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July/August 2010
Global ID
Five Lessons from the International AIDS Conference

Several important themes emerged from the 18th International AIDS Conference in Vienna in July, including exciting research results for new methods to prevent HIV infection and concerns over future funding. Here is a brief summary of the Center for Global Health Policy’s top five lessons learned from the week-long conference:

  • Universal Access to HIV Treatment and Prevention Remains Elusive: From comments by Bill Gates to the many activist demonstrations, fear over dwindling funds dedicated to the HIV/AIDS pandemic was a main theme. The Obama administration took significant heat at the conference for recent budget proposals for fiscal year (FY) 2011 that indicate a retreat from the promise to fund global AIDS at $50 billion over the next five years. Read more on the Global Center’s blog.
  • Keeping Step with PrEP: Many trials testing the ability of antiretrovirals (ARV) to prevent acquisition of HIV infection are underway, and results from two gained attention at IAS 2010. Most notably, the CAPRISA trial demonstrated that a vaginal gel containing tenofovir can protect women from acquiring HIV, lowering the rate of HIV infection in women in South Africa using the gel by 39 percent over two and a half years.  However, there are concerns about whether resources will be available to offer pre-exposure prophylaxis (PrEP) to those who need it most. The blog has more details.
  • Early Treatment Preserves Health and is Cost-Effective: Several sessions underscored the cost-effectiveness of treating early versus treating later, when costly opportunistic infections begin to emerge. During a “When to Start” panel, Dr. Peter Mugyenyi, director and founder of the Joint Clinical Research Center in Kampala, Uganda, said the cost of treating an opportunistic infection like cytomegalovirus for one month is equal to the cost of providing HIV treatment for three years in Uganda. For more, click here.
  • HIV/TB Co-Infection:  Important Findings but Low Profile: Although tuberculosis (TB) accounts for nearly a quarter of HIV-related deaths worldwide, issues related to HIV/TB co-infection did not merit a plenary talk at the conference. Data from the CAMELIA trial, however, showed that initiating ARV therapy at the earliest opportunity when treating HIV/TB co-infection is most beneficial.  The clinical trial in Cambodia found prolonged survival in untreated HIV-infected adults with very weak immune systems and newly diagnosed TB by starting anti-HIV therapy two weeks after beginning TB treatment, rather than waiting eight weeks, as has been standard. The Global Center’s blog has more on the study.
  • Bridging the Gap: An IAS 2010 pre-meeting with HIV/AIDS health experts, policymakers, and economists focused on how HIV fits into the larger agenda of strengthening health systems in developing countries. Does investing in HIV treatment and prevention mean an investment in health infrastructure overall, or are the two separate and distinct? Experts argued that lessons learned from the scale up of HIV programs informed investments in overall health systems. Learn more here.

Read more about the IAS conference and other global health news at sciencespeaks.wordpress.com. Recent posts include:

  • A summary of a Centers for Disease Control and Prevention (CDC) clinical safety trial that found oral tenofovir used for PrEP was safe, well-tolerated, and did not seem to promote increased behavioral disinhibition in HIV-negative men who have sex with men in three U.S. cities. There is hope that this tool could empower women and men to protect themselves from HIV infection, and additional studies are underway. 
  • The Global Center’s candid interview with Ezekiel Emanuel, MD, a special advisor for health policy to the director of the White House Office of Management and Budget.  Dr. Emanuel is one of the architects of the Obama administration’s Global Health Initiative, and he has been a lightning rod of criticism for activists urging a more vigorous global AIDS response from the administration.

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