God, AIDS, Africa & HOPE

Reflections / Gedanken

Signs of hope – remission without long-term treatment

At the recent conference of the International Aids Society in Paris it was a topic hotly discussed by academics, researchers and representatives of NGO’s:

A 9-year-old South African child diagnosed with HIV when he was 1 month old has been in HIV remission for 8½ years — without regular treatment. This is the first reported case of a child controlling their HIV infection without drugs in Africa and the third known case globally. The related research was conducted among others by Prof Dr Mark Cotton, board member of our HOPE Cape Town Association.

Soon after diagnosis, the child was placed on antiretroviral treatment, or ART, for 40 weeks, at which point treatment was stopped and the child’s health was monitored. Blood tests in late 2015 revealed the child is in HIV remission, meaning levels of the virus in the blood are undetectable using standard tests. Subsequent testing of samples dating back to the child’s infancy confirm remission was achieved soon after treatment was stopped. Treatment was paused as part of a larger research trial investigating the potential for early ART to decrease infant mortality and cut the need for lifelong treatment among newborns infected with HIV. “This is really very rare,” said Dr. Avy Violari, head of pediatric clinical trials at the Perinatal HIV Research Unit at the University of Witwatersrand in South Africa. Violari is the child’s doctor and presented the findings at the 9th International AIDS Society Conference on HIV Science in Paris

The child, not identified, was part of a study known as the Children with HIV Early Anti-retroviral Therapy, or CHER, trial, conducted in the years 2005 to 2011. More than 370 infants infected with HIV were randomly assigned to immediately receive ART for either 40 weeks or 96 weeks. A third group received no immediate treatment, but instead was looked after according to standard guidelines at the time. The CHER trial set out to investigate whether mortality rates could be reduced, but also whether earlier treatment could keep children healthy enough to enable them to come off treatment for certain periods. “We were hoping to make it a slower-progressing disease,” said Violari.

The study found mortality decreased by 76% and HIV disease progression reduced by 75% among the infants who received treatment immediately, for 40 or 96 weeks. The group receiving standard treatment saw an increase in mortality based on interim results, so that arm of the trial was stopped early. But virus levels in the 9-year-old case remained and remain undetectable. “The child is the only child showing remission,” said Violari. “We cannot see virus in the blood … we can see fragments of the virus in the cells,” she said, adding that these fragments appear not to be able to replicate, for now.

The South African child is the third reported case of long-term HIV remission in a child after early, limited treatment with antiretroviral drugs.

The first case was a Mississippi baby, a girl born in 2010, who received ART just 30 hours after birth until she was 18 months old, at which point HIV remission was achieved. The baby sustained remission for 27 months, until 2015, when she rebounded and the virus was found in her blood, crushing hopes that this approach could be the route to a “functional cure” for HIV. Next came the 2015 case of a French teenager, now 20, whose mother was HIV positive. The French child was given antiretroviral treatment soon after birth, stopped treatment at age 6 and has maintained undetectable levels of the virus in her blood since.

“We are delighted and excited by what happened with this child … we need to extrapolate from this to the benefit of other children on antiretroviral drugs,” said Prof Mark Cotton, Professor of Pediatrics at Stellenbosch University in South Africa, who co-led the study. “Africa is still the epicenter of the epidemic and more babies are acquiring HIV than anywhere else.”

Cotton hopes his team presenting these results will boost morale, both among cure researchers and those managing treatment programs for children across the continent.

More links:

Hope for future HIV cure revived
It is really very rare
Without drugs

Filed under: Africa, HIV and AIDS, HIV Treatment, HOPE Cape Town Association, HOPE Cape Town Association & Trust, Medical and Research, South Africa, , , , , , , , , , , , , , , ,

IAS conference 2017

Fragments of thoughts and impressions

It is my first IAS conference I have attended and compared with the World Aids conference it is a smaller crowd: round about 6000 people from all over the world coming in Paris together to discuss developments in the fields of HIV and Aids.

The first impression is that the conference is much more academic and discerning – it feels that most talks and presentations are indeed on a much higher academic level then at local Aids Conferences or the big world conference.

I am staying at a hotel outside Paris in Nanterre a commune in the Hauts-de-Seine department, the western suburbs of Paris. It is located some 11 km north-west of the centre of Paris. It feels strange – and from the beginning I can feel people have to live in a way which does not support human interaction – it feels cold, just doing the job of housing people without consideration on the human desire to live in a nice and friendly environment. It’s a sort of shock for somebody living in South Africa – it is strange but it feels like as soul-less place. The hotel is situated on top of a commuter train tunnel and station – every now and then one can feel the coming and going of a train while laying in bed.
So I guess all is there to sustain living and working, there are high rising buildings and all kind of services, but the thought I take with is that I can understand such suburbs create problems and even violence.

The mix of people here is amazing – mostly and certainly from the African region of Algeria, Tunisia and Morocco – it feels non-European in a European way – figure it out what it means.

And travelling to the conference centre – using the train and the metro – being part of a huge crowd in the morning and evening entering and exiting the dark alleys of the underground world – being part of the endless movements of people pushing their way through the crowd to reach their daily destiny – it is breath-taking – but not in the usual sense of the word. I definitely recall all my blessings living with some space and lots of day light in South Africa.

The conference itself is for a non scientific person sometimes difficult to follow – but I guess it is not about the exact details of every molecule one has to understand, the sheer feeling of understanding the principle – the idea behind all the details – the sometimes keen thoughts and trials and errors are a fascinating mental adventure – it stimulates my brain and forces me to read and study and “google”  – I have to admit that is a great experience to be beamed for a while into an environment really challenging you on knowledge and understanding.
But I believe that people running organisations must have at least a grasp about the background work done and the driving forces behind new developments before they reach the grass-root scene to be put into practice. Fruitful communication, bridging the gap between science and grass-root as HOPE Cape Town is trying to achieve on a daily base means for those in charge constant learning and communication with all spheres of their work environment.

Last but not least it was great meeting people from other countries and engaging in discussions – learning from each other and about each other and feeling the compassion of trying to rid the world of a viral onslaught. And yes, there is of course also lots of business – lots of calculation, but even there, you very often sense that those being employed in the big pharmaceutical companies understand that there is humanity needed in business. The connectivity of the global village, the threat that a virus can easily come and bite those far away helped indeed to change some of the attitudes which governed such entities a decade ago. Surely there is still lots to optimize and clarify – a balance must be put into place between commerce and humanity but I guess the battles of treatment have brought some clarity and movement into the field. Well, a watchful eye seems to be always necessary when it comes to that topic.

I will leave Paris tomorrow with lots of new understanding about the work done in the laboratories of this world. I leave proud knowing that our very board member of HOPE Cape Town, Prof Mark Cotton co-chaired the CHER study which produced one of the most published results of the conference: the child for 9 years in remission after being treated as a baby. I leave motivated knowing how many people dedicated their lives and career to fight back a pandemic which brought so much death and sorrow onto human mankind. It simply feels great to be part of a movement which has the goal to end a pandemic and give people a chance to live life and sexuality without fear. To live and to love to the utmost in their lifetime.

The only question I was wondering – how many other priests or clergy have been to this conference – not that it really matters but it would be nice to know that more of my fellow brothers are engaged on this level in a matter of live and death for millions in this world.

 

Filed under: General, HIV and AIDS, HIV Prevention, HIV Treatment, HOPE Cape Town Association & Trust, HOPE Cape Town Trust, Networking, Reflection, Society and living environment, South Africa, Uncategorized, , , , , , , , , , , ,

HOPE Cape Town USA

Since last year, HOPE Cape Town in South Africa has a sister organisation in the USA, registered and recognized as a non-profit entity. Last Saturday the board of HOPE Cape Town USA finalized the mission and vision statement which reads as follows:

 

HOPE Cape Town USA

Background

HCT USA understands that in a rapidly globalizing world a life-threatening health pandemic such as HIV/AIDS has no borders and can easily spread from one continent to another; and understands that root causes of vulnerability and marginalization are similar throughout the world, and connects people in both USA and South Africa. It also understands the danger of resistance to HIV/AIDS as well as related conditions such as tuberculosis, as experienced in southern Africa.

As a result, HCT USA believes there is tremendous value in linking with Hope Cape Town in South Africa as well as other national and international civil society organizations to learn and exchange best practice, expertise and create synergies in HIV/AIDS prevention and treatment among marginalized segments of populations.

Also, HCT USA recognizes that behaviour change reducing risk of exposure to HIV/AIDS is in great part a result of change in social norms in which education plays a large role. Focusing on changing social norms and education will reduce the effects of misinformation and stigma and help create a more accepting environment, and result in an increase demand and supply for, as well as access to and use of available treatment among the most vulnerable and marginalized.

Vision

HOPE Cape Town USA strives to improve the quality of life of vulnerable and marginalized children, youth and families affected by HIV/AIDS, and related illnesses, and help them to reach their own full potential.

Mission

HOPE Cape Town USA’s (HCT USA) mission is to assist people living with HIV, AIDS and related illnesses in the USA and South Africa.

HCT USA’s aim is to support the ongoing work of HOPE Cape Town in South Africa, reduce the spread of HIV among vulnerable and marginalized children and youth in USA and support those living with HIV.

This mission is realised by the following means

  • Advocate, fundraise and support HOPE Cape Town programs in South Africa
  • Build a body of data to understand needs, challenges and interconnections of children,
    youth and families living with HIV, AIDS or related illnesses in South Africa and USA
  • support vulnerable and marginalized children, youth and families in the USA, beginning in the Dallas/Fort Worth (Tx) area
  • Collaborate with other NGO’s in the fields to create synergies and expertise and
    interconnect globally with the aim to learn, share and optimize programs
  • Disseminate correct information, reduce misconceptions about the pandemic and so
    eliminate discrimination and create access to appropriate info on the syndrome, prevention and treatment options.
  • Change behaviour to reduce risk of exposure to HIV/AIDS by focusing on changing social
    norms and education, and reduce the effects of misinformation and stigma and help create a more accepting environment
  • Increase demand and supply for, as well as access to and use of available treatment among
    the most vulnerable and marginalized.

Filed under: Africa, HIV and AIDS, HOPE Cape Town Association & Trust, HOPE Cape Town USA, Networking, Society and living environment, South Africa, , , , , , , , , , ,

Durban2016 – a reflection on the World Aids Conference

durbanTomorrow ends the World Aids Conference in Durban – most probably the same way it started, with lots of encouraging words and hopes held high: treatment for all, equity, justice and equal treatment for those on the margins of the so-called society.

It was a week full of talks, presentations, encounters – a week full of demands, pleas, promises and a concert of different voices: researchers, activists, business people – all wanting to have a share and a say in the biggest HIV related global conference, taking place every two years.

The magic year 2020 and the numbers 90 – 90 – 90 were repeated and mentioned over and over: 90 % of the infected people should know their status; from those knowing 90% should be on treatment – and from those on treatment 90% should be undetectable.
Another magic year named very often was 2030 – the aimed end of the Aids pandemic.

But let’s be honest: all the tears, pleas and promises could not hide the fact: as the world stands today, we will not reach this goal. 16 out of 37 million people are in the moment on treatment – and the Global Aids Fund lacks promised money to reach all of the ones in need of treatment. The so-called “war on terror”, the financial crisis, the madness of politics let made financial pledges degrade into empty promises. The gap between what governments have pledged, what is needed and what they finally pay into the global fund is going into millions of US Dollars.

And it is not the lack of money – besides the madness of war and terror, perceived or real – it is the assumption that we have the Aids pandemic under control. It seems forgotten that every year 2 million new infections are still counted and 1 million people perish as a consequence of HIV, Aids and related illnesses.

But even the future looks bleak – conferences like this are needed: they serve as a public reminder of the injustice of poverty, sickness and premature death and the responsibilities of governments and public health sectors. They also bring people together one would not meet otherwise.
In South Africa without the activism we still would be told that HIV does not cause Aids and that antiretroviral treatment kills. Only activism, toi-toi and conferences as well as taking the government to court as civil society brought the much-needed results. But we should never forget those having died because Manto Tshabalala Msimang and others fought against common sense for a far too long time.

I am grateful that this conference brought me together with gay, lesbian, transgender, intersex people, with male and female sex workers and with drug users – encounters without the moral pointing finger – it was about meeting other human beings with their struggles like I have my struggles. It was about listening and giving everybody dignity and space to talk, to share, to explore, to feel loved and accepted. How much could also the churches learn from such encounters – understanding that the world is much more diverse and colorful than most allow themselves to accept in their small little world of daily and religious life.

Conferences like this also help to deepen the understanding of HIV and its related problems, it gives the chance to celebrate successes, mourn failures and last but not least to feel not alone in the battle against a deadly syndrome. 18 000 people from all over the world, united in an ongoing battle to save lives, to demand access to treatment, to put the fingers on human rights abuses and inhumane and unjust laws hindering our fellow brothers and sisters to live life to the fullest.

Conferences like this are energizing – they liberate one from the narrow views one automatically have working day in and day out in the same social and cultural environment – for me as a priest they open up to what “catholic” really means in the full sense of the word.

Churches are praised for their active role in the fight, but they are not very much appreciated when it comes to legal matters or global or national policy decisions. The anti-gay laws in Nigeria, the questions of sexual orientation and the women’s rights in matters reproduction are contentious issues which impact clearly also onto the fight against HIV and Aids. Sometimes it seems that moral considerations overshadow the life-and-death consequences, such stances have on grassroots level.
And obviously the long stance of my own church regarding condoms did not help either – and it took Benedict XVI’s interview to start open up this question in his acknowledgment, that if a male escort uses a condom to protect his customer it is the beginning of morality.

So lastly conferences like this put the finger on open questions, on answer demanding questions, they make the bridge between teaching, sciences, research, religion, faith and real life palpable and it’s the conversation between all parties which could bring solutions adequate to the life of the ordinary person plagued by all the challenges on a daily base.

So thank you to the organizers of the conference for making it possible once again to meet, to greet, to exchange, to laugh together, to learn together, to fight together, to discern together, to disagree with each other in the quest of the best answer possible.

Filed under: Africa, Catholic Church, HIV and AIDS, HIV Prevention, HIV Treatment, HOPE Cape Town Association, HOPE Cape Town Association & Trust, Medical and Research, Networking, Politics and Society, Reflection, Religion and Ethics, Society and living environment, South Africa, , , , , , , , , , , , , , , , , , , , , , , , , ,

From Transgender to PrEP – good to know…

It’s time again to suggest some reading for the interested parties to get more insight in HIV and AIDS related matters:

Violence against women is not only in the USA but also in South Africa a very hot topic. The “Well-Project” has written about it and I am sure we all can learn from the extensive knowledge of these articles:
Violence against women and HIV

The CROI conferences are always a good source of new information. Here are the most important HIV research news from the 2015 conference:
6 important HIV research findings

The Body.Com is providing news and information about HIV on different levels. To download the app go here:
TheBody.com in the palm of your hand

The question of transmission between sero-different partners are often of great concern, read about the results of studies regarding gay sero-different couples:
No HIV transmission between serodifferent couples if undetectable load – preliminary results

PrEP – Pre-exposure prophylaxis (PrEP) works very well at preventing HIV transmission. Even if that is from a costing point still utopia for South African it is worth to read about it and its obstacles of perception:
How to overcome the challenges of accessing PrEP

Transgender people are having a difficult time – read about how transgender people fighting stigma and injustice:
How Transgender People fighting Stigma…

Starting early treatment gives you advantages – so get tested in times:
Starting HIV treatment early leads to better health..

Enjoy reading!

Filed under: General, HIV and AIDS, HIV Prevention, HIV Treatment, HOPE Cape Town Association & Trust, Medical and Research, Politics and Society, Reflection, Society and living environment, , , , , , , , , , , , , , , , , , , , ,

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