The XIX International AIDS Conference (AIDS 2012) that took place last week in Washington, D.C., “ignited momentum to shift from ‘fighting AIDS’ to ‘ending AIDS,’” Mohga Kamal-Yanni, senior health adviser at Oxfam International, and Urvarshi Rajcoomer, policy and advocacy adviser at Oxfam in South Africa, write in a Mail & Guardian opinion piece. “Oxfam believes investing in health systems such as infrastructure and health worker, drug supply chain and health information systems, is a critical prerequisite to ending AIDS,” they write. However, “to make this a reality,” pharmaceutical companies, donor governments, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank “must now do their part,” they continue.
Treatment and Prevention Strategies
In this post in Huffington Post’s “Impact” blog, Deborah Derrick, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, examines “the success of U.S. efforts to promote better global health through support for [PEPFAR] and the Global Fund to Fight AIDS, Tuberculosis and Malaria.” She highlights U.S. Secretary of State Hillary Clinton’s recent trip to Africa, writing that Clinton’s “encouraging words” at the Reach Out Mbuya health center in Uganda reinforced U.S. commitment to an AIDS-free generation. She notes both PEPFAR and the Global Fund have supported the center and adds that “through hundreds of similar local programs all over the world, the Global Fund provides treatment to 3.6 million people who are HIV-positive.”
In this post in Huffington Post’s “Healthy Living” blog, John-Manuel Andriote, a journalist and author living with HIV, writes, “For all of us living with HIV infection — Oct. 27 will mark seven years since my own diagnosis — the question we face daily, hopefully more consciously and deliberately than most, is how shall we live, knowing as we do that we will most assuredly die one day?” Reflecting on the XIX International AIDS Conference (AIDS 2012) that took place in Washington last month, he continues, “An AIDS-free generation is certainly a worthy goal,” but “even if tens of billions of additional dollars are allocated to address HIV/AIDS, even if the Republicans don’t succeed in inflicting their Darwinian ‘survival of the fittest’ upon the nation and the world, the question will continue to be what it has been for 31 years … Will we have the political will to end AIDS?”
This post in the Center for Global Health Policy’s “Science Speaks” blog examines the use of stavudine, “also known as d4T, an antiretroviral treatment that was dropped in wealthy countries years ago and that the World Health Organization has recommended stop being included in treatment programs,” to treat HIV in Malawi. “[W]hile children and pregnant or breastfeeding women, as well as tuberculosis patients have access to less toxic treatments, stavudine continues to be the first treatment supplied to most Malawi patients under the terms of the country’s grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria,” the blog writes, adding, “In a letter [.pdf] to Global Fund General Manager Gabriel Jaramillo and [U.S. Global AIDS Coordinator Ambassador] Eric Goosby, the Centre for Development of People (CEDEP), Health GAP (Global Access Project), and the Malawi Network of People Living with HIV/AIDS (MANET+) are asking the Global Fund to find a way to switch to first line treatment in Malawi that is acceptable to patients and World Health Organization standards” (8/15).
UNAIDS Executive Director Calls On African Leaders To Reduce 'Triple Dependency' On External Sources Of HIV Drugs, Commodities, Technologies
“Delivering a speech at [Wednesday's] opening session of the 16th Conference of the West African Economic and Monetary Union (UEMOA), UNAIDS Executive Director Michel Sidibe congratulated leaders across the region for their personal commitment to the HIV response, specifically with regard to upholding human rights and protecting human capital,” UNAIDS reports in an article on its website. “Addressing eight Heads of State and other high-level participants in Lome, Togo, he called on African leaders to reduce their ‘triple dependency’ on external sources for HIV drugs, commodities, and technologies,” the agency writes, adding, “To ensure the health and security of their populations, African leaders should focus greater attention and resources on the local production of medicines, said the UNAIDS executive director” (6/6).
Noting that the “[r]oll-out of antiretroviral treatment for HIV in sub-Saharan Africa has been accompanied by rising rates of drug resistance,” Raph Hamers, a global health research fellow at the Academic Medical Centre of the University of Amsterdam, and colleagues “call for improved patient management and the integration of population-based drug resistance surveillance into national treatment programs” in this BMJ analysis. “In sub-Saharan Africa, the region with the highest HIV/AIDS burden, high-level political commitment and substantial international funding have led to an unparalleled scale-up of access to treatment over the past eight years,” they write, adding, “However, little attention has been paid to the potential emergence and spread of drug-resistant HIV and its public health implications.”
“The potential for antiretroviral medicine to reduce transmission of HIV and tuberculosis has been demonstrated, but the challenges of using treatment to prevent infection will need to be tackled country by country, and with focus on people for whom it will have the biggest impact, the latest bulletin on HIV treatment from the World Health Organization says,” the Center for Global Health Policy’s “Science Speaks” blog reports. “WHO’s June 2012 Antiretroviral Treatment as Prevention (TasP) of HIV and TB Programmatic Update is the latest of a series of documents the organization says will lead to a completed set of guidelines on treatment and prevention in July 2013,” the blog reports, noting, “The organization also plans to release new recommendations in time for the July International AIDS Conference, addressing the preventative use of antiretroviral medicine by people who are uninfected but potentially exposed to HIV, including those involved in commercial sex work, in ongoing relationships with infected partners, and men who have sex with men” (6/18).
Less Expensive ARV Combination Just As Effective For Women In Developing Countries As Costlier ARVs, Study Shows
A new study by researchers at Brigham and Women’s Hospital in Boston shows that the less-expensive antiretroviral nevirapine, when used in combination with other antiretroviral drugs (ARVs), is as effective as a more expensive combination among women in developing countries, VOA News reports. While the nevirapine-containing combination was not as effective as some ARV combinations available in the U.S., “about 83 percent of women were able to suppress their virus and stay alive and well after starting the nevirapine-based regimen,” according to lead author Shahin Lockman, an associate professor at Harvard Medical School, who looked at the combinations among 500 African women with late-stage HIV infection, according to the news service.
“Scientists, stymied for decades by the complexity of the human immunodeficiency virus, are making progress on several fronts in the search for a cure for HIV infections,” but “[a] major stumbling block is the fact that HIV lies low in pools or reservoirs of latent infection that even powerful drugs cannot reach, scientists told the Conference on Retroviruses and Opportunistic Infections, one of the world’s largest scientific meetings on HIV/AIDS,” in Seattle last week, Reuters reports. “Promising tactics range from flushing hidden HIV from cells to changing out a person’s own immune system cells, making them resistant to HIV and then putting them back into the patient’s body,” the news service writes.
“The rising enthusiasm for providing more medicines threatens to come at the expense of promising initiatives for preventing HIV infections in the first place — initiatives that could save many lives, with less money,” Craig Timberg, the newspaper’s deputy national security editor, and Daniel Halperin, an epidemiologist at the University of North Carolina, write in this Washington Post opinion piece. “Ambitious treatment efforts and smart prevention programs are, of course, not inherently at odds. But especially in an era of fiscal constraint, these two goals could come into conflict,” they write, continuing, “The result, wasteful in dollars spent and lives diminished, would represent only the latest misjudgment by powerful donor nations such as the United States, which still struggle to understand the root causes of an epidemic that has spread most widely in weaker, poorer nations.”