. The report includes sections on “leading with science,” “smart investments,” “country ownership,” and “shared responsibility,” according to the blog (Mazzotta, 5/4).
“While the battle against HIV/AIDS attracts more donor funding globally than all other diseases combined, it has not diverted attention from fighting unrelated afflictions — such as malaria, measles and malnutrition — and may be improving health services overall in targeted countries, according to a study on Rwanda published” Wednesday in the American Journal of Tropical Medicine and Hygiene, an American Society of Tropical Medicine and Hygiene (ASTMH) press release reports. “A six-year investigation of health clinics in Rwanda by researchers at Brandeis University infuses fresh evidence into a long-standing debate about whether the intensive focus on HIV/AIDS, which in 2010 alone killed 1.8 million people, is undermining other health services, particularly in African countries that are at the epicenter of the pandemic,” the press release states (5/2).
The PBS NewsHour on Friday featured an interview of Anthony Fauci, director of the NIH National Institute of Allergy and Infectious Diseases (NIAID), by Senior Correspondent Ray Suarez, in which they discussed an FDA panel’s recommendation that the antiretroviral Truvada be approved for pre-exposure prophylaxis (PrEP) to prevent HIV among healthy people at risk of contracting the virus. If approved, Truvada “can be potentially very effective” as a prevention modality among specific populations at high risk of contracting HIV, Fauci said, according to the interview. Fauci also discussed the medication’s cost and concerns about adherence to the drug regimen, PBS notes (Suarez, 5/11).
International AIDS Conference To Highlight International, Domestic U.S. AIDS Policies, Politico Reports
When the International AIDS Conference convenes in Washington in July, the first time the U.S. will host the conference in more than 20 years, “it will signal that the U.S. has brought its HIV policies into better alignment with the principles it advocates abroad,” Politico reports, referencing the lifting of the “Helms rule” — which denied U.S. visas to people who are HIV positive — in 2009. “The policy was especially painful to advocates because U.S. scientific and financial investments are largely responsible for stemming the tide of the epidemic around the world,” the news service writes. “But the meeting will also highlight other ways that the U.S. has fallen short, advocates say,” the news service writes, noting that the U.S. epidemic is not slowing. Politico discusses the successes and criticisms of several domestic HIV/AIDS initiatives under the Obama administration (Feder, 5/13).
“[P]articipants at a symposium held last week by the U.K. Consortium on AIDS and International Development warned that [progress on HIV and tuberculosis (TB) vaccines] could be jeopardized by the recent downturn in global health funding,” BMJ reports. The journal summarizes comments made at the meeting by researchers and advocacy group representatives, who stressed that successful vaccines for HIV and TB would save millions in existing research investments and long-term treatment costs (Moszynski, 5/22).
In a two-part series in his Slate blog “The Reckoning,” author Michael Moran examines the “silo” effect of Western aid to improve health in Africa, writing in the first part, “Charities know that raising money for exotic disease eradication in the West is a good deal easier than, say, funding upgrades to substandard cardiac facilities. Yet the later is the real win in the long run.” He references an article published recently in Foreign Affairs by Thomas Bollyky, which Moran summarizes by saying, “Bollyky argues coordinated action to confront communicable crises like HIV/AIDS, malaria or tuberculosis must be part of the world’s approach to global health. But by ignoring far greater, non-communicable problems, he says, we doom Africans to low life expectancies and fail to create the impetus for reform and behavioral changes that could be transformational” (5/28).