Kaisernetwork.org (Washington, DC)
7 August 2008
AIDS 2008
Fauci, Piot Discuss Progress in HIV/AIDS Treatments, Prevention
[Aug 07, 2008]
National Institute of Allergy and Infectious Diseases Director Anthony Fauci and UNAIDS Executive Director Peter Piot on Wednesday at the XVII International AIDS Conference in Mexico City discussed progress in HIV/AIDS treatments and prevention efforts and the future of HIV treatment, Bloomberg reports.
According to Fauci, HIV-positive people eventually might be able to stop taking drugs and live without symptoms if they are treated aggressively with newer antiretroviral drugs. Treating patients soon after they are contract HIV could protect the immune system and suppress their viral loads, allowing them to slowly stop taking the drugs.
Fauci said that he believes physicians will someday "be able to ... eradicate HIV microbiologically" in "some patients, not very many," and have a "functional cure" for others. He said such a possibility "will likely require aggressive drug regimens and rely on the timing of initiating therapy." A "cure will likely require early diagnosis and treatment," Fauci said, adding, "Studies need to be done in [the] next few years to determine if very aggressive therapy early on will allow us to get a functional cure." In addition, a vaccine that targets people with a specific genetic makeup could be available within 20 years, Fauci said. Fauci said that while research into an HIV vaccine is ongoing, researchers also are looking into using antiretrovirals to prevent HIV.
Piot said that the pharmaceutical industry needs to continue to invest in the development of new HIV treatments and look into the possibility of using existing antiretrovirals to prevent HIV transmission. "We have to make sure the drug development remains in step with the evolution of the virus and that industry continues to invest," Piot said, adding that there are "worrying signs that that isn't the case, and that is something we have to put on the table."
In addition, effective prevention methods that target men who have sex with men, commercial sex workers and injection drug users need to be scaled up to slow the spread of the virus, Piot said, adding that health workers also must learn how to target prevention messages more effectively. "No company will try to sell soap if they haven't done research for the community they are trying to sell to," Piot said, adding, "It would pay off if we could bring that experience from the business world to our amateur approaches" to HIV prevention campaigns (Pettypiece, Bloomberg, 8/6).
Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference. A webcast on AIDS research featuring Fauci and Piot is available online.
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Efforts To Fight HIV/AIDS Not Reaching Enough Children, Health Workers at Conference Say
[Aug 07, 2008]
Despite significant funding for HIV/AIDS treatment in the developing world and efforts to prevent mother-to-child transmission, the global response to the disease has "short-changed" children, health workers at the XVII International AIDS Conference in Mexico City said Wednesday during the conference's first plenary lecture on children, the New York Times reports. In the past five years, 1.5 million children have died of AIDS-related causes, and 15 million children have lost one or both parents to the disease, according to Michael Sidibe, a UNAIDS official. An estimated two million children younger than age 15 are HIV-positive.
Jim Yong Kim of Harvard University said that about 6% to 10% of children in need of antiretroviral drugs receive them, compared with 30% of adults (Altman, New York Times, 8/7). In addition, fewer than one in 10 infants in low- and middle-income countries were tested for HIV within two months of their birth, despite new evidence that early treatment significantly increases their chances of survival, South Africa's The Star reports (Green, The Star, 8/7).
Linda Richter, a psychologist in South Africa who delivered the lecture, said too little government and donor money reaches children living with HIV/AIDS. What money is allocated toward children with HIV/AIDS generally goes to consultants and overhead costs, according to Richter (New York Times, 8/7). Richter said HIV in children has increased eightfold in sub-Saharan Africa, where 90% of the world's HIV-positive children live. The increase is largely the result of MTCT, as many pregnant women did not know they were HIV-positive or did not have access to prevention services (The Star, 8/7). Too few pregnant women receive the antiretroviral drugs that could prevent transmission of HIV, Richter said.
Richter said that although the news media have often focused on the experience of AIDS orphans, "children orphaned by AIDS are, sadly, only the tip of the iceberg of HIV-affected children" (New York Times, 8/7). "It is the needs of all children, especially vulnerable children, not whether they meet the definition of orphan, that must be our primary focus," Richter said, adding, "The focus on orphans had individualized the challenge of care and support. It has framed the epidemic's impact on children as individuals rather than a national social problem and has separated assistance to children from efforts to support families and communities" (The Star, 8/7).
Richter, who said all children in communities severely affected by HIV/AIDS require psychological, nutritional and other support, added that treating children in HIV/AIDS programs would be more effective and efficient if money went directly to families and communities. She added that low-income people have shown that they make good decisions about obtaining food and other provisions and that financial barriers, including bus fare to treatment centers, often prevent women from taking their children for medical care.
A report released by the Joint Learning Initiative on Children and HIV/AIDS said that governments and donors should develop new approaches to help children most affected by the disease. Other speakers during the lecture said that children would be better served through a study of family dynamics. Lorraine Sherr of University College London said that more needs to be done to help families cope psychologically following the death of an HIV-positive family member (New York Times, 8/7).
Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference. Related webcasts include:
The plenary session featuring Richter.
A Joint Learning Initiative event.
A session on Achieving Universal Access for Young People.
Link to this story.
U.N. Goal of 'Universal Access' to Antiretrovirals Unlikely To Be Reached Worldwide
[Aug 07, 2008]
The United Nations' goal of providing universal access to antiretroviral drugs by 2010 is unlikely to be reached by some countries, Michel Kazatchkine, executive director of the Global Fund To Fight AIDS, Tuberculosis and Malaria, and Peter Piot, executive director of UNAIDS, said on Wednesday at the XVII International AIDS Conference in Mexico City, AFP/Yahoo! News reports. The 2010 target was agreed to at a 2006 United Nations General Assembly meeting and later supported by the Group of Eight industrialized nations.
Kazatchkine and Piot said they believe U.N. members are still committed to the target, but they doubt the goal would be reached by every country. "2010 is 18 months from now. What we've seen is that in a number of countries, they've already reached their universal access targets, others not." According to Piot's spokesperson, some countries could achieve universal access in 2011 or 2012, which is in line with their national programs. Kazatchkine said, "When we look at global targets, none of us believes that it will be 100% everywhere," adding, "But if you look at individual countries, and if you look at the percent that have achieved universal coverage or (will) be close to universal coverage, there may be much more than you think of."
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