Posts Tagged ‘IAS’

Daniel R. Kuritzkes, MD, Professor of Medicine at Harvard Medical School

The International AIDS Conference starts up in less than a week in Vienna, Austria.  ScienceSpeaks is gathering thoughts from leaders in the field HIV/AIDS treatment, research and advocacy in the question and answer series “Looking toward Vienna.”

Daniel R. Kuritzkes, MD, is a Professor of Medicine at Harvard Medical School. He is also the Head Director of the AIDS Research section of Retroviral Therapeutics at Brigham & Women’s Hospital in Boston.  Dr. Kuritzkes also serves as Vice Chair of the Executive Committee of the Adult AIDS Clinical Trials Group (ACTG) and is the Director and Principal Investigator of the Harvard Adult AIDS Clinical Trials Unit.

What are your expectations for the conference?

I hope that the conference will be another opportunity for networking and for inter-disciplinary discussion, particularly for people that have been developing therapeutics and those charged with rolling out ART in developing countries where there is high demand for these medicines.

I’m looking forward to dialogue about the intersection of therapeutics and prevention. The results of the first PrEP trials will be fostering much discussion, with the presentation of the CAPRISA trial results.

Any sessions you are particularly looking forward to?

President Clinton is going to be speaking again on Monday and that’s always interesting and exciting. Also, the sessions on therapeutics and drug resistance are a particular interest of mine. The discussions on the intersection of therapeutics and prevention, and discussions of the ongoing roll-out of HIV treatment in developing countries, are what this meeting especially helps to foster.

I do expect to hear news about novel antiretroviral regimens, HIV drug resistance, the role of immune activation in disease pathogenesis, HIV prevention, and of course HIV and TB.

The pivotal trial for rilpivirine (TMC278) will also be presented.  This drug potentially provides an alternative to efavirenz (EFV), lacking the CNS toxicity and the teratogenicity of EFV.  In addition, the AIDS Clinical Trials Group will be presenting data on bone effects of NNRTI- and PI-based regimens.  Lastly, before the actual conference gets underway there is an IAS-sponsored workshop dealing with viral persistence and eradication (Friday-Saturday) that I will be attending.

Are you aware of any new research in Vienna being released on HIV drugs?


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The International AIDS Society (IAS) announced Monday that the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), with its Center for Global Health Policy, will be one of two local scientific partners for the 2012 International AIDS Conference — to be held in Washington, DC in July 2012. HIVMA represents more than 3800 physicians, scientists and other health professionals who work in the field of HIV medicine in all 50 states and in a wide range of countries across the globe.

The National Institutes of Health has been selected to be the other local scientific partner. Other community local partners include the Black AIDS Institute, the District of Columbia Department of Health, the Office of National AIDS Policy, The US Positive Women’s Network. Sidaction was selected as the civil society partner.

In a press release, Chair of AIDS 2012 and IAS President-Elect Elly Katabira said, “With the announcement of these impressive and diverse civil society and local partnerships for AIDS 2012, we can look forward to ensuring that the conference further strengthens the U.S. role in global AIDS initiatives and re-energizes both the global and U.S domestic response to the epidemic.”

The IAS is the world’s leading independent association of HIV professionals, with 14,000 members in 190 countries. Along with its permanent partners, the Global Network of People Living with HIV, the International Council of AIDS Service Organizations, the International Community of Women with HIV/AIDS, and the United Nations Joint Program on HIV/AIDS, they will host the 2010 International AIDS Conference in Vienna, Austria, from July 18-23. Stay tuned to ScienceSpeaks for special articles leading up to the Conference and for live blogging from Vienna next week.

In other news, HIVMA chair Michael Saag, MD, will attend the unveiling of the National HIV/AIDS Strategy at the White House Tuesday afternoon. He will also attend an evening reception for the AIDS community where President Obama is expected to speak. The Global Health Center’s Director Christine Lubinski and HIVMA Executive Director Andrea Weddle also will be there.

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There is yet more reaction from Monday’s New York Times story on the unraveling of the fight against global AIDS. A very powerful, pointed post by International AIDS Society President-elect Elly Katabira gets right at the crux of the current crisis.

“Why are we now losing a battle that we had fought so hard… and won? ” he writes. “And where are the friends, including the G8 nations, that pledged to support universal access to HIV care in 2005?”

Click here to read the full post.

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With an eye toward rebuilding international commitment to combating global AIDS, the International AIDS Society (IAS) has created a new online tool to help scientists and other HIV advocates pressure their leaders to live up to Universal Access goals at upcoming G8 & G20 meetings.

With this e-advocacy campaign, individuals can click here to send a letter to any world leader (it’s available in six languages), urging top government officials to maintain leadership on global AIDS. In the U.S., for example, the letter would go to the White House, as well as House Speaker Nancy Pelosi and officials at the Office of the Global AIDS Coordinator.

The letter—which can be customized—reads, in part:

“Despite impressive advances, however, political and financial support for universal access is waning, and important gains against the epidemic may now be lost. In some high-burden countries, patients are being turned away from clinics, and clinicians are being forced to decide who will receive lifesaving treatment – and who will not. Reducing access to ART could lead to increased HIV drug resistance and would mean millions in need will die premature, avoidable deaths.”

It urges leaders to fully fund the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as to work with G8 and G20 leaders to make sure that AIDS is high on their summit agendas.

Write now!

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What is the best way to scale up and improve HIV treatment, care, and prevention for women and children?

The International AIDS Society tries to answer that pressing question with today’s release of a “comprehensive research agenda” focused specifically on addressing HIV knowledge gaps related to women and children. The IAS document, called “Asking the Right Questions: Advancing and HIV Research Agenda for Women and Children,” was created in coordination with more than a dozen other global health organizations.

This coalition notes that women and children make up the majority of the 33 million people living with HIV today, and yet there are many scientific barriers to proper treatment and prevention. For example, treating HIV in infants and children is very difficult because of a lack of pediatric dosages of antiretroviral drugs.

“HIV is the leading cause of death among women of reproductive age, and the leading cause of child death in many African countries, yet women and children are often either overlooked completely or folded into general responses to HIV,” IAS Executive Director Robin Gorna says in this press release touting the research agenda. “This agenda defines priority research needed to greatly improve our knowledge about and capacity to prevent and treat HIV in women and children. Implementation of this research agenda is key to closing these knowledge and service gaps, and to saving women’s and children’s lives.”

The research agenda lists four general categories as priorities:

1) Clinical research on prevention of mother-to-child transmission (PMTCT) and pediatric treatment

2) Clinical research on treatment issues for women

3) Operations research for women

4) Operations and implementation research related to PMTCT, including pediatric care, treatment and support.

Click here to read the whole document.

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“Sustainability” is the catchphrase increasingly tossed around in discussions about fighting the global HIV/AIDS epidemic. Now, a new opinion piece in the journal AIDS explores what it would take to achieve meaningful sustainability—outlining some key steps necessary to foster strong, enduring treatment programs in resource-poor settings.

As a backdrop, the authors, including Edward J. Mills, MD, of the University of Ottawa, and Julio Montaner, president of the International AIDS Society, note that the current international financial crisis has put HIV funding streams in jeopardy and report on decreased treatment targets, drug stock-outs, and other developments that threaten the recent gains in transforming HIV from a death sentence to a chronic management disease.

“Under dire circumstances, plans should be in place to ensure that we do not slide back to a time of little hope,” the authors write in AIDS. With indications that foreign policy priorities are shifting in the U.S. and elsewhere, the authors say that it’s time to examine “how to build a long-term response to HIV/AIDS that is less dependent on the vagaries of external support.”

They outline four arenas that merit intense focus for any such effort:

*Increasing human resources in a way that builds domestic production of health workers in Africa;

*Developing training capacity using regional expertise and a “university without borders” to provide training throughout Africa;

*Supporting regional drug production with keen attention to patent pools and related issues; and

*Building research capacity in a way that will increase career opportunities and bolster retention of African researchers.

Executing these steps will require more funding in the short term, the authors concede, “but donors must move beyond taking a 3-year perspective on a lifelong disease.”

Here’s the cite for the piece:

Ensuring sustainable antiretroviral provision during economic crises.
AIDS. 2009 Dec 17;
Authors: Mills EJ, Ford N, Nabiryo C, Cooper C, Montaner J

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Today’s White House news conference on the Obama Administration’s global HIV/AIDS efforts did not, in fact, provide all that much news.

The main announcement came from Secretary Hillary Clinton, who said the International AIDS Society would host its 2012 conference in Washington, D.C., a step made possible by the Administration’s repeal of the HIV entry ban. That two-decades-old ban barred HIV-positive individuals from coming to the U.S., a discriminatory rule that had no basis in public health.

Its demise “is a significant victory for public health and human rights,” Dr. Elly Katabira, associate dean for AIDS research at Makerere University and president-elect of IAS, said at the White House event. To be sure, it’s great that for the first time in 22 years the IAS meeting will be held in the U.S.–in D.C. no less, a city that, as Dr. Katabira noted, has been heavily affected by the HIV epidemic.

Clinton said that PEPFAR would serve as “the cornerstone of our Global Health Initiative,” the White House proposal, first unveiled in May, which called for spending $63 billion over six years on a new global health strategy. And Jeffrey Crowley, director of the White House Office of National AIDS Policy, said that Obama would build on PEPFAR’s success by “doubling PEPFAR funding over the next six years” as part of the GHI proposal. But Crowley didn’t elaborate, and the math behind that statement was unclear.

For now, we know that Ambassador Eric Goosby, MD, the Administration’s global AIDS coordinator, has predicted PEPFAR may be flat-funded, or nearly so, for fiscal years 2010 and 2011. And with key details of the Administration’s GHI remain under wraps, there’s still growing concern the administration will pull back from global AIDS scale up.

At today’s event, Dr. Goosby, said he would outline the five-year US global AIDS strategy later this week. The Office of the US Global AIDS Coordinator will also release some “annexes” later this week that provide more detail about the Administration’s plans to transition PEPFAR from an emergency response to a more sustainable “country-owned, country-driven” program, as Dr. Goosby put it.

“PEPFAR’s five-year strategy will focus on sustainability, programs that are country-owned and country-driven … programs that build upon our success and incorporate efficiencies,” Dr. Goosby said. 

So perhaps we’ll get some of the nitty-gritty details later this week. For now, on the eve of World AIDS Day, many critical questions about the Administration’s vision for PEPFAR and its commitment to scaling up the global AIDS initiative remain unanswered. What about funding levels? What about treatment targets? What about new evidence-based policies on needle exchange?

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