AIDS Therapy Under $100 Per Year Possible and 13 Other International HIV/AIDS Brief Updates  

 Humanitarian Times

(July 18, 2002) - $100 THERAPY IN SIGHT, WHILE ACCESS, DISTRIBUTION & TARGETING GREW in attention for Barcelona's participants.  A session organized by Health Gap Coalition & MSF proposed centralized procurement & further competition between generic & proprietary drug manufacturers, to lower prices of triple-antiretroviral therapy to below $100 per therapy per year.  The Pan American Health Org (PAHO) recently reported that the prices of anti-retroviral drugs fell 54% between May 2001 & May 2002 in Latin American/Caribbean countries. 
(www.paho.org/English/HCP/HCA/analysis.pdf).

-  BARCELONA CONF CONCLUDES WITH NO AIDS CURE & NO HIV VACCINE IN SIGHT
Participants learned that an effective immune response to one strain does not imply protection against other strains; thus, the feasibility of a vaccine that protects against all HIV strains (among 10 subtypes) seems less feasible.  While some scientists argued that anti-retroviral drugs can never fully cure AIDS, new studies of T-20 (fusion inhibitors) showed its efficacy in reducing viral loads.  The extent of AIDS in Asia, Latin America & E. Europe has grown in recent literature. 

In closing the conf, Nelson Mandela highlighted the problems of AIDS orphans who are ostracized from their communities.  The popular children's television show Sesame Street will introduce a new HIV- positive character to show children that it's okay to touch, hug & work with HIV infected persons.  However, under consequent attack by conservative politicians in the US, the US public broadcasting service yesterday said it would not allow the HIV-positive character to appear on TV in the US.

- COMMON SPERMICIDE (NONOXYNOL-9) DOES NOT PROTECT AGAINST HIV infection, as previously believed, nor against gonorrhea or chlamydia, according to a June 28, 2002 report of WHO. 

- NEW "REFUGEES & AIDS:  WHAT SHOULD THE HUMANITARIAN COMMUNITY DO" by the Women's Com. for Ref Women & Children, reviews protocols & strategies for AIDS control, stresses human rights of refugees, &
promotes the Minimum Initial Services Package (MISP) of reproductive health for emergencies.  (see www.womenscommission.org/reports )

- OXFAM URGES $8Bn DONATIONS THIS YEAR TO THE GLOBAL FUND FOR HIV/AIDS
TB & Malaria in new policy paper, "False Start of New Start" (Oxfam, July)  which also encourages keeping allocations transparent.

- HIGH LEVELS OF HIV INFECTION IN SOUTH AFRICAN ARMY DEBATED
this week:  The Min. Defense said only 17,500 troops (out of 76,000) are HIV-positive to rebut a newspaper claim that 60% are.

- I.C.M.H. REPORTS EXAMINE HIV, FORCED MIGRATION, SECURITY & MILITARIES with a focus on Africa.  ICMH, the Int'l Center for Migration & Health, established jointly by IOM & WHO & based in Geneva, pioneered inquiry into population movements, military movements, sexual violence & AIDS.  Its 2002 "HIV/AIDS and Security" consolidates data on HIV incidence & risk factors in uniformed personnel.  Email:  admin@icmh.ch or  fax: (41 22) 783 10 87.  see:  www.icmh.ch  

-REPORT FINDS THAT MORE THAN 13.4 MILLION CHILDREN HAVE LOST ONE OR BOTH PARENTS TO AIDS. The report, entitled Children On the Brink. is jointly published by USAID, UNAIDS and UNICEF.

- NEGATIVE POPULATION GROWTH PROJECTED BY 2010 FOR 5 AFRICAN COUNTRIES
concludes a July 7-released study by USAID & the US Census Bureau, The
AIDS Pandemic in the 21st Century  that also estimates that in 2010 more infants will die of HIV than all other causes in Botswana, Zimbabwe, S. Africa & Namibia, countering other child health successes.

- "STEPS FOR THE FUTURE" FILM SERIES PORTRAYS LIFE IN AFRICA WITH AIDS
including documentaries showing on television in southern Africa, & this week in New York.  See:  www.steps.co.za

- COST-EFFECTIVE AIDS STRATEGIES COMPARED IN JULY 6 LANCET ARTICLES.
Grulich & Kaldor compare the limits & values of prevalence vs.incidence data, the importance of sentinel site surveillance & the newer behavioral surveys in Africa, now collectively showing some success in reduced HIV transmissions (such as Uganda).  Reviewing Uganda's experience, Weidle et al. find HAART therapy delayed death better than 2NRTI, & write, "Int'l donor resources can be used to
ensure capacity for effective drug management systems, availability of trained health-care staff, laboratory infrastructure, social services, HIV prevention, & regulatory oversight."  Stover et al. use a complex epidemiological model to show that scaling up successful AIDS prevention efforts would "prevent 29mn new infections by 2010" & "reverse the growth of epidemics." Peter Piot et al. also defended treatment:  "the economic justification for HAART is its leverage effect on HIV prevention & its potential to secure the future against disabling social & economic ills."

- "PREVENTION CAUSES REVERSAL" OF HIV EPIDEMIC WRITES Dr. GARY SLUTKIN
in NY Times July 7 letter.  Slutkin  (Univ. of Illinois Prof of Int'l Health), emphasizes that what worked in Uganda in the 80s & 90s was "community information, education & mobilization campaign in almost every district and village in the country.  Intensive & regular training occurred for more than 20 organizations & groups - from the political party & resistance committees to women's groups & refugees."

- AIDS FOCUS IN July 10 JOURNAL OF AMERICAN MEDICAL ASSOCIATION (JAMA)
has updated therapeutic protocols for HIV-infected adults: e.g.,because of toxicity of current drugs, "the threshold for initiation of therapy has shifted to a later time in the course of the disease." Dorenbaum et al. find, from a prospective cohort study in the US that hepatitis C infection does not increase the risk of HIV infection.
Grant et al. report that HIV resistance to reverse-transcriptase inhibitors continues to rise.

- REVISED "GUIDELINES FOR HIV INTERVENTIONS IN EMERGENCY SETTINGS" DUE
by the end of 2002 through the working group of the UN Inter-Agency
Standing Committee (UN), under WHO Chair.

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