White House marks World AIDS Day

Commemorating World AIDS Day on Wednesday President Barack Obama called for continuing to fight HIV/AIDS domestically and abroad, Agence France-Presse reports (12/1).

"At a time when so many men and women are living with HIV and AIDS every day, let's also recommit ourselves to build on the tremendous progress we've made both in preventing and treating the disease and ending the stigma and discrimination that too often surround it," Obama said in a video shown at a White House event to mark the occasion, CQ HealthBeat reports. "It is my hope that together we can move closer to the day when we eliminate this disease from the face of the earth," Obama said.

Addressing event attendees, Director of the National Institute of Allergy and Infectious Disease (NIAID) Anthony Fauci said, "I totally believe that we will be able to cure HIV in a subset of individuals." CQ HealthBeat continues: "He said the subset he is referring to is those who get into treatment early enough so that they don't have an 'enormous HIV reservoir that you are going to have to get rid of'" (Bunis, 12/1).

"We have saved millions of lives from AIDS over the past decade. By investing in what we know works, we can save millions more in the future," Secretary of State Hillary Rodham Clinton said in a statement marking World AIDS Day, the AFP reports (12/1). Clinton also said in the statement: "The Obama administration has made the fight against AIDS central to the Global Health Initiative, our commitment to strengthening global health systems and implementing sustainable solutions to improve the health of entire communities. One major focus of the Global Health Initiative is strengthening our partnerships around the world so they reflect and reinforce the global effort needed to defeat AIDS" (12/1).

PEPFAR on Wednesday released updated results from its programs, according to a State Department press release. "[T]he U.S. is directly supporting life-saving antiretroviral treatment for more than 3.2 million men, women and children worldwide as of September 30, 2010, up from less than 2.5 million in 2009. In the coming years, the U.S. has committed to directly support more than four million people on treatment, more than doubling the number of people directly supported on treatment during the first five years of PEPFAR," the release states.

The release also noted the U.S. commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria:
"Of the estimated 5.2 million individuals in low- and middle-income countries who currently receive treatment, nearly 4.7 million receive support through PEPFAR bilateral programs, the Global Fund, or both. The U.S. is the first and largest donor to the Global Fund, having provided more than $5.1 billion to date and announced an historic multi-year pledge of $4 billion for 2011-2013, a 38 percent increase in U.S. support" (12/1).

CQ HealthBeat also quotes statements from former President George W. Bush's Washington Post opinion piece calling on Congress to maintain its commitment to AIDS funding, which appeared in the newspaper Wednesday (12/1). AFP notes President Bill Clinton's appeal Wednesday in an opinion piece in the Independent Wednesday for efforts to be made to find ways to fill gaps in funding for global HIV/AIDS programs and "save more lives with the money we do have" (12/1).

Talk Radio News Service notes several ways to reduce costs in global HIV/AIDS programs supported by the U.S., as described by U.S. Global AIDS Coordinator Ambassador Eric Goosby. "He says small changes like switching the distribution systems from air to ground transport or cooperating with the FDA to increase the amount of affordable generic drugs available have freed up millions of dollars that can now be better used to carry out hands-on high impact interventions, such as an aggressive prevention programs," the news service writes.

"Better understanding where the new seroconversions are and then positioning our prevention interventions in front of those expanding movements of the virus through that population is a central piece of every prevention strategy and at the core of all of our prevention programs," Goosby said, according to the news service (11/30).

Global Health Leaders Reflect On Progress, Challenges In Global HIV/AIDS Fight

While marking gains made in the global fight against HIV/AIDS, International AIDS Society (IAS) President Elly Katabira warned against HIV/AIDS complacency, VOA News reports. "Particularly, I'm concerned that some people are beginning to take it light(ly)," Katabira said. "For example, thinking that since drugs are available, therefore the disease is treatable. ... And also I know, particularly in countries where the epidemic is a major issue, the contribution for funding for access to care is not as what we would want it to be," he added.

Katabira also warned that more funding is needed for global HIV/AIDS programs: Some "people believe that AIDS has received already enough money and therefore they don't need any more. We need to change that and keep reminding them that, yes, the battle is not yet over," he said. Katabira noted that he hoped 2011 would see "more commitment for accelerated access to HIV care" and changes to legislation in some countries that drive high-risk populations underground (DeCapua, 12/1).

"Our common goal is clear: universal access to HIV prevention, treatment, care and support. We must also work to make the AIDS response sustainable," U.N. Secretary-General Ban Ki-moon said in a statement, U.N. News Centre writes. "Three decades into this crisis, let us set our sights on achieving the 'three zeros' - zero new HIV infections, zero discrimination and zero AIDS-related deaths," Ban added.

"There is no room for complacency, and we must do more and better to ultimately reverse the epidemic," President of the U.N. General Assembly Joseph Deiss said. "This is a clear message for the United Nations General Assembly, when world leaders will gather in June 2011 to review progress made in fighting the epidemic and in achieving universal access to HIV prevention, treatment, care and support by 2010." U.N. News Centre includes quotes from WHO Secretary-General Margaret Chan, Executive Director of UNAIDS Michel Sidibe and Director of WHO's HIV/AIDS Department Gottfried Hirnschall (12/1).

Media Outlets Examine HIV/AIDS Epidemic In E. Europe, Central Asia

Deputy Executive Director of UNAIDS Paul Delay ahead of World AIDS Day warned that "complacency among young people" is driving the spread of HIV/AIDS in some regions, according to Agence France-Presse. "There seem to be secondary and tertiary waves of the epidemic, particularly the sexually transmitted side," De Lay said, according to the news service. "You have a young people who don't know enough about AIDS, there is less of a fear factor about it."

"In Eastern Europe and Central Asia 'there has been been an explosion of young people who are experimenting with injected drugs,' according to [De Lay]. "This is 'ripe' for spreading HIV/AIDS and pregnant addicts pass on the infection to their children extending 'an ongoing transmission cycle,' said De Lay" (12/1).

"Russia has become the epicentre of the global HIV pandemic, even as infection rates plateau in the rest of the world," the Financial Times writes in an article that examines the government's failure to invest in HIV education and prevention strategies in the region. "The Kremlin has mobilised funds to combat the virus, citing AIDS as a threat to national security. But while the budget for treatment is rising rapidly, there is no state support for prevention of the disease," the news service writes.

According to the Financial Times, "Official statistics put the number of cases in Russia at 565,000 out of a total population of about 142m. But independent experts estimate the real figure is twice as high. Last year alone, there were more than 58,000 new infections … More than two-thirds of HIV patients in Russia are intravenous drug users."

The article traces the history of the Krelim's response to HIV/AIDS, which the article notes began in 2003. Since then, "Russia has poured funds into testing and treatment, allocating larger sums for imports of antiretroviral drugs each year. HIV patients have complained that medication is inefficiently distributed, but the programme has had success in some areas. Transmission of HIV from pregnant mothers to unborn children has been reduced to almost zero," Financial Times writes. The article examines growing international pressure on the government in Russia to support harm reduction strategies for injecting drug users (IDUs) and the role the Global Fund has played in providing some HIV prevention programs to the region (Gorst, 11/30).

France24 features a Q&A with Denis Broun, of UNAIDS, on how IDU is contributing to the spread of HIV/AIDS in Russia and the Ukraine. During the interview, Broun notes the gaps in the countries' prevention and harm reduction strategies and describes how UNAIDS is working with organizations in the region on data collection to track HIV/AIDS cases (12/1).

WHO Releases New TB Prevention Guidelines For People Living With HIV/AIDS

Also Wednesday, the WHO released new guidelines (.pdf) "show[ing] that children and adults living with HIV can be protected from tuberculosis (TB) infection with a regular, low-cost preventive medication," U.N. News Centre adds. "Of the nearly two million AIDS-related deaths each year, a quarter of them are associated with TB," the news service writes (12/1).

"Because of their weakened immune system, people living with HIV are less able to fight TB infection and are more likely to develop active TB which can be deadly and can spread to others. …  Taking medicine containing the anti-TB drug isoniazid is a simple and cost-effective measure that prevents the TB bacteria from becoming active if it is present," according to a WHO press release. The release notes that while treatment with Isoniazid Preventive Therapy (IPT) "is not new … it has been underused. Only 85,000 (or 0.2%) of all people living with HIV received isoniazid for TB prevention in 2009."

"[B]ased on new scientific evidence that updates the previous 1998 policy," the WHO recommends: "children and adults living with HIV, including pregnant women and those receiving antiretroviral treatment, should receive isoniazid prevention therapy"; "Isoniazid should be provided for six to 36 months, or as a life-long treatment in settings with high HIV and TB prevalence"; "People living with HIV who may have TB symptoms should be further screened for active TB or other conditions so that they are able to access the appropriate treatments," according to the release (12/1).

Also In HIV/AIDS News: ART, HIV Vaccine; Implications Of Pope's Comments For Catholic AID Workers In Africa; HIV In South Africa

• The Financial Times examines how antiretroviral therapy (ART) changed the HIV/AIDS landscape, by helping to extend the lives of people living with HIV/AIDS and by reducing the ability of patient's infected with the virus who are taking ARTs to spread the virus to others. "With the continued failure to develop an effective HIV vaccine, some public health experts see ART as an alternative way to prevent infection spreading," the news service writes. The piece continues: "Modelling studies suggest that HIV transmission could be eliminated within 10 years through a huge expansion of ART" to all patients living with HIV, a strategy termed "treatment as prevention."

  "Although small-scale trials of treatment as prevention are being organised in North America and South Africa, there would be huge practical, financial and ethical obstacles to overcome before the strategy could be rolled out globally," the Financial Times writes. An accompanying Financial Times sidebar examines recent progress in the development of an HIV vaccine (Cookson, 11/30). 

• The Associated Press reports on the impact Pope Benedict XVI's recent statements on condoms could have on Catholic HIV/AIDS workers in Africa, "the continent with the highest numbers" of HIV/AIDS cases "and the fastest-growing number of Catholic converts."

  The article continues, "For many Catholics in the front lines watching people die of AIDS, Benedict's pronouncement confers a belated blessing on what they are already doing," as described by Catholic leaders and AIDS workers in the piece. "Still, Catholic AIDS workers insisted that only abstinence and fidelity can provide a long-term solution to ending the AIDS pandemic. They said condoms should not be distributed indiscriminately, for fear they might promote promiscuity and worsen the crisis. The largest Catholic donor in the world, the U.S.-based Catholic Relief Services, has reiterated that it will not be distributing condoms (12/1).

• More than 200,000 people living with HIV/AIDS in South Africa have started antiretrovirals (ARVs) since April, bringing the total number of patients receiving the drugs in the country to one million, Deputy President Kgalema Motlanthe said during a World AIDS Day event on Wednesday, AFP reports. While noting the gains in treatment access, Motlanthe said, "It is important to emphasize that even as we continue to make headway with our treatment programme, prevention remains the mainstay of our response to the dual epidemic of HIV and TB" (Timse, 12/1).

  An AP story features comments from an interview with South African Health Minister Aaron Motsoaledi, including his concerns over the cost of treatment.  "'If we stop anything, we will just reverse all our gains,' [Motsoaledi] said." The health minister also "said private groups working in South Africa have told him they are struggling because of a drop in international funds, blamed in part on the global recession," according to the AP. The article examines the country's "ambitious testing and treatment campaign and more vigorous efforts to stop the disease's spread" that were announced on World AIDS Day 2009 (Faul, 12/1).