What will the HIV/AIDS epidemic look like in 2031, on its 50th anniversary? A provocative article in Health Affairs, online here, tries to answer that question, and the picture is not pretty.
Without a “gamer changer” in prevention, the AIDS epidemic will still be raging when we reach that milestone, write Robert Hecht, managing director of the Results for Development Institute, and his co-authors in the lead article.
“Without a change in approach, a major pandemic will still be with us in 2031,” Hecht et al declare. “Modeling carried out for the AIDS 2031 project suggests that funding required for developing countries to address the pandemic could reach $35 billion annually by 2031—three times the current level. Even then, more than a million people will still be newly infected each year.”
They argue that smart policy decisions and more efficient treatment strategies, among other steps, could cut costs and lead to better results. But the findings signal a major funding shortfall in global AIDS programs in the coming decade, not to mention the here and now.
“We are staring at the face of a huge crisis,” Hecht said in a news release highlighting the Health Affairs article.
Hecht’s piece is just one in a series of articles in this issue of Health Affairs devoted to current challenges in HIV/AIDS prevention and treatment. The November/December issue also includes an article by Stefano Bertozzi, of the Bill & Melinda Gates Foundation, on the need to shift away from the emergency response mode in AIDS to a more sustainable effort, and a piece by Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, and Gregory Folkers, who call for increased global funding for AIDS prevention research. Click here to check out this issue.
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What will come of Anthony Fauci’s call for a “transformative” research agenda for tuberculosis, in which doctors and scientists get new resources and support in the search for better drugs and diagnostics to combat this ancient scourge?
Fauci, head of the National Institute of Allergy and Infectious Diseases, delivered that appeal for a more aggressive approach to TB last summer, during the Pacific Health Summit meeting in Seattle on the growing threat of drug-resistant TB. The Pacific Health Summit just issued this report on that meeting, providing a fresh reminder of Fauci’s stirring remarks.
“Why don’t we have 30 new drugs for tuberculosis, a disease that we know is eminently curable?” Fauci asked in an opening speech to leaders at the summit. One reason, he suggested, is that “a transforming research effort has not been evident…we are seeing the winds of change, but what we really need is a storm.”
Part of the reason we might not get that storm is highlighted in this very interesting post on scienceline.org about low TB rates in the U.S. and how they may provide false reassurance that TB is not a real (or close) threat. That item includes a great poster from a 1920s public health campaign against TB–the kind of campaign that Dr. Robin Wood talked about during his visit to Washington last week. Click here and here to read more on that.
That blog item and the Pacific Health Summitt report come just as TB gets some needed attention on Capitol Hill, where a Congressional briefing scheduled for tomorrow will focus on “how U.S. investment in global health research has advanced” the scientific quest for more effective TB treatment strategies. Click here to get more info on that event.
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Posted in Uncategorized, tagged Fauci, funding, Goosby, HIV/AIDS, Obama, OCAG, PEPFAR, prevention, resources on July 20, 2009|
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This post is by Center Director Christine Lubinski, who is attending the 2009 IAS conference in Cape Town.
Dr. Anthony Fauci, director of NIAID, addresses IAS meeting in Cape Town
There was no shortage of hot-button questions for Dr. Eric Goosby, the new US Global AIDS Coordinator, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, at the International AIDS Conference today.
*What new directions might the new Administration take regarding injecting drug users and sex workers? (Read do we still have to live with a ban on funding for syringe exchange and the prostitution pledge?)
*How can the AIDS response achieve better outcomes and improve programming for maternal/child health and family planning with same level of resources?
*How will the U.S. response work to ensure that treatment advances (presumably less toxic regimens and earlier access) reach the developing world? (more…)
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Note: From July 19-22, the Center for Global Health Policy’s staff will be live blogging from the International AIDS Society 2009 meeting in Cape Town. This post was written by Center director Christine Lubinski, who attended a two-day pre-meeting on HIV/TB co-infection.
Despite the scope and gravity of HIV/TB confection, there are glimmers of hope from the field—new diagnostics, a better vaccine, and a host of other innovations were the subject of a two-day session in Cape Town, “Catalyzing HIV/TB Research: innovation, funding, and networking,” which served as a prelude to the 2009 IAS meeting. The backdrop provided a fitting reminder of the urgency of this health crisis; South Africa is the epicenter of the co-infection epidemic, with one quarter of the world’s cases of HIV/TB co-infection.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, headlined the meeting, organized by the World Health Organization, the International AIDS Society, the Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE), and other groups. Calling the most commonly used diagnostics for TB “ridiculous,” Fauci noted that it was “tragic and shameful” that generations of research advances had “bypassed TB research.” As he did at the Pacific Health Summit on MDR-TB in June, Fauci called for a transformative research response to TB and by extension, HIV/TB co-infection.
Dr. Fauci’s address was followed by a series of presentations that both highlighted the enormity of the problem and its associated morbidity and mortality, but also framed the potential that further research and more widespread implementation of interventions hold.
Dr. Robin Wood, from the Desmond Tutu HIV Research Center at the University of Cape Town, focused on the impact of ART on TB prevention. Dr. Wood reported that 67 percent of persons presenting for ART in their clinics have TB or have had TB. Analyzing the impact of ART on a high HIV prevalence township community, researchers found a 77 percent reduction in HIV/TB co-infection during the 5-year ARV rollout period. Wood noted while there is widespread speculation about the impact of community-wide ART penetration on HIV incidence, there is little doubt that small changes in HIV prevalence produce dramatic changes in TB incidence. The earlier ART is started, the greater the impact on TB, given the increased vulnerability to TB as HIV disease progresses. (more…)
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Posted in global health, HIV/AIDS TB co-infection, Pacific Health Summit, TB, tagged Fauci, MDR-TB, NIAID, NIH, Pacific Health Summit, TB, XDR TB on June 17, 2009|
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This live blog is from the Pacific Health Summit in Seattle, a three-day meeting that opened Tuesday night. Its focus is the global response to multidrug-resistant tuberculosis.
Anthony Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told the Pacific Health Summit today that it was urgent to begin a broad new research agenda to fight tuberculosis around the world.
In an invitation-only meeting involving 250 global TB experts from 25 countries, including representatives that ranged from industry to foundations to governments, Fauci delivered a sweeping “state of the science’’ speech that built a case for a major new sustained TB research effort.
“We have had decades of relative neglect given the extent the of the problem,’’ Fauci said. “There is much catching up to do and this will require a sustained effort’’ with major funding commitments. (more…)
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