Kaisernetwork.org (Washington, DC)
8 May 2008
Politics and Policy
AIDS Orphan Advocates Call for Increased Community-Based Programs, Passage of PEPFAR Bill
Science & Medicine
Biotech Firm GeoVax Labs To Launch Phase II Trials of HIV Vaccine Candidate
Rapid HIV Tests Highly Effective in Preventing Mother-to-Child HIV Transmission in India, Study Finds
Global Challenges
New HIV Cases Increasing in Germany, Institute Says
Namibia To Launch Pilot HIV Testing, Counseling Project
HIV/AIDS Funding in Tanzania Expected to Total $476M, Government Report Says
Politics and Policy
AIDS Orphan Advocates Call for Increased Community-Based Programs, Passage of PEPFAR Bill
[May 08, 2008]
Advocacy groups on Wednesday during a briefing about the millions of children worldwide who have lost one or both parents to AIDS called for an increase in community-based programs to assist AIDS orphans, as well as the passage of legislation to reauthorize the President's Emergency Plan for AIDS Relief, CQ HealthBeat reports (Cooley, CQ HealthBeat, 5/7). The House last month voted to approve a bill (HR 5501) that would reauthorize PEPFAR at $50 billion over the next five years, among other measures. The Senate version, which also would allocate $50 billion over five years, passed the Foreign Relations Committee in March and is awaiting floor consideration (Kaiser Daily HIV/AIDS Report, 4/3).
Speakers at the briefing -- which was hosted by the groups Global Action for Children and Francois-Xavier Bagnoud -- said that community-based efforts in addition to increases in PEPFAR funding are necessary to address HIV/AIDS. FXB Founder Albina du Boisrouvray said that local initiatives are needed to prevent children from "drifting" into commercial sex work or becoming child soldiers, which she called "ills that we spend so many billions fighting downstream instead of preventing upstream."
Jim Yong Kim -- a professor of health, human rights and medicine at Harvard University -- said, "We have to take a hard look at how we're spending our money." He and other speakers called for family-centered approaches to addressing AIDS orphans, adding that institutional care often is associated with poor outcomes. "Your average American, when thinking of the orphan crisis, thinks either of adoption or orphanages," advocate Diana Aubourg Millner said. She and Kim said that they support programs that encourage family members and communities to care for orphans.
Kim also said that money should be given directly to communities instead of large international and often faith-based groups. He said that cash transfers given directly to impoverished families have increased school enrollment and attendance in Honduras, Mexico, South Africa and Zambia. In addition, Kim emphasized the role of PEPFAR funding in supporting and expanding such initiatives. "Nothing has made me prouder of being an American than watching what PEPFAR has done," he said (CQ HealthBeat, 5/7).
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Science & Medicine
Biotech Firm GeoVax Labs To Launch Phase II Trials of HIV Vaccine Candidate
[May 08, 2008]
The Atlanta-based biotechnology firm GeoVax Labs plans to launch Phase II clinical trials of its experimental HIV vaccine this summer, company officials recently announced, the Atlanta Journal-Constitution reports (Hendrick, Atlanta Journal-Constitution, 5/8).
GeoVax while in midstage development of its HIV vaccine candidate enrolled 140 people in four independent national trials. The firm is developing the experimental HIV vaccine in collaboration with Emory University, CDC and NIH. According to Emory officials, a prototype of the vaccine provided long-term protection against development of AIDS in nonhuman primate studies conducted more than three years ago at the Yerkes National Primate Research Center in Atlanta. NIH awarded the firm a $15 million grant in October 2007 to further its research and continue human clinical trials (Kaiser Daily HIV/AIDS Report, 10/1/07).
The vaccine is the only candidate among several under development that is "on the verge" of being moved to Phase II trials by the HIV Vaccine Trials Network, the Journal-Constitution reports.
"The upcoming Phase II trial is being conducted in a larger number of healthy individuals," Bob McNally, president and CEO of GeoVax, said. He added, "Now that the delivery combinations of the vaccine have been worked out, the Phase II trial will expand the participants to 150 vaccinated volunteers and 75 volunteers as a control group who do not receive the vaccine."
The trial participants are not at risk of contracting HIV, and the purpose of the study is to gauge the CD4+ T cell and antibody response to the vaccine, according to McNally. "The significance of the results will be to give a level of comfort" to FDA and GeoVax that when the vaccine is given to at-risk participants, there will be a "high degree of likelihood that the patients will be protected from contracting the disease," McNally said.
"We've had excellent results in our early stage human trials," Harriet Robinson, chief scientific adviser to GeoVax, said. She noted that no vaccine has ever prevented infection but that she hopes the candidate will "prevent the development of disease and transmission." Robinson also said she hopes the vaccine might ultimately be administered to adolescents.
Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, said the vaccine's advancement to Phase II trials is a significant achievement. GeoVax's Phase I data are "compelling and warran[t] taking (the vaccine) into Phase II," he said. "But there is still much more to be done," Warren said. He added, "You are not looking for efficacy in these trials. That comes later in much larger trials. With GeoVax, they're still in the early phases of product development. The early data look good. If it looks good after Phase II, it will go into Phase III. There are still a number of more hurdles."
Warren noted that several candidates have advanced to Phase II trials, adding that two of three that advanced to Phase III have failed. Don Hildebrand, board chair of GeoVax, said that "only a handful of AIDS vaccines have reached" the same level of evaluation as GeoVax's (Atlanta Journal-Constitution, 5/8).
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Rapid HIV Tests Highly Effective in Preventing Mother-to-Child HIV Transmission in India, Study Finds
[May 08, 2008]
Rapid HIV tests have been found to be highly effective in preventing mother-to-child HIV transmission in clinical trials in India, according to a study published online Tuesday in PLoS Medicine, the Times of India reports (Sinha, Times of India, 5/7). For the study, the researchers used OraSure Technologies' OraQuick Advance Rapid HIV 1/2 Antibody Test (Derfel, Montreal Gazette, 5/6).
The OraQuick test requires users to swab their gums and then place the swab in a holder. After 20 minutes, one line appears on the strip if the test result is negative and the person is HIV-negative, and two appear if the result is positive and the person is HIV-positive. Positive results require a follow-up test with a medical professional for confirmation (Kaiser Daily HIV/AIDS Report, 4/1). According to the Gazette, although standard blood tests are available in India, they are not always accessible. In addition, it can take up to two hours to receive results from standard blood tests, and laboratory technicians are not on call during the evening to administer the tests -- meaning that most women give birth without being tested for HIV (Montreal Gazette, 5/6).
For the study, Nitika Pant Pai of the division of infectious diseases at McGill University's Health Center and colleagues administered both an oral HIV test and a traditional blood test to 1,222 pregnant women during a nine-month period in the labor ward of the Mahatma Gandhi Institute of Medical Sciences in India. The results from both tests corresponded in 100% of cases, the researchers found (ANI/DailyIndia.com, 5/6). Of the participants, about 82% had never taken an HIV test, according to the study. The tests found that 11 women were HIV-positive. These women were given antiretroviral drugs to prevent MTCT. According to the study, 10 of these infants survived and tested negative for HIV.
According to the World Health Organization, there were 420,000 new HIV cases among children reported last year in India, most of which occurred through MTCT (Montreal Gazette, 5/6). "Most Indian women do not receive prenatal care and therefore do not get tested for HIV during pregnancy," Pai said, adding, "Testing in the labor ward is the last chance to prevent" MTCT (ANI/DailyIndia.com, 5/6). In addition, "Indian patients often refuse blood collection in fear" of being ostracized, but "saliva collection poses no problem," according to Pai (Times of India, 5/7). Pai suggested that the OraQuick test should become a standard procedure in India, as well as in South Africa and China (Montreal Gazette, 5/6).
The study is available online.
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Global Challenges
New HIV Cases Increasing in Germany, Institute Says
[May 08, 2008]
The number of new HIV cases reported in Germany increased by 4% in 2007, according to data recently released by the Robert Koch Institute, Xinhua/People's Daily reports. The country recorded 2,752 new HIV cases last year, compared with 2,643 in 2006, the institute said (Xinhua/People's Daily, 5/6).
There was a 12% increase in the number of new HIV cases reported among men who have sex with men, according to the institute. The researchers said that cases among MSM account for about 65% of all HIV cases in Germany, Deutsche Welle reports. New confirmed HIV cases declined among injection drug users and immigrants from countries with high HIV/AIDS burdens, the institute said (Deutsche Welle, 5/7).
However, new cases increased by 7.5% overall among heterosexuals, the data showed. Cases increased by 8% among men and declined by 12% among women. The institute said that urban areas -- including Berlin, Cologne, Duesseldorf, Frankfurt, Hamburg and Munich -- had the highest HIV risk (Xinhua/People's Daily, 5/6).
HIV/AIDS rates in Germany have increased steadily since 2001, which could be in part because of an increase in testing and early diagnosis, Deutsche Welle reports. RKI President Joerg Hacker noted that one of the "little-known reasons" for the increase in new HIV cases is the high number of syphilis cases in Germany. Germany has seen an increase in syphilis cases annually since 2004, Deutsche Welle reports. There are about 59,000 HIV-positive people living in the country (Deutsche Welle, 5/7).
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Namibia To Launch Pilot HIV Testing, Counseling Project
[May 08, 2008]
The Namibian Ministry of Health and Social Services will launch a pilot project to provide no-cost HIV testing and counseling in certain regions of the country to mark its National HIV Testing Day on May 9, Namibia's New Era reports. The project will run in the Caprivi, Erongo, Oshana, Karas and Khomas regions for three days beginning on May 8. According to Oshana Health Director Naftali Hamata, the goal of the project is to encourage communities to access counseling and testing services, as well as to persuade large numbers of people to learn their HIV status. Hamata called on all members of the community, particularly men, to access no-cost testing and counseling at any health facility during the project time frame.
"Many a time, people, and especially men, are seeking counseling and testing when they are referred by doctors, getting married or for insurance," he said, adding, "More often they come to hospital when they are already wasted and appropriate assistance can no longer be given." Hamata also called on people who are unaware of their HIV status to be tested. "Knowing our status will help us to plan our future, live positively and be productive," he said. All regions involved in the project are required to meet specific targets, according to the New Era. Oshana is required to offer testing and counseling to 2,244 people during the three days of the project. The region last year provided testing to 21,558 people (Ingwafa, New Era, 5/7).
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HIV/AIDS Funding in Tanzania Expected to Total $476M, Government Report Says
[May 08, 2008]
Funding for HIV/AIDS in Tanzania from the government and international donors from 2007 to 2008 is expected to total more than 568 billion Tanzanian shillings, or about $476 million, according to a recently released government report, the Africa Science News Service reports.
According to the report, aid from the U.S. and the Global Fund To Fight AIDS, Tuberculosis and Malaria accounted for 86% of donor support in 2007 and might increase to more than 90% in 2008. In addition, the report found that funding for HIV/AIDS services is expected to equal 10% of all public expenditure in the country, or about 3% of Tanzania's gross domestic product.
The report also noted that in 2006, HIV treatment and care represented 64% of combined U.S. and Global Fund aid. HIV prevention accounted for 15% of total expenditure, and economic and social support accounted for 8% in 2006, the report found.
The report also predicts continued increases in HIV/AIDS aid at levels of more than 500 billion shillings, or about $419 million, in 2008. However, the increase is based on the confirmation of a proposed increase in funding from the President's Emergency Plan for AIDS Relief to $300 million, Africa Science News Service reports (Neondo, Africa Science News Service, 5/7).
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