H5N1

Canada: Harper government fails Africa on AIDS drugs

Via The Star, an editorial: Harper government fails Africa on AIDS drugs. Excerpt:

Canada shrugged as the United Nations issued a plea this weekend for help for millions of people in Africa and other poor regions who are fighting AIDS with scant access to life-saving drugs. 

Well, Canada didn’t shrug exactly. 

It was Prime Minister Stephen Harper’s Conservative government that decided to usher in World AIDS Day on Saturday by killing a bid in Parliament to speed more low-cost drugs to the poorest countries. Bill C-398, put forward by New Democrat MP Hélène Laverdière, would have made it easier for our generic drug firms to copy patented AIDS drugs and sell them to poor countries at cut-rate prices, while paying royalties to the patent holders. A strong majority of Canadians favour such action. 

But for years, the Harper government has trotted out one unpersuasive objection after another. They claimed it would violate our trade obligations, until international experts refuted them. Then they argued that it would hurt Big Pharma, until the major drug firms announced they wouldn’t object (subject to a few minor caveats). Then they argued that plenty of generics were available, although half the people who need them don’t get them. When all else failed, the Tories just flexed their majority Wednesday and killed the bill. 

As Stephen Lewis, the UN’s former AIDS envoy, rightly observed, the Conservatives “have chosen patent protection over the lives of children.” Some 330,000 children were infected with HIV last year, 90 per cent in Africa. One in four will get treatment.

Jordan takes note of the novel coronavirus

The Jordan Times has picked up a Reuters report on Friday's news: Two deaths in April blamed on SARS-like coronavirus. Much of the story is a rehash of earlier accounts, quoting WHO spokesperson Gregory Hartl. Buried well down in the story is the local angle:

The Jordan cases were among a total of 12 cases of severe acute respiratory illness that erupted last April linked to a hospital in Zarqa, some 22km east of Amman, Hartl said. Most were health workers, he added. 

“The link is the hospital. It could be some environmental thing or human-to-human transmission,” he said. 

“The main thing is the fact that even if it were human-to-human transmission, which we don’t know, it doesn’t seem to spread very well or efficiently,” Hartl said. 

The two so-called “clusters” of cases, in Saudi Arabia and Jordan, raised the possibility of “limited human-to-human transmission”, or exposure to a common source, the WHO said. 

“Ongoing investigation may or may not be able to distinguish between these possibilities,” the UN agency said, noting that some viruses are transmitted within families but are not transmissible enough to cause large community outbreaks.

Did WHO do the right thing about coronavirus in Jordan?

Via his blog Operational Biosurveillance, Dr. James Wilson posts: Review: The Novel Coronavirus Warning Sequence (Jordan). Excerpt:

Some in the security field would understandably suggest that, with tensions in the Middle East being high we should not "rock the boat" over confusion regarding attribution. As we have pointed out multiple times with the full weight of years of operational experience monitoring and assessing the world for infectious disease events, crises, and disasters, this is a poor strategy. Investigation of attribution is rarely relevant to pre-emptive warning and awareness of front line medical responders.  

Rolling the dice in the hope an unrecognized traveler, infected with a previously uncharacterized infectious agent, from Jordan would not arrive in New York City or other US megalopolitan area is gambling with the lives of not only the Jordanian patient but everyone in the emergency department waiting room and all of the medical staff who would have unknowingly come into contact with the patient.  

Needless to say, had novel coronavirus entered the US in April 2012, we might have seen a nosocomial outbreak as the Jordanians saw - an outbreak that would have proceeded unchecked with a substantial amount of social disruption thanks to the tagline, "unknown" and "killed".  In short, this was a foolish and reckless gamble. 

A little housekeeping

I've spent some of this dark, rainy December afternoon doing some site maintenance. Quite a few cobwebsites are gone (some have been gathering dust for five or six years), and I've dropped the advertising links to my books. That made room for rearrangements: Hot Zone Sources is now in the right-hand column just under the Google search function, and other lists have been moved up or down.

I use the site as a workspace, and in theory all the links would result in frequent new posts. In practice, some are seldom visited; I leave them there because some visitors might find them useful even if I don't. If you know of sites that should be here (especially bloggers), please let me know. 

Canada: Sharing wisdom to improve HIV/AIDS treatment

Further to the post below, a report in The Tyee by my colleague Tom Sandborn: Sharing Wisdom to Improve HIV/AIDS Treatment. Excerpt:

What is one of Vancouver's strengths in the fight for progress in HIV/AIDS treatment?  

Civility. 

That's one quality members of a delegation of Jamaican media and political figures took note of during a visit to share knowledge and understanding about the disease. 

"Vancouver is so civil. And we know that civility is needed to make any progress," Dervan Malcolm, an energetic and successful radio talk show host on leading Jamaican station Power 106 FM told The Tyee. "I am impressed with what we are learning about HIV/AIDS treatment here." 

Civility might be the underlying value. But a groundbreaking, made-in-B.C. program helps, too. 

The delegates offered their comments days before the B.C. government announced that a pilot project called "Stop HIV/AIDS," with the aim to end HIV transmission, will go province-wide starting April 1.  

Health Minister Margaret MacDiarmid said yesterday that the government is committing $19.9 million in annual funding to new outreach programs, testing methods, more front-line staff and to cover other prevention and treatment programs, according to a Canadian Press report. 

Since the project's launch in 2009, infection rates in B.C. have dropped dramatically. Julian Montaner, leader of the BC Centre for Excellence in HIV/AIDS, said the program is working towards eliminating the disease altogether in the province.

The delegates from Jamaica visited the centre earlier this week, and sat down with The Tyee to discuss impressions of Vancouver's approach to HIV/AIDS treatment and prevention, and impressions of their own country's efforts. 

The rate of HIV prevalence for adults in Jamaica was believed to be 1.7 per cent, or about 32,000 people, in 2009. In the same year roughly 65,000 Canadians were believed to be living with HIV/AIDS, mainly in B.C., Ontario and Quebec.

Canada: BC rolls out provincial program to combat HIV/AIDS

Via the British Columbia Centre for Excellence in HIV/AIDS, a story we can be proud of: B.C. rolls out provincial program to combat HIV/AIDS. Excerpt:

On the eve of World AIDS Day, Health Minister Margaret MacDiarmid announced $19.9 million in annual funding for the provincial expansion of a successful pilot program that reduces HIV transmission by ensuring those living with HIV have access to the best care and treatment. 

"Over the past 30 years, we have turned around a disease that was once an imminent death sentence into a long-term manageable condition," said MacDiarmid. 

"As part of our vision for an AIDS-free generation, we are providing $19.9 million in annual funding to health authorities to expand the successful pilot initiatives throughout British Columbia. By reaching and engaging more British Columbians at-risk for or living with HIV/AIDS, not only will better care be provided, the treatment will also significantly reduce the spread of the virus." 

Beginning April 1, 2013, the Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) program will allow health professionals and community partners to better engage the broader community and specific at-risk groups in HIV testing, reach more people with HIV/AIDS, and enable more people to be treated. 

Some examples of where health authorities could spend the money include: new outreach programs, new HIV testing technologies like rapid point of care testing, additional front line staff or funding for community groups to run prevention, testing, treatment and support programs. 

Expansion will be carried out by the province's health authorities with support and leadership from the BC Centre for Excellence in HIV/AIDS, which pioneered the concept of Treatment as Prevention under the guidance of the centre's director Dr. Julio Montaner. The centre will also continue to monitor and evaluate the progress of the program. 

The initial four-year, $48-million pilot started in 2009 in Vancouver and Prince George, and has allowed health professionals in the pilot areas to identify more people that have HIV/AIDS and enabled more people to be treated. In contrast, in non-pilot health authorities, there has been an overall decline in the number of people being diagnosed with HIV and the number of people accessing treatment. 

The landmark drug cocktail Highly Active Antiretroviral Therapy (HAART), also pioneered by Dr. Montaner and his team in the early 1990s, can reduce the amount of virus in the blood and bodily fluids to undetectable levels, greatly reducing HIV transmission. 

HIV medications are free of charge to all B.C. residents living with HIV, and HAART has been adopted in Canada and around the world as the gold standard of treatment.

Haiti on World AIDS Day

Via HaitiLibre.com: World Day Against AIDS. Excerpt:

According to Dr. Reynold Grand'Pierre, Director of the Directorate of Family Health (DSF) in Haiti before the earthquake of January 2010, were estimated to 120,000 the number of people living with HIV in Haiti, whose 6.800 children under 15 years. 

"The public information campaign on the Prevention of HIV Transmission from Mother to Child (PMTCT) was launched to eliminate by 2015 the transmission of HIV and syphilis from mother to child, throughout the territory of Haiti." 

Dr. Guirlène Calixte, Programme Officer at "Management Ressource Community Health" (MARCH), ensures that PMTCT, has allowed significant advances in Haiti. "In 2010, MARCH tracked 3,600 pregnant women and less than 30 of them were positive," recalling that "the prevalence of HIV / AIDS is currently around 2% while in Haiti before 2000, it was 6%."

Uganda: Why HIV prevalence is on the rise

Via The Saturday Monitor: Why HIV prevalence is on the rise. Excerpt:

Every year, 130,000 new infections are reported, and donors are growing weary and restless, as they consider the prospect of an ever-rising cost of keeping thousands of infected people alive. The national HIV strategic plan, for instance, targeted a 40 per cent reduction in new infections by 2012. This would be 100,000 infections annually. 

According to Ministry of Health estimates, the country is still registering close to 130,000 new infections every year—a surplus of over 30,000 new cases above the target, causing leading experts to warn that unless critical interventions are put in place, the epidemic could be moving in a reverse direction. 

So, what has gone wrong with Uganda’s anti-HIV campaign? 

Speaking at a public forum on HIV/Aids, as part of Makerere University’s 90th anniversary celebrations, Dr Alex Coutinho, who heads the Infectious Diseases Institute, said multiple factors were behind the rise in Uganda’s HIV prevalence. 

While there was a time when the government made HIV a major national concern, it is no longer the case among the political leadership. 

Dr Coutinho says the leaders have not been speaking enough about HIV/Aids. Their support for the campaign is not as visible and vocal as it used to be in the early years of the epidemic. 

“Often times, leaders don’t do by example. When was the last time you saw leaders coming forward to be publicly tested for HIV/Aids? When have we seen leaders—the men coming out publicly to be circumcised,” he asks. 

Although President Museveni has played a key role in leading the fight against HIV/Aids, Dr Coutinho says Uganda has several other leaders the people listen to, but who are not contributing much to the campaign against the scourge. He also accuses the government of having failed to direct programmes to the rural areas, which are a key driver of the epidemic. 

“In fact, most of the movement (of HIV/ Aids) in the wrong direction is coming from rural areas. There are some programmes that we are not putting particularly to rural populations that are accounting for this rise from five to seven per cent,” he asserts. 

There is also the question of double-standards. Married women can’t abstain and are expected to be faithful, so they can’t use condoms. But many men are not faithful or even expected to be. What’s more, the economic and social disempowerment of women forces them to remain in high-risk relationships, making it hard to achieve much progress. 

On the other hand, Uganda also appears to be a victim of its own success, officials say. News of the early success and the comfort created by the availability of antiretroviral drugs that help postpone the onset of Aids have led to complacency and a return to risky sexual behaviour. 

As a result, fewer people are using condoms regularly and more people, including married people in long-term relationships are taking on multiple sexual partners.

Over 40% of HIV patients in Guinea do not have access to ARVs

Via Xinhua: Over 40% of HIV patients in Guinea do not have access to ARVs. Excerpt:

Over 40 percent of the people infected with HIV/AIDS in Guinea do not have access to anti- retroviral drugs (ARVs), a source from Medicins Sans Frontiere (MSF, Doctors Without Borders) said in a statement on Friday, just a day before the World AIDS Day. 

Guinea has a 1.5 percent prevalence rate of HIV infections which translates to 80,000 people from all genders as well as people from different professional background. 

Among those infected, only one out of six children receives the appropriate medication while only four out of ten infected women receive ARV medication. 

The Guinean government and its development partners intend to use the World AIDS Day to sensitize the public about the disease which is common in the poor countries and urge them to change their behavior. 

Estimates of the socio-economic impact of AIDS in Guinea show that if no immediate concrete action is taken, then the number of deaths of infected people who are aged between 15 - 49 years will reach 37 percent in 2015.

Bill Gates: On World AIDS Day, a call to action

Via The Gates Notes.com, a statement by Bill Gates: On World AIDS Day, a Call to Action.

Each year on December 1 we observe World AIDS Day as an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with the virus, and remember people who’ve died. 

The theme for World AIDS Day this year is "Working Together for an AIDS-Free Generation." This year is especially important because the world is making huge progress against HIV, but we still don’t have all the tools we need to end the epidemic. This is a time for everyone to learn the facts about AIDS and put knowledge into action. 

When you look at the facts, you see there’s a very clear, cause-effect relationship between the world’s level of investment in HIV treatment and prevention and the number of lives saved. Providing women, men and children with access to low-cost treatment literally means the difference between life and death. Access to treatment is reviving entire communities by helping people live healthy and productive lives. 

But we still have much more to do. The rate of new infections is going down, but the number of people who get infected every year is still double the number who gain access to treatment. We need to stay focused on developing new prevention methods, like long-lasting pills and injectables, that can provide people with sustained protection over time. 

And we have to stay focused on finding an HIV vaccine. A lot of new discoveries have given us hope that we can produce a safe and effective vaccine to protect future generations. 

The organization leading the international anti-AIDS effort is The Global Fund, which currently provides HIV treatment to nearly 4 million people in Africa and is also a key partner in efforts to end mother-to-child transmission of HIV. The Global Fund has a new executive director, Mark Dybul, the former U.S. global AIDS coordinator. And it recently adopted a new approach to funding grants by investing additional money in health programs that are poised to achieve the strongest impact. 

I’m convinced that the right people and organizations are assembled to push toward beating this epidemic. What’s not yet in place are the necessary financial resources. The Global Fund relies on voluntary contributions. Many governments and private organizations, including our foundation, have invested significant amounts, but the donations received so far fall short of what is needed to expand affordable treatment to those who need it. 

One of the best ways that people can support the fight against AIDS is to donate to the Global Fund. You can contribute through the UN Foundation or by buying great holiday gifts through Product Red. 

Take a few minutes to learn more about World AIDS day from these sites: UNAIDS for global information and AIDS.gov for information about the state of HIV in the United States. Then consider helping with a contribution to the Global Fund.