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04Dec

Michel D. Kazatchkine: No Funding, No AIDS Free Generation

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In a modern, globalized world, the country in which you live or the income you earn should not determine whether or not your child will become HIV positive. And yet in my country, France, only three babies were infected last year with HIV during their mothers’ pregnancy, labor, delivery, or when breastfeeding, while globally, 390,000 babies were born HIV-positive, most of them in Sub-Saharan Africa. Without medical intervention, nearly half of these babies will die before their second birthday.

In 2012, we can and must do better. We can prevent millions of new infections, and get ahead of the AIDS epidemic because it costs less than $1 per day to give a mother medicine to prevent this type of transmission. That is why the global health community has set its sights on the virtual elimination of mother to child transmission of HIV by 2015. Reaching this goal is possible if we increase funding so that every woman living with HIV has access to the life-saving drugs she needs. Since 2000, the Global Fund has assisted over one million pregnant women in this way. This is a great achievement but sadly, we are still reaching only half of those who need our help. To achieve the goal of an “AIDS free generation” resources are the key. Simply stated: without resources, there are no results.

It was the administration of George W. Bush that established the President’s Emergency Plan for AIDS Relief (PEPFAR) and provided funds for the Global Fund to Fight AIDS, Tuberculosis and Malaria. Both have enjoyed widespread bi-partisan support in Congress. Secretary of State Hillary Clinton has continued US leadership in the fight and recently announced the Obama Administration’s support for an AIDS free generation by 2015.

It is my hope that in these times of austerity, Congress will continue turning the tide against the HIV/AIDS pandemic. Now is not the time to let economic challenges erode the gains made at the expense of the most vulnerable, those least to blame for the financial crises and those most in need. We know the impact and results that our resources can have and also that the sums required to make an AIDS free generation possible will neither save nor break the national budget of any developed nation. To support our leaders in this endeavor, it is essential that we stand together to protect and build upon the gains we have made in global health. Governments throughout the world, consumers of (RED) products and corporations like Chevron have given unprecedented sums to the Global Fund to Fight AIDS, Tuberculosis and Malaria to achieve the success that we have seen to date. For example, since May 2006, the Ghana AIDS program has received more than $50 million of the $180 million raised by (RED). This has contributed, amongst other things, to nearly 500,000 pregnant women receiving testing and counseling for HIV (the equivalent of 5 Super Bowl audiences), and over 13,000 HIV-positive pregnant women receiving medication to stop transmission of HIV to their child.

While donor budgets are constrained, people’s generosity is not. When I see people buying (RED) products — a deliberate and well informed consumer choice — I see that generosity. It helps me to sustain my belief and hope that we can end the AIDS epidemic.

(RED) is a way that any individual consumer can take part in the global fight against AIDS. Every dollar raised is a dollar that purchases medicines or helps provide much needed medical services. Please support the fight against the AIDS pandemic and help to end mother to child transmission of HIV by choosing to buy (RED) products; joining organizations such as ONE to keep your political leaders’ focus on the goal of an AIDS free generation; donating directly to the Global Fund via www.joinred.com; or just spreading the word that everyone has a role to play in fighting AIDS.

By founding (RED), Bono has used his tremendous influence to enable millions of consumers to take part in the fight against AIDS. His support for the Global Fund has been unwavering and inspirational. This World AIDS Day, I will be in Washington D.C. with Bono to celebrate our achievements, but, more importantly, to encourage both governments and businesses to keep up the fight against AIDS. Join us!

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Follow Michel D. Kazatchkine on Twitter: www.twitter.com/kazatchkine

Source: http://www.huffingtonpost.com/michel-d-kazatchkine/no-funding-no-aids-free-g_b_1122505.html

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04Dec

NYC recommends AIDS drugs for any person with HIV (AP)

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NEW YORK ? Health officials in the nation’s largest city are recommending that any residents living with HIV be offered AIDS drugs as soon as the virus is diagnosed, an aggressive move that has been shown to prolong life and stem the spread of the disease.

Standard practice has been to have patients put off the expensive pill regimen ? which can cost up to $15,000 a year in the United States ? until the immune system weakens.

But New York City Health Commissioner Thomas Farley said recent studies have shown that the benefits of early treatment, combined with education and testing, appear to be a promising strategy for countering the epidemic.

“I’m more optimistic now than I’ve ever been about this epidemic that we can drive our new rates down to zero or close to it ? eventually. I don’t know how soon. But I’m very optimistic of the direction that it’s going to take the epidemic to,” Farley said Wednesday.

More than 110,000 people in New York City are infected with HIV, more than in any other U.S. city and about 75 percent of all cases in the state. San Francisco, which had more than 18,000 people living with HIV, is believed to be the only other major city to have made a similar recommendation, in 2010.

City health officials said the new recommendation could initially help about 3,000 people get on medications. About 66,000 New Yorkers living with HIV that the Health Department tracks are being effectively treated with AIDS drugs, they said. But they said it was difficult to estimate how many people would eventually need the medications.

Some doctors agree with the Department of Health that it is time to update the guidelines for initiating AIDS drug treatment.

“The New York City health department is a little bit ahead of the curve. In my opinion, the rest of the country will follow, and I think it will be pretty quick,” said Dr. Michael Saag of the University of Alabama at Birmingham and past chairman of the HIV Medicine Association.

The standard measure of the CD4 count ? a way to measure the strength of the immune system ? is an outdated trigger for therapy, a relic from research on early antiretroviral drugs, Saag said.

“It’s an anachronism. It’s old school. It’s yesterday,” Saag said. “I agree completely with the New York City health department.”

Dr. Joel Gallant of Johns Hopkins University School of Medicine and vice chair of the HIV Medicine Association also agrees with the New York recommendation for offering early treatment. He recommends early treatment for his own patients.

“Nobody I know who is an HIV expert feels that it’s a bad idea to treat HIV at high CD4 counts from a medical or scientific standpoint,” Gallant said. “If there are objections, they’d usually be based on cost or feasibility.”

Saag said the cost questions are very important because brand-name drugs can retail for $1,200 to $1,600 per month.

“For sure, they’re very expensive drugs and we should be careful about that,” he said, though he added that the medications are going generic so costs should come down.

City health officials said they anticipated that the cost for expanding the use of AIDS drugs would be covered by private insurance or by the AIDS Drug Assistance Program, a $270 million program for the uninsured or underinsured that is partially funded through federal dollars. The health officials said they expect the benefits over the long term would far outweigh the initial costs because there would be fewer hospitalizations and new HIV cases.

“There will be some increasing costs over the short term,” Farley said. “But over the long term, it’s absolutely the right thing for the epidemic.”

HIV experts are split about whether early therapy should be recommended or optional. Besides the high costs, the pills have side effects from nausea to liver damage. Patients unwilling to take them religiously for life could develop drug resistance.

A panel that recently updated U.S. guidelines was divided evenly, with half favoring starting therapy early for everyone and half regarding an early start as elective.

But there’s growing evidence that untreated HIV can lead to cancers and heart disease. What’s more, antiretroviral drugs are safer, have fewer side effects and work better than they did in the past. New research also indicates that people live better, healthier lives and their sex partners are less likely to get infected.

The new research cited by the city’s Health Department in making its recommendations includes a nine-nation study whose preliminary results were announced earlier this year and showed that earlier treatment meant patients were 96 percent less likely to spread the virus to their uninfected partners.

Dr. Moupali Das, the director of research at the San Francisco Department of Health HIV Prevention Section, said its surveillance data indicated that physicians were treating their HIV patients early even before the city recommended doing so. She said the average amount of time from diagnosis to having no virus in the blood went from 32 months in 2004 to eight months in 2008.

“That reflects that the newer medications are more potent and efficacious, and the doctors were likely initiating them earlier,” she said.

She said they are currently analyzing what has happened since the recommendations went into effect. But, anecdotally, she said that there has been a change among patients seeking treatment. “It’s changed the dialogue and empowered our patient population,” she said.

Public health experts predict the guidelines for starting AIDS drugs treatment will shift toward a clear recommendation for early treatment.

But New York City’s health commissioner said officials there could not wait to respond.

“What we’re doing here is we’re making a really clear and unequivocal statement that we think this is good for the health of the patient, good for the health of the entire population, good for the response to the epidemic,” Farley said.

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AP Medical Writer Carla K. Johnson in Chicago contributed to this report.

Source: http://us.rd.yahoo.com/dailynews/rss/health/*http%3A//news.yahoo.com/s/ap/20111201/ap_on_he_me/us_aids_prevention

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