Highlighting the XIX International AIDS Conference (AIDS 2012), which concluded in Washington, D.C., on Friday, this New York Times editorial examines the future of the global AIDS response. “There is no prospect that scientists will any time soon find the ultimate solutions to the AIDS epidemic, namely a vaccine that would prevent infection with the AIDS virus or a ‘cure’ for people already infected with the virus,” the editorial states, adding, “Even so, health care leaders already have many tools that have been shown in rigorous trials to prevent transmission of the virus, making it feasible to talk of controlling the epidemic within the foreseeable future.” The editorial continues, “Instead of waiting for these future possibilities, [NIAID Director Anthony Fauci] and other health leaders are proposing the broad adoption of other available tools to reduce the spread of the virus so as to produce an ‘AIDS-free generation,’ a goal enunciated last year by Secretary of State Hillary Rodham Clinton.” The editorial adds, “The only question is whether the nations of the world are willing to put up enough money and make the effort to do it” (7/27).
Speakers at Tuesday’s plenary session at the XIX International AIDS Conference in Washington, D.C. highlighted the challenges that lie ahead in the response to HIV/AIDS and discussed potential solutions, ABC News reports (Duwell, 7/25). Bernhard Schwartlander, director for evidence, strategy and results at UNAIDS, “highlighted the many new possibilities for collaboration, activism, and financing for the AIDS response as economic growth is rapidly changing the global order,” UNAIDS reports in a feature story (7/24). “A lot of very clever and dedicated people are working very hard in making sure that services are delivered more efficiently, and … more people receive HIV services with the same amount of money,” he said at the session, PlusNews writes (7/25). According to UNAIDS, Schwartlander “outlined a number of innovative financing methods … such as the financial transaction tax; front-loading investments for health through bonds; or utilizing fines paid by pharmaceutical companies for anti-competitive practices for health assistance” (7/24).
In this post in the Center for Global Health Policy’s “Science Speaks” blog, IAVI President and CEO Margaret McGlynn, AVAC Executive Director Mitchell Warren and UNAIDS Executive Director Michel Sidibe highlight the release of a report from the HIV Vaccine & Microbicides Resource Tracking Working Group, which “documents 2011 research investments in preventive and therapeutic HIV vaccines, cure research, microbicide development, pre-exposure prophylaxis (PrEP) and operations research to support implementation of such evidence-based interventions as the prevention of vertical transmission, voluntary medical male circumcision and the use of antiretroviral therapies for HIV prevention” (Barton, 7/23). In related news, in a post in USAID’s “Impact” blog, McGlynn writes about recent advances that have “fueled optimism and lent a new momentum to the field of HIV vaccine” research and development (R&D) (7/24).
Though “a massive 24-year global effort to eradicate [polio] forever is now within striking distance of its goal, … there is still a very real danger that the entire campaign could come undone,” Jay Winsten, associate dean at the Harvard School of Public Health, and Emily Serazin, a principal in the Washington, D.C. office of the Boston Consulting Group, write in a Wall Street Journal opinion piece. The campaign to eradicate the disease faces geopolitical challenges, “[b]ut the biggest danger faced by the campaign is a dramatic funding shortfall of $945 million — almost half the amount originally budgeted for 2012-13,” they write. “The challenges faced by the polio campaign are emblematic of problems that affect worldwide efforts to conquer vaccine-preventable diseases such as measles and whooping cough,” Winsten and Serazin state and note that a Global Vaccine Action Plan was recently compiled by a huge collaborative effort and endorsed by the World Health Assembly. “With sufficient funding and political will, the massive health and economic benefits of vaccines are indeed attainable,” they conclude (7/24).
Bill Gates Stresses Importance Of Investment In Both HIV Treatment And Research For Vaccines, Microbicides
In a symposium session on Monday at the XIX International AIDS Conference in Washington, D.C., politicians and public health experts joined Bill & Melinda Gates Foundation Co-Chair Bill Gates for a discussion about improving effectiveness and efficiency in the HIV/AIDS response, the Washington Post reports (Brown/Botelho, 7/23). “Gates … reiterated the importance for nations and donors to support research, but also expressed support for ongoing treatment initiatives in the meantime,” according to Agence France-Presse. “No one should think that we have got the tools yet. We will get the tools but only if we stay the course in terms of the scientific investments,” Gates said, AFP notes (Sheridan, 7/23). The Washington Post adds that “[t]he main one lacking is a vaccine, but also important and missing are woman-controlled means to prevent infection, such as a vaginal microbicide” (7/23).
Scientists Plan To Announce Research Strategy Aimed At Pursuing HIV/AIDS Cure, Wall Street Journal Reports
On July 19, ahead of the XIX International AIDS Conference in Washington, D.C., “prominent AIDS scientists plan to announce the first comprehensive research strategy aimed at pursuing new leads and addressing hurdles to a cure” for HIV/AIDS, the Wall Street Journal reports. “The announcement of the initiative will be followed by a two-day symposium on cure research,” the newspaper continues, noting, “Recent research has offered a glimpse of paths to a cure. That promise, together with breakthroughs in preventing transmission of the disease, is spurring optimism that the epidemic, which kills about 1.7 million people a year, can eventually be brought under control.” The newspaper highlights several cases and studies on prevention and treatment (McKay/Winslow, 7/18). The Associated Press/Washington Post features a video examining some of the research (Bradley, 7/19).
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.
“A cure for AIDS remains a distant prospect but a host of drug treatments and other advances have fueled fresh hope that new [HIV] infections may someday be halted for good,” Agence France-Presse reports. “Strategies for ending the 30-year AIDS epidemic through advances in treatment, testing and prevention are high on the agenda of” the XIX International AIDS Conference, “when it returns to the United States next week after two decades,” according to the news agency (Sheridan, 7/14). “Thanks to drugs that can control the virus for decades, AIDS is no longer a death sentence,” Reuters writes in an article examining AIDS vaccine research. “New infections have fallen by 21 percent since the peak of the pandemic in 1997 and advances in prevention — through voluntary circumcision programs, prevention of mother-to-child transmission and early treatment — promise to cut that rate even more,” the news service states (Steenhuysen, 7/15).
Pakistan Polio Immunization Campaign Might Not Reach 240,000 Children Because Of Militant Leaders' Bans On Vaccine
A national polio vaccination campaign set to begin this week in Pakistan might not reach 240,000 children in the northwest because of a Taliban ban on the inoculations, Agence France-Presse reports. Local militant leaders “have banned polio vaccinations in the northwestern tribal region of Waziristan to protest against U.S. drone attacks” and “have condemned the immunization campaign, which is slated to begin on Monday, as a cover for espionage,” the news agency writes (7/14). The social affairs secretary for the country’s Federally Administered Tribal Areas “says local officials and non-governmental organizations are working with tribal elders and clerics to help convince the Taliban and other militant groups to allow the immunization campaign to take place in North and South Waziristan,” according to VOA News’ “Breaking News” blog (7/13). TIME reports that the leaders have said the ban on vaccinations “would not be lifted until the drone strikes stop” (Baker, 7/15).
“What stands out in my mind from this week’s presentations [at the XIX International AIDS Conference (AIDS 2012)] is that [HIV] interventions previously proved to work in controlled clinical trials are now — over and over again — proving effective outside the research setting, in the real world, in poor and rich communities alike. The pieces are coming together,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, writes in a Washington Post opinion piece. He discusses several of the interventions, including the scale up of antiretroviral therapy (ART), treatment as prevention, voluntary medical male circumcision, and pre-exposure prophylaxis (PrEP). “Ending the HIV pandemic is an enormous and multifaceted challenge, but we know it is possible,” Fauci writes, adding that it will require “commitment” and “investments.” He continues, “We must enhance what works and eliminate what does not, overcome legal and political barriers, and remove the stigma associated with HIV.” Fauci concludes, “The global community has a historic opportunity based on solid scientific evidence to end the AIDS pandemic, opening the door to an AIDS-free generation” (7/26).