Test and Treat to End HIV in 40 Years

posted: 22/02/2010

A global public health strategy for testing and treating everyone with HIV is now being considered.
Health officials are considering a radical shift in the strategy against HIV that would see everyone tested for the virus and people with HIV then put on a lifetime course of drugs. The strategy, which would involve testing most of the world's population for HIV, aims to reduce the transmission so much that HIV would die out completely over the next 40 years.
 

Brian Williams, professor of epidemiology at the South African Centre for Epidemiological Modelling and Analysis in Stellenbosch, said that HIV transmission could be stopped within five years with the use of antiretroviral drugs (ARVs). "The epidemic of HIV is really one of the worst plagues of human history," Williams told the American Association for the Advancement of Science meeting in San Diego. "I hope we can get to the starting line in one to two years and get complete coverage of patients in five years. Maybe that's being optimistic, but we're facing Armageddon."
 

Two years of trials now
Major trials of this universal test and treat strategy are planned in Africa and the USA and will affect whether this becomes part of global public health policy in the next two years.
More than 30 million people are infected with HIV globally and two million die of the disease each year. But across the globe only 12% of those living with HIV get the treatment they need. The disease is overwhelmingly prevalent in sub-Saharan Africa, which accounts for a quarter of all HIV cases globally. Half of these are in South Africa.
 

Broadly the epidemic calculations are that a person with HIV may pass on HIV to between five to 10 others in their time with HIV. Treating people within a year of becoming infected can reduce transmission tenfold, enough to cause the HIV epidemic to die out.
 

Trials plans
In the trials, people will be offered HIV tests once a year, either as routine when they visit their GP, or through mobile clinics in more remote regions. Those testing positive will be put on a lifetime course of ARVs.
"Over the past 25 years we have saved the lives of probably two to three million people using antiretroviral drugs, but almost nothing we have done has had any impact on transmission of the disease," Williams said. "We have stopped people dying but we haven't stopped the epidemic."
If patients take ARVs when they should, the amount of virus in their bodies should fall so low that it becomes undetectable, and they are then extremely unlikely to pass the virus on.

Five years to see the results but worth the price
"The question is, can we use these drugs not only to keep people alive, but also to stop transmission and I believe that we can. We could effectively stop transmission of HIV in five years." Scientists estimate that the cost of implementing the strategy in South Africa alone will be $3bn-$4bn a year. The world currently spends $30bn (£19.4bn) a year on HIV research and treatment, a figure that some experts believe will double over the next decade.
 

Sub-Saharan Africa has seen a dramatic rise in cases of tuberculosis among HIV patients, who are also susceptible to other infections because their immune systems are weakened.
"If you factor in all of the costs, in my opinion, doing this would be cost saving from day one, because the cost of the drugs would be more than balanced by the cost of treating people for all of these other diseases and then letting them die," Williams said. "We're killing probably half a million young adults every year in the prime of their life just at the point where they should be contributing to society and the cost of that to society is enormous," he added. "The only thing that's more expensive than doing this is not doing this."
 

HIV patients in southern Africa are more likely to take ARVs when they should than people living in developed countries, according to health officials. The finding gives doctors hope that the blanket administering of drugs might suppress the virus enough that it dies out naturally.

George House Trust comment 

This assumes a great deal. We are still a long way from providing treatment to all the millions of people in sub-Saharan Africa who need it. This strategy would require us to deliver HIV treatment for vastly more people, reliably, day after day, for decades.

The computer prediction of the epidemic will be correct as long as every African does get tested for HIV every year, everyone who tests positive then starts taking antiretrovirals immediately and 98 out of 100 do not miss a dose. How would people in the UK respond if outsiders decided all adults in the UK must have a HIV test every year?

We know gay men in rich countries use condoms far less now than before effective treatment became available in the mid 1990s, but somehow it's assumed heterosexuals in Africa won't also use condoms less.  

Source

 

HIV and Children Booklet

posted: 03/02/2010

HIV & Children, NAM’s easy to read booklet is now updated and freshly available. It tells you all about HIV treatment and care for HIV-positive children.
 

Like all NAM's booklets it’s free to people with HIV

Or read them online 

or download the booklets as PDFs from them direct 
 

Get Health Insurance for Isle of Man or Channel Islands

posted: 26/01/2010

Anyone travelling to either the Channel Islands or Isle of Man, especially people with HIV, should get health insurance. The UK government cancelled the deal with the Channel Islands in April last year which allowed UK people to use the health service on the Islands free. From April 1st this year the deal is cancelled for people going to the Isle of Man.
 

EU health travel cards won't help

EU travel cards won’t work in the islands either, which are not part of the UK, nor part of the EU.
 

Anyone needing health care will either have to have health insurance or have to pay the full cost. The only treatment you will be able to have without insurance is at an Island hospital Accident and Emergency department but this will not include hospital admission to a ward.
 

Travel Insurance for people with HIV - links and click through to Next page for more

Source 
 

 

Keep Free Prescription Promise

posted: 21/01/2010

UPDATED 26 January - further information

Gordon Brown promised at the labour party conference in 2008 to end prescription charges for people with long term conditions like HIV. Over a year later people are still paying. Now the Prescription Charges Coalition of 20 charities has called on Gordon Brown to keep his promise.
 

‘Prescription charges are a deeply unfair burden on people with long-term conditions — those who need medicines the most for day-to-day quality of life', they say in their letter. ‘Patients should not be prevented by an NHS charge from accessing treatment to improve their quality of life.'
 

Time is short because of coming election

The charities said they hoped that the government would be able to find a way to implement this policy as soon as possible. Time is short – new regulations need to be tabled within the next month or the general election will shut the door to reform.
 

Join the campaign and email your MP

Email your MP here and back the campaign – it’s easy to help.

first source 
another report

HIV Drugs Patent Pool

posted: 18/12/2009

An international agreement to pool drug patents for HIV treatments has just been launched, putting even more pressure on drug companies to give up their monopoly rights to HIV drugs. The idea is to make low cost treatment far more widely available in poorer countries.
 

Unitaid, an international drug purchasing facility, voted for the pool in Geneva this week. It was welcomed by campaigners and the British government, which has strongly backed the idea.
 

Campaigners say millions of lives could be saved by drug companies giving up their patent rights to allow anti-HIV drugs to be produced cheaply by generic manufacturers. It would also allow different companies' drugs to be combined in simple-to-take multi-drug combination pills for people in the developing world.
 

The rich multi-national patent-holding drug companies would get a royalty in exchange while keeping their exclusive 20-year patent rights in wealthy countries.
 

'Victory' for developing world
"The Unitaid decision is a huge victory for those in need of HIV treatment around the world," Diarmaid McDonald, the co-ordinator of the umbrella group Stop Aids, said. "It will help to break down the patent barriers which stop people getting the drugs they need to stay alive. Unitaid and the UK government should be commended for their leadership on this." McDonald said the focus "now shifts to the big drug companies", adding: "It will test the sincerity of their rhetoric on helping the most vulnerable in our world."
 

People Campaigning

A grass roots campaign is asking people to email the ten leading drug multi-nationals with HIV patents to ask them to take the patent pool plunge.

Drug companies divided
"Companies like Gilead and Merck showed real leadership within the industry by speaking positively of the patent pool – they must now go beyond words and contribute their patents to the pool. The pressure will be on others within the industry to follow or to explain why they are willing to turn their backs on an initiative with such huge potential to save lives."
 

A small number of companies have so far shown a willingness to discuss flexibility over their patents, but the British firm GlaxoSmithKline (GSK) – a leading manufacturer of HIV drugs – is not interested.
Andrew Witty, GSK’s chief executive, said this summer that he had reservations and believed the company's price cuts and other initiatives would produce better results.
 

GSK under more pressure
McDonald said there had been meetings with GSK, but stressed that the company was a long way from committing to any involvement. "They have come up with lengthy questions and hesitations and concerns about the patent pool and have been less than co-operative in how they have engaged with the Unitaid task force," he added. "The pressure is going to increase on GSK to justify their rationale for walking away from an initiative which could save millions of lives."

Treatment at the crossroads
The international development minister, Mike Foster, applauded the board's decision. "The international community is at a crossroads in meeting the demand for HIV treatment," he said. "Last year, 2.7 million people were newly infected with HIV and 2 million people died from Aids – the need to make effective HIV medicines affordable for developing countries has never been greater. The Unitaid patent pool could be a key means of addressing the treatment crisis."
 

The UK is a founder member of Unitaid, along with Chile, Brazil, Norway and France. Much of its funding comes from a tax on airlines.
 

Michelle Childs, the policy director at Médecins Sans Frontières, the volunteer doctors organisation that pioneered the use of HIV drugs in the developing world, said the pool would be judged by its outcome. "We've been encouraged by the positive responses from a number of companies to our campaign in support of the pool," she said.
 

"Now that the pool has been given a green light, patent holders need to move from expressions of general support to firm and formal license commitments. We urge them to do so. This needs to happen fast as the clock is ticking for millions of patients."
 

Source

Unitaid report