Tamar Kahn
5 August 2008
Mexico City — The 17th World AIDS conference opened this week, with global leaders warning against complacency and urging the world to do more to prevent the spread of HIV/AIDS.
"For the first time, fewer people are dying of AIDS and fewer people are becoming infected with HIV ... (but) the end of AIDS is nowhere in sight," the executive director of the United Nations joint programme on HIV/AIDS (UNAIDS), Peter Piot, said at a press conference .
For every person who started treatment, almost three more became infected, he said.
And although the world had made tremendous strides in getting treatment to HIV-positive people - 3- million of them in the developing world - twice as many people were still unable to get life-saving medication .
About 33-million people were living with HIV last year , 2,7-million became newly infected and 2-million died, according to UNAIDS.
Piot's call for fresh energy in preventing new HIV infections was echoed by former Botswana president Festus Mogae, who urged African leaders in particular to devise new ways to combat the disease.
"Substantial progress has been made on treatment, but the (prevention) message isn't getting through despite our best efforts," he said. Sub-Saharan Africa is home to 22-million HIV-positive people, two-thirds of the global total.
The week-long conference is being held in Latin America for the first time in a bid to draw attention to regional issues such as how to prevent HIV/AIDS spreading among men who have sex with men - a taboo subject in many conservative communities in the region.
SA, with the world's biggest HIV-positive population - 5,7-million people according to the latest estimates from the UN - and large HIV/AIDS research community, also features prominently on the programme.
SA's Deputy Social Development Minister Jean Swanson-Jacobs expressed concern over the financial cost of providing life-long treatment to the growing number of HIV-positive patients in SA. By June, 510000 patients had been enrolled in the government's treatment programme, making it the largest in the world.
"We are anxious about the affordability of this programme - we need cheaper drugs, cheaper diagnostic tools, but most importantly we need to make HIV prevention effective." The cost of treatment was a global concern, she said.
More than 90% of the patients receiving antiretroviral therapy at state clinics and hospitals were on relatively cheap first-line regimens, but in time many of them would need to switch to more expensive second-line therapy, the health department's HIV/AIDS head, Nomonde Xundu, said.
Earlier in the day, Cape Town scientist Andrew Boule presented a study at a satellite session that highlighted drawbacks in using nevirapine for HIV-positive patients who were also infected with tuberculosis.
Patients who were co-infected with HIV and TB fared better if their cocktail of HIV drugs included efavirenz instead of nevirapine as they were better able to suppress the virus and had fewer side effects than those receiving a nevirapine-based combination.
While the study, published this week in the Journal of the American Medical Association , does not have immediate implications for SA, which already provides efavirenz to patients infected with TB and HIV, it raises difficult questions for most other sub-Saharan African countries since they provide co-infected patients with three-in-one pills containing nevirapine.
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