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AIDS 2010: Number Of HIV-Positive Patients On ARVs Grew To 5.2M In 2009 With 10M Still In Need, WHO Says

“The number of HIV-positive people receiving antiretroviral drugs [ARVs] for their infections jumped by more than a quarter in 2009, growing from 4 million to 5.2 million, the World Health Organization said Monday at the International AIDS Conference in Vienna,” the Los Angeles Times reports (7/19).

“Between 2003 and 2010, the number of patients receiving lifesaving antiretroviral treatment increased twelve-fold, according to the Geneva-based body,” the Associated Press notes (Oleksyn, 7/19).

“This is the largest increase in people accessing treatment in a single year. It is an extremely encouraging development,” Hiroki Nakatani, WHO assistant director-general for HIV, tuberculosis, malaria and neglected tropical diseases, said in a statement issued by the WHO (7/19).

The WHO in November revised its HIV treatment recommendations, advising HIV treatment begin when the patient CD4 levels – a measure of immune system response – fall around 350, rather than 200  (Kaiser Daily Global Health Policy Report, 11/30). During AIDS 2010, the WHO will be calling for countries to begin earlier HIV treatment for patients living with HIV, “stating that early use of medicines also acts as a preventive measure by reducing levels of the virus in the body, so carriers are less likely to pass on the disease,” as well as helping slash rates of HIV-related deaths, Bloomberg reports (Craig, 7/19).

On Monday at AIDS 2010 the WHO “issued the first overhaul of its guidelines on HIV drugs in four years,” Agence-France Presse reports. In the 156-page report the WHO elaborated on the HIV treatment recommendations the agency issued last November, “along with many other guidelines on drug use, including second-line therapy if a first course of treatment fails,” the news service writes.

“Guideline revisions have an enormous impact, both for new patients and health budgets,” AFP writes. “Earlier initiation means that people will be exposed longer – about one or two years more, said the report – to ART’s side effects and the risk of viral resistance.” According to the WHO, the report will be updated again in 2012, AFP notes (7/19).

“WHO’s treatment guidelines expand the number of people recommended for HIV treatment from an estimated 10 million to an estimated 15 million. The cost needed for HIV treatment in 2010 will be about US$ 9 billion, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS),” according to the WHO statement.

“Starting treatment earlier gives us an opportunity to enable people living with HIV to stay healthier and live longer,” Gottfried Hirnschall, WHO director of HIV/AIDS, said (7/19).

“Earlier HIV treatment can prevent so-called ‘opportunistic infections’ including tuberculosis (TB), which is the biggest killer of people with HIV,” Reuters reports (Kelland, 7/19). “The agency estimated that AIDS-related deaths could be reduced by 20% from 2010 to 2015 if the new recommendation was widely adopted. Tuberculosis deaths … could be reduced by as much as 90% if people with both HIV and TB infections began treatment earlier,” according to the Los Angeles Times (7/19).

TV Shows Help Change Attitudes About HIV/AIDS

A study of MTV shows in Kenya, Trinidad and Tobago and Zambia designed to convey messages to young people about HIV/AIDS had “dramatic” results on attitudes about the disease, Reuters reports. Researchers found that the U.N.-backed shows changed the way young people think about HIV/AIDS, according to the study, released Tuesday at AIDS 2010, the news service writes (Kelland, 7/20).

“UNICEF and PEPFAR worked out priority messages to get across to young people through the story, about having multiple sexual partners, about the need to get tested for HIV, and about stigma,” the Guardian writes (Boseley, 7/20).

“MTV, with funding from the Bill & Melinda Gates Foundation, commissioned Johns Hopkins University to evaluate” the drama series, which reached youth in 96% of the Top 50 HIV/AIDS impacted countries working with over 85 broadcasters in over 100 countries,” according to a press release. The study “shows that young people understand the messages conveyed in [the TV series] Shuga, that young people talk about HIV issues after seeing the programme. Among those young people who have seen the programme, those who like and find the storylines realistic are more likely to change their attitudes and behavioural intentions around HIV and AIDS (towards healthier attitudes and behaviours),” the press release states (7/20).

“More than 80 percent of those who saw Shuga believed it changed their thinking about multiple concurrent partners, HIV testing and the stigma associated with” HIV, Reuters writes (7/20).

News Outlets Examine Search For AIDS Vaccine

“AIDS experts and advocates gathering in Vienna … will hear about progress in protecting people from the deadly virus using drugs, and ways to affect behavior. No breakthrough news is expected on a vaccine. But researchers are more hopeful than they have been in years that it may be possible,” Reuters reports in an article highlighting recent progress towards and AIDS vaccine.

“Two studies published in the past year have greatly raised hopes,” the news service writes. “In one published last September, a combination of two older vaccines lowered the infection rate by about a third after three years among 16,000 ordinary Thai volunteers. In a second study, published earlier this month, researchers discovered human antibodies that can protect against a wide range of AIDS viruses.”

“There has been a renaissance in AIDS vaccines,” Seth Berkley, president of the International AIDS Vaccine Initiative, said (Fox, 7/17). A related Reuters factbox notes some recent AIDS vaccine developments (7/18).

“Experts are optimistic that breakthroughs in HIV vaccine research are possible if they work together,” Inter Press Service writes in an article examining the quest to create an effective AIDS vaccine. According to IPS, the Global HIV Vaccine Enterprise, a collaborative group comprised of more than 400 scientists from around the world, plans to release a strategic plan in September. The article also discusses other prevention approaches and outlines why a vaccine is so desirable (Jaffer, 7/18).

Group Wants Investigation Of U.S. Trade Policy’s Affect On Drug Access; PEPFAR Saves With Generics

A coalition of health and HIV/AIDS organizations announced Tuesday that they had “formally asked” U.N. Special Rapporteur on the Right to Health Anand Grover to examine whether U.S. trade policies are “violating the health rights of millions of poor people around the world” because they can make it harder to access “life-saving drugs,” Reuters reports.

According to the groups, the U.S. has used an “annual report produced by the U.S. Trade Representative’s office that ranks countries with the worst records on protecting U.S. intellectual property rights for goods ranging from CDs to medicines … to pressure countries to give up certain public health rights they have under a World Trade Organization agreement on intellectual property rights known as TRIPS.”

“‘Up to and including the 2009 Special 301 report, Brazil, India, Thailand and other countries were threatened with sanctions under Special 301 for taking advantage of TRIPS flexibilities, including utilizing transition periods and issuing compulsory licenses’ to allow domestic firms to produce cheaper versions of drugs patented by U.S. companies, the groups said in their allegation letter to Grover,” Reuters writes. “This year’s Special 301 report again put Thailand on its ‘priority watch list,’ one step short of its most serious designation. The country has battled with U.S. drug companies over steps it has taken in its aggressive anti-AIDS campaign” (Palmer, 7/20).

In related news, a study published in the Journal of the American Medical Association shows that PEPFAR “saved an estimated $323,343,256 from 2005 to 2008 through the use of generic antiretroviral drugs (ARVs),” according to a press release issued by PEPFAR, Georgetown University’s O’Neill Institute and Supply Chain Management System.

“Among PEPFAR-supported programs in 16 countries, availability of generic ARVs was associated with increased ARV procurement and substantial estimated cost savings. While ARV expenditures increased from $116.8 million in 2005 to $202.2 million in 2008, procurement increased from 6.2 million to 22.1 million monthly packs. The proportion spent on generic ARVs increased from 9.2% in 2005 to 76.4% in 2008, and the proportion of generic packs procured increased from 14.8% in 2005 to 89.3% in 2008,” the press release states.

Ambassador Eric Goosby, the U.S. global AIDS coordinator, said, “Drugs are no longer the main driver of treatment costs, so in addition to savings from generics, the systems we’ve put into place for procurement and distribution are making efficiencies possible throughout national health systems. Our increasing efficiency is saving money that PEPFAR and the broader U.S. Global Health Initiative can use to save more lives – and that’s the bottom line” (7/18).

All of the Kaiser Family Foundation’s webcasts of select sessions from AIDS 2010 are available at www.kff.org/aids2010.

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