God, AIDS, Africa & HOPE

Reflections / Gedanken

Strategic goal of UNAIDS by 2015: 3.Injecting drug use and HIV

UNAIDS strategy goal by 2015:

  • All new HIV infections prevented among people who use drugs.

Globally, there are an estimated three million people who inject drugs also living with HIV—with nearly 13 million more at risk of HIV infection. Access to HIV prevention services, including harm-reduction programmes has increased but not at the required levels. In 2009 the median coverage of HIV prevention services was 32%.  It is estimated that on average globally fewer than two clean needles are provided per month per person who injects drugs, there are about eight people in opioid substitution treatment for every 100 people who inject drugs. According to WHO, UNODC and UNAIDS target-setting guidelines, the availability of fewer than 100 syringes per person who injects drugs per year is considered low. Few countries have data on HIV treatment coverage for people living with HIV who inject drugs, 14 countries treat 5% or fewer and in only nine countries does treatment reach more than 10% of people living with HIV who inject drugs. UNAIDS calls for scaling up comprehensive, evidence informed and human-rights-based programmes accessible to all people who inject drugs (i.e. attending to harm reduction alongside demand reduction), including programmes to reduce hepatitis co-infection, increasing access to HIV treatment, and ensuring legal and policy frameworks serve HIV prevention efforts.

more info: www.unaids.org

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, , , , ,

Strategic goal of UNAIDS by 2015: 2.Vertical transmission and maternal mortality

UNAIDS strategy goal by 2015:

  • Vertical transmission of HIV eliminated and AIDS-related maternal mortality reduced by half.

The virtual elimination of mother-to-child transmission is possible by 2015. Significant progress has been made in the past decade. Infection rates among children born to mothers living with HIV have declined by 26% from 2001 to 2009.  However, much more needs to be done to prevent mothers from dying and babies from becoming infected with HIV. HIV is the leading cause of mortality in women of reproductive age. Without intervention about one in three children born to HIV-infected mothers will be infected.  UNAIDS calls for scaling up access to and the use of quality regimens and services for the prevention of mother-to-child HIV transmission, ensuring mothers have continued access to HIV treatment, and scaling up access to sexual and reproductive health services and reproductive rights for women and their partners.

More info: www.unaids.org

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, , , , , ,

UNAIDS Press Release regarding the Milleniumgoals

In lead-up to June High Level Meeting, progress report presents overview of efforts needed to help countries achieve universal access to HIV services and zero new HIV infections, discrimination and AIDS-related deaths.

NAIROBI, 31 March 2011—Thirty years into the AIDS epidemic, investments in the AIDS response are yielding results, according to a new report released today by United Nations Secretary-General Ban Ki-moon. Titled Uniting for universal access: towards zero new HIV infections, zero discrimination and zero AIDS-related deaths, the report highlights that the global rate of new HIV infections is declining, treatment access is expanding and the world has made significant strides in reducing HIV transmission from mother to child. Between 2001 and 2009, the rate of new HIV infections in 33 countries—including 22 in sub-Saharan Africa—fell by at least 25%. By the end of 2010, more than 6 million people were on antiretroviral treatment in low- and middle-income countries. And for the first time, in 2009, global coverage of services to prevent mother-to-child transmission of HIV exceeded 50%. But despite the recent achievements, the report underscores that the gains are fragile. For every person who starts antiretroviral treatment, two people become newly infected with HIV. Every day 7 000 people are newly infected, including 1 000 children. Weak national infrastructures, financing shortfalls and discrimination against vulnerable populations are among the factors that continue to impede access to HIV prevention, treatment, care and support services. The Secretary-General’s report, based on data submitted by 182 countries, provides five key recommendations that will be reviewed by global leaders at a UN General Assembly High Level Meeting on AIDS, 8–10 June 2011.

“World leaders have a unique opportunity at this critical moment to evaluate achievements and gaps in the global AIDS response,” said Secretary-General Ban Ki-moon at the press briefing in the Kenyan capital. “We must take bold decisions that will dramatically transform the AIDS response and help us move towards an HIV-free generation.” “Thirty years into the epidemic, it is imperative for us to re-energise the response today for success in the years ahead,” said UNAIDS Executive Director Michel Sidibé, who joined Mr Ban for the launch of the report. “Gains in HIV prevention and antiretroviral treatment are significant, but we need to do more to stop people from becoming infected—an HIV prevention revolution is needed now more than ever.”

Rebecca Auma Awiti, a mother living with HIV and field coordinator with the non-governmental organization Women Fighting AIDS in Kenya told her story at the press conference. “Thanks to the universal access movement, my three children were born HIV-free and I am able to see them grow up because of treatment access,” she said.

In the report there are five recommendations made by the UN Secretary-General to strengthen the AIDS response:

  • Harness the energy of young people for an HIV prevention revolution;
  • Revitalize the push towards achieving universal access to HIV prevention, treatment, care and support by 2015;
  • Work with countries to make HIV programmes more cost effective, efficient and sustainable;
  • Promote the health, human rights and dignity of women and girls; and
  • Ensure mutual accountability in the AIDS response to translate commitments into action.

The Secretary-General calls upon all stakeholders to support the recommendations in the report and use them to work towards realizing six global targets:

  • Reduce by 50% the sexual transmission of HIV—including among key populations, such as young people, men who have sex with men, in the context of sex work; and prevent all new HIV infections as a result of injecting drug use;
  • Eliminate HIV transmission from mother to child;
  • Reduce by 50% tuberculosis deaths in people living with HIV;
  • Ensure HIV treatment for 13 million people;
  • Reduce by 50% the number of countries with HIV-related restrictions on entry, stay and residence; and
  • Ensure equal access to education for children orphaned and made vulnerable by AIDS.

As international funding for HIV assistance declined for the first time in 2009, the report encourages countries to prioritize funding for HIV programmes, including low- and middle-income countries that have the ability to cover their own HIV-related costs. It also stresses the importance of shared responsibility and accountability to ensure the AIDS response has sufficient resources for the coming years.

The report and more information about the High Level Meeting on AIDS can be found online at: unaids.org/en/aboutunaids/unitednationsdeclarationsandgoals/2011highlevelmeetingonaids/

 

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, , , , , ,

POZ Magazine: Cure Watch…

In December 2010, a man was declared cured of HIV. While his example won’t be widely repeated, it could lead to more useful strategies for a cure.
Timothy Ray Brown is “the Berlin patient.” He needed a stem-cell transplant to fight recurrent leukemia. His doctor, Gero Huetter, MD, knew that a small percent of people of northern European ancestry have a genetic variant called double CCR5 delta-32 deletion that seems to protect them from HIV. The virus attaches to CCR5 receptors on CD4 immune cells in order to enter and infect the cells (another attachment protein, CXCR4, is less commonly used). People genetically prevented from producing CCR5 receptors don’t contract HIV despite exposure.
For Brown’s transplant, Huetter found a match who had the genetic variant. After two transplants, Brown found that his HIV receded along with his cancer. Now, nearly four years after the second transplant, he remains free of HIV—without meds.
This cure is not widely useful, and not only because of its expense. Stem cell transplants rank among the most dangerous of medical procedures. Also called bone marrow transplants, they involve wiping out the immune system with high-dose radiation and chemotherapy before infusing stem cells from a donor. The body then grows a new immune system matching the donor’s. During chemo and radiation and before the new immunity takes hold, the recipient is vulnerable to infections and at serious risk of organ damage and other life-threatening conditions. There is also significant danger that the recipient’s body will reject the transplant.
Yet Brown’s case opens vistas for HIV eradication. While meds (entry inhibitors) blocking CCR5 attachment are in the HIV-treatment arsenal, they do not erase the virus and must be taken continuously. Brown’s experience shows that if CCR5 receptors can be genetically altered, the virus might be wiped out, making a lifetime of HIV meds unnecessary.
Researchers are working on exactly that, using technology called “zinc finger DNA-binding protein nuclease” to modify CD4 cells to match those of people with the double CCR5 delta-32 deletion. Several current studies ask whether infusing such cells—without the life-threatening transplant—will allow the Berlin cure to go global.

POZ magazine original article

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , , ,

POZ Magazine: HIV Drug Development Stalls

Companies that develop HIV drugs are at a standstill in bringing new medicines to market, Bloomberg reports. Of the 31 HIV meds on the market, only six were approved after 2004; Intelence was the last drug approved—and that was three years ago. The newest antiretrovirals are much safer and more effective, have fewer side effects and must be taken less frequently. As a result, the bar for bringing new drugs to market has gotten higher and fewer drugs are in the pipeline. This also means that HIV-positive people who develop drug resistance have fewer treatment options.

Source:  Poz Magazine

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , ,

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