The New York Times and the Financial Times examine concerns expressed by AIDS activists and members of an FDA panel that last week recommended Gilead Sciences’ antiretroviral drug Truvada be approved for pre-exposure prophylaxis (PrEP) to prevent HIV among healthy people at risk of contracting the virus. According to the New York Times, “Such a pill has long been a goal of research, something that might help stem a global epidemic that is still causing two million new worldwide cases each year, including 50,000 in the United States” (Grady, 5/14). The Financial Times says some have concerns over the real world efficacy of the drug; whether its approval would encourage reckless behavior, such as not using condoms; side effects that might require additional treatment; the development of drug-resistant HIV strains; and the cost of the drug.
NPR's 'All Things Considered' Examines How Greater Acceptance Of India's Gay Community Helps HIV Fight
NPR’s “Shots” blog includes an “All Things Considered” story that examines how “a 2009 benchmark ruling in Delhi’s High Court,” which “struck down a 148-year-old law known as Section 377, a holdover from British colonial rule that made homosexual acts illegal,” has led to a wider level of HIV outreach to Mumbai’s gay community. Vivek Anand, CEO of the Humsafar Trust, “which provides free HIV tests and other health services to Mumbai’s gay community,” said the ruling has helped health workers gain a better understanding of HIV prevalence among India’s gay population, the blog notes.
Botswana, Lesotho, Swaziland, Zambia, and Zimbabwe all have launched national campaigns urging men to undergo circumcision to help reduce their risk of contracting or transmitting HIV infection, but “all the countries are lagging far behind their targets,” Agence France-Presse reports in an article focusing on efforts in Botswana. A three-year-old campaign in Botswana, aimed at convincing 460,000 men to get circumcised, “has reached only seven percent of this figure,” the news agency notes, adding, “Now the government has enlisted the help of top musicians and launched a new series of advertisements touting ‘safe male circumcision’ as a lifeline.”
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).
“In the last 20 years, the world has saved more than 50 million children’s lives and reduced maternal mortality by one-third,” “accomplishments [that] have been the result of good science, good management, bipartisan political support, the engagement of USAID and many other U.S. Government agencies, and the participation of faith-based organizations, civil society, and the private sector,” according to a summary of USAID’s “Global Health and Child Survival: Progress Report to Congress 2010-2011.” The summary states, “With prospects for ending preventable child and maternal deaths, creating an AIDS-free generation, and laying the foundations for universal health coverage, future generations will look back at this period as a turning point in the history of global health” (5/10).
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).
In this post on the Center for Global Development’s (CGD) “Global Health Policy” blog, Research Fellow Victoria Fan, Director of Global Health Policy Amanda Glassman, and Research Assistant Rachel Silverman of CGD examine what they call the “serious limitations” of a study published recently in the American Journal of Tropical Medicine & Hygiene that looked at the impact of HIV/AIDS funding on Rwanda’s health system. After describing several “shortcomings,” they write, “We understand that the authors likely suffered from significant data constraints; likewise, we recognize the enormous empirical challenges in demonstrating system-wide effects at the national level. Still, it remains important to carefully state results and recognize the limitations of one’s research.” They conclude, “The jury is still out on whether HIV/AIDS funding has displaced or improved efforts on other disease control priorities” (5/10).
“In a move that could lead to a new milestone for treatment in the evolution of the worldwide AIDS epidemic,” a Food and Drug Administration (FDA) panel on Thursday recommended Gilead Sciences’ antiretroviral drug Truvada be approved for pre-exposure prophylaxis (PrEP) to prevent HIV among healthy people at risk of contracting the virus, Reuters reports, noting the drug is already approved to treat HIV infection (Morgan, 5/10). “The panel voted 19-3 to approve the drug for use in gay men and 19-2, with one member abstaining, for heterosexual couples in which one person is HIV-negative,” according to the Wall Street Journal (Dooren, 5/10). “The recommendation is the first time that government advisers have advocated giving antiviral medicine to healthy people who might be exposed through sexual activity to the virus that causes AIDS,” the New York Times writes (Grady, 5/10). Though the FDA is not required to follow the panel’s advice, it usually does, and “[a] final decision is expected by June 15,” the Associated Press/Fox News reports (5/11).
“Algeria will partner with the Joint United Nations Programme on HIV/AIDS (UNAIDS) to build the first HIV/AIDS research center in the Middle East and North Africa (MENA),” Nature Middle East reports. “The center, which should be operational by 2013, will be based in the city of Tamanrasset in southern Algeria” and “will bring together researchers from Africa, Europe and the United States working on treatment and prevention of HIV/AIDS,” the magazine writes.
“Over the next few weeks, appropriators will be engaged in the challenging task of evaluating U.S. foreign assistance funding, including how effectively Congress’ global health investments are being used,” Charles Lyons, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation; Molly Joel Coye, interim president and CEO of PATH; Carolyn Miles, president and CEO of Save the Children; and Richard Stearns, president of World Vision, write in this Roll Call opinion piece. They continue, “As organizations funded in part by the U.S. government to implement global health programs in the field,” we “see firsthand how U.S. global health programs are working, and why now is not the time to cut multilateral and bilateral funding for these efforts.”