/ 3 June 2011

Thirty years on, Aids fight may tilt more to treatment

After 30 years of Aids prevention efforts, global leaders may now need to shift their focus to spending more on drugs used to treat the syndrome as new data show this is also the best way to prevent the virus from spreading.

The UN General Assembly will take up the issue next week as it assesses progress in fighting the syndrome — first reported on June 5 1981 — that has infected more than 60-million people and claimed nearly 30-million lives.

Guiding the meeting is groundbreaking new data that shows early treatment of the human immunodeficiency virus, or HIV, can cut its transmission to a sexual partner by 96%.

“There had been for a long time this artificial dichotomy or artificial tension between treatment versus prevention. Now it is very clear that treatment is prevention and treatment is an important part of a multifaceted combination strategy,” Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases division of the National Institutes of Health (NIH), told Reuters.

Fauci, who has made Aids research his life’s work, has a big role to play in the discussion of the NIH-funded study made public on May 12.

“A month ago, we didn’t have that data. People were still arguing. ‘Well, we are not so sure if you treat people you are really going to prevent infection,'” Fauci said. “The policy makers need to sit down and say, ‘Now that we know this, is this going to be enough incentive to change around our policy?'”

Metaphor for inequality
That could mean redirecting, or adding to, global spending on fighting Aids, particularly how much is spent on education or other research versus antiretroviral drugs that allow patients to live with the suppressed disease for many years.

In 2010, nearly $16-billion was spent on HIV response in low and middle-income countries, according to the UN Programme on HIV/Aids.

UNAids says at least $22-billion will be needed to combat the syndrome by 2015, helping avert 12-million new infections and 7.4-million more deaths in the next decade.

Globally, the number of people living with HIV rose to 34-million by the end of 2010, from 33.3-million a year earlier. But in poorer countries, a majority of eligible patients were not receiving antiretroviral treatment, according to UNAids.

Fauci says he has already discussed this with policymakers and may make public his views on needed policy changes at the International Aids Society meeting in Rome.

“I don’t think it’s going to be one-size-fits all,” Fauci said of the policy approach. “There is going to be certainly a difference between how things are looked at in the developing world and the developed world. And within the developed world, I think it will be a country-by-country issue.”

UNAids executive director Michel Sidibe noted that Aids remained “a metaphor for inequality” as the vast majority of patients live in Africa, where every year nearly 400 000 babies are born with HIV.

“If you’re privileged to be born in the North, you will not die from HIV. It you’re privileged to be born in the North, you will not have a baby born with HIV,” Sidibe said.

“Countries need to start looking at innovative financing. We need to have drugs which are not just for the rich market.” – Reuters