This Week in HIV/AIDS News

Singer Elton John Calls for Increased HIV/AIDS Education, Care

Singer Elton John on Tuesday at the 2009 Bio International Convention in Atlanta called for renewed efforts to fight HIV/AIDS, the Atlanta Journal-Constitution reports. John, founder of the Elton John AIDS Foundation, addressed an audience that included CEOs of organizations working to develop HIV/AIDS therapies and vaccines. He called on governments and institutions to increase their focus on education, especially among young people; access to medical treatment; and needle-exchange programs (Poole, Atlanta Journal-Constitution, 5/19).

“There are long-standing stereotypes and prejudices that inhibit our efforts to combat AIDS,” John said, adding, “I am asking for your leadership.” According to John, CDC estimates that one in every three new HIV cases occurs among people younger than age 30, a statistic that he said has not received adequate attention. “It is unfathomable and unconscionable that we are not making a bigger effort to educate this demographic about HIV/AIDS with creative materials and up-to-date information,” John said, adding, “Our failure to do so is costing lives” (Turner, AP/PennLive.com, 5/19).

John also noted a recent report by the Kaiser Family Foundation, which found that the number of Americans who believe HIV/AIDS is an urgent health problem has declined to 6% currently from 44% in 1995. Bob McNally, CEO of GeoVax Labs, said John’s message is that “just not enough is being done” and that “people continue to die from the disease.” He added that John “spurred the audience towards being advocates” (Atlanta Journal-Constitution, 5/20).

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”

HIV/AIDS Advocates React to Obama’s Proposed Global Health Initiative

Some HIV/AIDS advocates have voiced disappointment with the level of HIV/AIDS funding in President Obama’s proposed $63 billion, six-year global health initiative, VOA News reports. According to VOA News, the advocates say that Obama has not met pledges he made as a presidential candidate, while other say that the “picture is more complicated.”

According to the Global AIDS Alliance, Obama previously pledged to dedicate $50 billion over five years to HIV/AIDS, TB and malaria, but has instead proposed $51 billion over six years. GAA Executive Director Paul Zeitz said this proposal translates into significantly less annual funding for PEPFAR (Kilner, VOA News, 5/19). Zeitz said, “President Obama has a moral obligation to demonstrate global leadership on behalf of the poorest and most marginalized people of the world, especially in Africa,” adding, “But by turning his back on those needs, the president is betraying the trust of tens of millions of people” (Pflanz, Daily Telegraph, 5/18).

Advocates estimate that the funding shortfall could result in about one million people going without HIV/AIDS treatment and about 2.9 million women going without treatment to prevent mother-to-child HIV transmission. James Kamau, coordinator for the Kenya Treatment Action Movement, said that one effect of Obama’s proposal is that other donor countries could take similar actions, leading to additional cuts. “In Kenya here we say when the lead sheep limps then it does not get the others to the pastures,” Kamau said, adding, “Now if [Obama] cuts back funding on the Global Fund, then the rest of the people will follow suit” (VOA News, 5/19).

Some have welcomed Obama’s proposal, saying that it has expanded the focus of global health initiatives to include other health issues that can be treated at a low cost but have not received as much attention, VOA News reports. Obama’s proposal includes $12 billion for these additional areas of focus, including more emphasis on maternal health and health infrastructure, according to VOA News.

According to VOA News, Obama’s proposal might be more than Congress is willing to allocate during the economic crisis. The current budget resolution under consideration by Congress would allocate $51 billion for foreign aid in FY 2010, almost $3 billion less than what Obama requested (VOA News, 5/18).

African Government Spending on Health
Although African Union leaders in 2001 signed a declaration pledging to spend 15% of national budgets on public health programs, Kamau said that a majority of these governments have failed to meet this level of spending, with countries such as Botswana, Namibia and Zambia being the only exceptions, IRIN/PlusNews reports (IRIN/PlusNews, 5/20). He added, “We need the African governments to start walking the talk. They have pledged 15% of budget to health, and they don’t do it because they get bilateral funding like PEPFAR and others.” Kamau added that PEPFAR is “an emergency fund, it’s not a permanent fund, so we need to know how we are going to sustain this in the long term” (VOA News, 5/18).

The Regional Network on Equity in Health said that African governments account for less than 1% of global health spending, although they make up 25% of the global disease burden, 60% of people living with HIV/AIDS worldwide, and the highest amount of people living with TB and malaria, according to IRIN/PlusNews. Still advocates urged the U.S. to re-evaluate its spending on global HIV programs, particularly short-term programs, IRIN/PlusNews reports. Zeitz said many advocates recognize that the U.S. is in the midst of a recession; however, he added that the U.S. “just spent one trillion dollars to bail out the banks on Wall Street, and the military budget has been increasing year on year … it is really a question of priorities” (IRIN/PlusNews, 5/20).

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”

Researchers Develop Questions To Determine Risk of HIV/AIDS Drug Resistance

Researchers from the Makerere University hospital in Uganda, the U.S. and Belgium have developed a formula, based on a set of questions, for determining HIV-positive people’s risk of treatment failure and drug resistance, according to a study recently published in the Journal of the International AIDS Society, the New York Times reports. According to the Times, most HIV-positive people in Africa rarely have access to viral load tests to determine if they are developing resistance to first-line antiretroviral drugs because the testing is expensive and complicated.

The researchers questioned 496 HIV-positive people about:

• How often they had taken their drugs in the past three days, the previous four weeks and since they began treatment;
• If they had ever missed two days of drugs;
• If they had ever paid for treatment;
• Whether women had ever taken nevirapine to prevent mother-to-child transmission; and
• If the patients had experienced weight loss or rashes.

The researchers also took blood samples to determine the participants’ CD4+ T cell counts. They found that having ever missed treatment for two days or a 30% decrease in CD4+ count predicted treatment failure. The researchers said that viral load testing, when available, be given to these patients first. In addition, the Times reports that the new method appears to work better than World Health Organization guidelines, which are based on clinical signs of HIV progression and CD4+ counts (McNeil, New York Times, 5/18).

The study is available online.

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”

Researchers Develop Vaccine Candidate That Is Successful in Blocking Simian Version of HIV

Researchers have successfully blocked SIV, the simian version of HIV, using a new technique that could help lead to the development of an effective HIV/AIDS vaccine, the Children’s Hospital of Philadelphia. The team also included scientists from Nationwide Children’s Hospital in Columbus, Ohio, and the New England Primate Research Center in Boston.

Johnson and colleagues developed a genetically altered virus that carried the vaccine candidate and injected it into the muscles of monkeys. The vaccine prompted the muscles to produce a protein that is designed to bind to SIV and prevent it from infecting cells (Goldstein, Philadelphia Inquirer, 5/18). After treating nine monkeys with the vaccine candidate for one month, the researchers injected them with SIV. Six monkeys were not administered the vaccine candidate before being injected with SIV. None of the immunized monkeys developed AIDS, while three showed indications of SIV infection. Researchers detected high concentrations of the proteins in their blood one year later. All six non-immunized monkeys became infected with SIV, and four died during the trial (Schmid, AP/Austin American-Statesman, 5/18). The DNA used in the carrier virus can deliver DNA into the cells of both monkeys and humans, according to the Inquirer.

Johnson said that the results of the trials were so encouraging that he plans to request approval from FDA to begin clinical trials in humans, the Inquirer reports. However, he said that there is “no guarantee that things that work in monkeys will work in humans,” adding that an HIV/AIDS vaccine could be 10 years away (Philadelphia Inquirer, 5/18). Recent HIV/AIDS vaccine failures prompted the researchers to try a different route that involved “bypassing the natural immune system that was the target of all previous HIV and SIV vaccines candidates,” Johnson said. “Some years ago I came to the conclusion that HIV was different from other viruses … and we might not ever be able to use traditional approaches,” he added (AP/Austin American-Statesman, 5/18).

Peggy Johnson — head of the HIV Vaccine Research Branch at NIH‘s National Institute of Allergy and Infectious Diseases, which helped fund the study — said, “As a concept, I think this is very promising.” She added, “We need to make the genes as humanized as possible so that the human body doesn’t react to that.” According to Peggy Johnson, tests will be needed to prove that the vaccine candidate can protect against sexually acquired HIV (Fox, Reuters, 5/17). Beatrice Hahn, an HIV/AIDS researcher with the University of Alabama-Birmingham, said that the study’s findings indicate that there is “a light at the end of the tunnel,” adding, “It shows thinking outside the box is a good idea and can yield results, and we need perhaps more of these nonconventional approaches” (AP/Austin American-Statesman, 5/18).

Hildegund Ertl, a virus expert at the Wistar Institute in Philadelphia, said, “It is a very innovative approach but currently, in my mind, still far from clinical use.” Ertl added that because most people have been exposed to adeno-associated viruses through cold viruses, they would be “likely to mount an immune response” to the vaccine. According to Phillip Johnson, most people have not been exposed to the strain of the adeno-associated virus that the researchers used as the carrier. He added that they “will be certainly looking at that as part of our Phase I testing in humans” (Philadelphia Inquirer, 5/18).

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”