Frequent antiretroviral therapy (ART) switches in HIV-infected Kenyan urban adults might limit the efficacy of ART. The authors sound the alarm that this is a potentially serious threat to the sustainability of HIV treatment programmes in Kenya and other developing countries.
Equity and HIV/AIDS
Antiretroviral durability and tolerability in HIV-infected adults living in urban Kenya
Hawkins C, Achenbach C, Fryda W, Ngare D, Murphy R: Journal of Acquired Immune Deficiency Syndrome 45: 304-310, 1 July 2007
Avoiding slippery slope of drug-rationing debate
Butler A: BuisnessDay, 27 July 2007
International medical and public health journals contain a growing body of writing on the practical and ethical implications of the rationing of antiretroviral (ARV) treatment around the world. The brief title of one important article neatly encapsulates the dilemma facing health professionals: “Which patients first?” Medics in most developing countries talk about “targeting priority patients” in order to emphasise that universal access to ARVs is their ultimate ambition. Campaign groups also avoid the language of rationing because they believe it undercuts their campaigns for ARVs and allows governments to retreat from universal treatment commitments.The truth, however, is that only a small proportion of those who could benefit from ARVs around the world are receiving them.
Early treatment of HIV-infected infants with ART significantly reduces mortality
Violari A, Cotton M, Gibb D, Babiker A, Steyn J, Jean-Phillip P, McIntyre J: International Aids Society Conference, 25 July 2007
Treating HIV-infected infants with antiretroviral therapy (ART) as early as possible, within the first six to 12 weeks of life — rather than waiting until they show signs of immunological or clinical deterioration — dramatically decreases their risk of early death, according to findings from the Children with HIV Early Antiretroviral Therapy (CHER) trial, a South African study presented today at the 4th International AIDS Society Conference on HIV Treatment and Pathogenesis in Sydney.
Focus on drug access at HIV/AIDS meet
South-North Development Monitor (SUNS) #6299, 22 July 2007
Delegates at a major international conference on HIV and AIDS urged developed countries to help guarantee the supply of affordable drugs to combat the virus and the syndrome. Over 5,000 delegates from 130 countries were in Sydney to attend the Fourth International AIDS Society (IAS 2007) conference featuring the latest developments in HIV biology, pathogenesis, treatment and prevention science. It explored how the gap between research and practice can be bridged, particularly in developing countries that bear the brunt of the HIV pandemic.
Joining hands: Integrating gender and HIV/AIDS in Angola, Tanzania and Uganda
Hadjipateras A, Akullu H, Owero J: Agency for Research and Cooperation in Development (ACORD), July 2006
ACORD, an Africa-led international alliance working for social justice and equality, aims to prevent the further spread and mitigate the impact of HIV/AIDS through community-based research and advocacy and working in alliance and partnership with others. This publication is documents and disseminates the lessons from research carried out by ACORD in Angola, Uganda and Tanzania.
Kenya: World Bank approves US$80 million HIV/AIDS program
Warutere P, Auma A: The World Bank, 26 June 2007
The World Bank approved a credit of US$80 million for Kenya to expand the coverage of targeted HIV and AIDS interventions to prevent and mitigate the impact of the disease. The Total War Against HIV and AIDS (TOWA) Project will assist Kenya to further reduce the prevalence of HIV/AIDS, which dropped from over 13 percent in 2001 to about 6 percent in 2005, by further strengthening the governance of the National AIDS Control Council (NACC)— the lead agency for designing strategies and overseeing the implementation of programmes to control the pandemic. The programmes include use of grant funds by non-governmental organisations (NGOs) which will be subjected to rigorous and transparent processes of selection, implementation monitoring and performance. This approach includes greater community oversight and blacklisting of NGOs that do not perform.
Missing the target: Time is Running Out to End AIDS
International Treatment Preparedness Coalition (ITPC), 18 July 2007
Global AIDS treatment efforts will fall far short of the G8 goal to reach five million Africans and provide global universal access to AIDS drugs in the next few years unless the pace of treatment scale up accelerates and the effort expands to address key barriers, according to this report. The report provides a 17-country overview of AIDS treatment successes and setbacks and offers an in-depth review of treatment delivery in six countries not covered in the group’s previous reports – Cambodia, China, Malawi, Uganda, Zambia and Zimbabwe.
New HIV/AIDS drugs 500% more costly, says MSF
Raja K: South-North Development Monitor (SUNS) 6299, 24 July 2007
The new HIV/AIDS drugs recommended by WHO raises the cost for patients by nearly 500%, according to Medecins Sans Frontieres. This could affect the availability of these drugs in developing countries. This finding by MSF was in the latest edition of its report "Untangling the Web of Price Reductions" released at the fourth International AIDS Society Conference, in Sydney, Australia.
Response rates for providing a blood specimen for HIV testing in a population-based survey of young adults in Zimbabwe
McNaghten AD, Herold JM, Dube HM, St. Louis ME: BMC Public Health 7:145, 5 July 2007
To determine differences among persons who provided blood specimens for HIV testing compared with those who did not among those interviewed for the population-based Zimbabwe Young Adult Survey (YAS). When comparing persons who provided specimens for HIV testing with those who did not, few significant differences were found. If those who did not provide specimens had prevalence rates twice that of those who did, overall prevalence would not be substantially affected. Refusal to provide blood specimens does not appear to have contributed to an underestimation of HIV prevalence.
The Africa Multi-Country AIDS Program 2000–2006: Results of the World Bank's response to a development crisis
The World Bank, 14 June 2007
A new World Bank report on HIV/AIDS launched in the Rwandan capital, Kigali, says the mobilization of empowered 'grassroots' communities, along with delivering condoms and life-saving treatments, are beginning to slow the pace of the continent's epidemic, which last year killed more than 2 million African adults and children, and left another 24.7 million Africans struggling to live with its deadly effects. According to the new report, ultimate success in defeating HIV/AIDS will depend on marshalling effective prevention, care, and treatment, measures to boost 'social immune systems' in African countries—changing their beliefs, perceptions, and social and individual behaviors around the disease so that eventually they can reverse the advance of HIV and stop the damage done by AIDS. The report says these changes are taking place as the epidemic shows signs of slowing in Uganda, Kenya, and Zimbabwe, and in urban Ethiopia, Rwanda, Burundi, Malawi, and Zambia.