Tuesday, October 18, 2011

International Experts Warn That Economic Downturn Could Stall Progress in Fighting the HIV/AIDS Pandemic

International Experts Warn That Economic Downturn Could Stall Progress in Fighting the HIV/AIDS Pandemic; Call for Expanded Investment in Prevention

WASHINGTON, Oct. 18, 2011 /PRNewswire-USNewswire/ -- As the world observes the 30th anniversary of HIV/AIDS, experts on the front lines in fighting the global pandemic are confronting a new and unexpected front in the war on this disease –the economic downturn, which has resulted in cuts to HIV prevention, care and treatment programs in the U.S. and poses a significant risk to HIV programs in resource-strained countries in the Caribbean, Africa, Eastern Europe and Central Asia.

Meeting in Washington at the 2011 National HIV/AIDS Summit --a major international scientific and policy conference hosted by the Forum for Collaborative HIV Research -- nearly 100 leading research scientists, advocates, members of industry and global health leaders cautioned policymakers that despite the extraordinary progress in the fight against HIV disease, the pandemic is still not under control and is a major drain on the economies of both developed and developing nations. Currently, there are 33 million people worldwide living with HIV, including 1.2 million people in the U.S. and each year, approximately 2.6 million new HIV infections and 1.8 million HIV-related deaths occur worldwide.

Agreeing that scientifically proven treatment and prevention tools already exist to turn around the trajectory of the HIV/AIDS pandemic, the experts at the summit mapped out the HIV/AIDS community's response to the global recession, which threatens to stall the great strides made over the last three decades in the care and treatment of people living with HIV. Specifically, the group called for an expanded investment in prevention programs, including reducing transmission through universal HIV testing and increased access to treatment for those already infected; antiretroviral (ARV) drug regimens to prevent mother-to-child transmission; and stepped up use of medically supervised adult male circumcision, topical microbicides, and pre-exposure prophylaxis with antiretroviral drugs to prevent HIV acquisition. According to recent estimates from the World Health Organization, expanded use of these prevention tools could avert half of the 62 million new HIV infections projected to occur between 2005 and 2015.

"Unless the incidence of HIV infection is sharply reduced, treatment will not be able to keep pace with all those who need it," said Veronica Miller, Ph.D., the Forum's executive director. "An increased focus on HIV prevention is crucial to overcoming this global epidemic and thus, must become a new priority for the global public health community."

Assessing the Scientific Progress to Date; Defining Immediate Priorities for Implementation

Unlike the myriad meetings looking back at the 30 years of HIV/AIDS, the 2011 National HIV/AIDS Summit not only tracked the scientific progress to date in controlling the HIV epidemic but also focused on the current challenges for the scientific community -- matching the advancements in treatment with the delivery of care to every person infected or potentially infected with the virus.

Presenting the state of the science, Martin S. Hirsch, MD, Professor of Infectious Disease and Immunology at Harvard Medical School and a seminal figure in the development of multi-drug therapy for HIV, charted the significant advances in understanding of HIV biology and pathogenesis, which led to the introduction of zidovudine (AZT) in 1987 and the use of combination Highly Active Antiretroviral Therapy, or HAART, in the late 1990s; and now, the refinement of HAART which leads to systemic suppression of HIV replication and significantly reduces the risk of HIV transmission to a sexual or needle-sharing partner. Increasing the treatment armamentarium, Dr. Hirsch also focused on the implications for medical practice of providing antiretroviral drugs to uninfected men and women exposed to HIV through sexual or needle sharing contact – a strategy called pre-exposure prophylaxis, or PrEP.

At the same time, Dr. Hirsch documented the accelerated pace of drug discovery, which has led to the development of more than 30 licensed antiretroviral medications for the treatment of HIV infection, including single pill fixed-dose combinations (FDCs) and PK (pharmacokinetic) boosters that lead to higher blood levels of some anti-HIV medications so that a lower dose can be taken. Moreover, Dr. Hirsch reported that the HIV drug development pipeline is robust, with 12 novel agents and fixed-dose combinations in Phase II or III studies and several promising compounds in Phase I clinical trials.

"Never in the history of infectious diseases have we learned so much about a viral disease in so little time. We have turned an almost universal death sentence into a manageable infection," Dr. Hirsch noted.

But despite these impressive gains, the Harvard scientist stressed that many challenges still lay ahead for the global HIV/AIDS community and therefore called for accelerated adoption of routine HIV testing to identify and treat more infected individuals earlier, increased use of antiretroviral pre- and post-exposure prophylaxis, and continued efforts to develop prophylactic and therapeutic vaccines and immunotherapies.

NIAID Director Tony Fauci Focuses on the Future

When it comes to charting the future course for the HIV/AIDS community, no one is more qualified than Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), who has directed the federal government's biomedical research efforts against HIV/AIDS since the beginning of the epidemic and is now one of the world's most widely cited scientists for his contributions to HIV disease. After an awards ceremony where former Surgeon General Dr. C. Everett Koop and Rep. Henry Waxman (D-CA) presented Dr. Fauci with the 2011 C. Everett Koop HIV/AIDS Public Health Leadership Award, the NIAID Director gave a national address to policymakers and the HIV/AIDS community on his lessons learned over 30 years in combating HIV/AIDS.

Describing HIV/AIDS as "one of the most catastrophic public health challenges that mankind has ever faced," Dr. Fauci said the most important lesson in the war against HIV/AIDS is that the battle is far from over. According to the NIAID Director, HIV remains a devastating pandemic that is traumatizing many communities, both in the United States and internationally.

Addressing the research challenges that lay ahead, Dr. Fauci said the development of a safe and effective AIDS vaccine would be the "ultimate game changer" along with finding a cure for those already infected with HIV. However, he stressed that the HIV/AIDS community already has the means to make extraordinary inroads in controlling the AIDS pandemic worldwide and called for accelerating the transition from scientific advances to the implementation of proven prevention tools, from needle exchange programs for injection drug users and antiretroviral treatment of HIV-infected pregnant women, to adult to male circumcision. Dr. Fauci also cited greater emphasis on "treatment as prevention" (universal HIV testing and immediate linkage to care of the newly identified HIV infected persons) and using pre- and post-exposure prophylaxis as important strategies to decrease HIV acquisition.

"We already have within our grasp the scientific wherewithal to turn around the trajectory of the HIV/AIDS pandemic using these treatment and prevention tools," Dr. Fauci told the summit attendees. "It is now up to all of us to demonstrate the political and social will and dedicate adequate resources to effectively translate these scientific advances into practice, and in doing so, save millions of lives and reduce the future financial burden to societies around the world."

In two panel sessions, distinguished scientists, advocates and global public health leaders restated Dr. Fauci's assessment, agreeing on the need to accelerate the field of "implementation science" in HIV, an area focused on answering key questions that will improve the prevention, early diagnosis and consistent treatment of people with HIV. At the same time, the panelists agreed that reducing the burden of HIV/AIDS will require sustained funding for the distribution of HIV medicines both in the U.S. and globally, and effective ways to reach, diagnose and treat both persons who are infected and those who are not yet diagnosed.

About the 2011 National HIV/AIDS Summit

Taking place on September 22 on Capitol Hill, the 2011 National HIV/AIDS Summit was convened by the Forum for Collaborative HIV Research to chart the progress to date in fighting HIV/AIDS and to focus on the current challenge for the scientific community -- matching the advancements in treatment with the delivery of care to every person infected or potentially infected with the virus.

Along with keynote addresses from Dr. Fauci and Dr. Hirsch, the summit featured two panel discussions. The first panel, entitled Progress in the World of Science, was moderated by Kenneth Mayer, MD, Director of HIV Prevention, Beth Israel Deaconess Medical Center and Medical Research Director, The Fenway Institute, and featured remarks from James Curran, MD, MPH, Dean of the Rollins School of Public Health at Emory University; Lynda Dee, President of AIDS Action Baltimore; Sharon Hillier, Ph.D., a leader in HIV/AIDS clinical research from the University of Pittsburgh School of Medicine; Jesse Milan, Jr., Vice President and Director, Community Health Systems at the Altarum Institute; and Roger Pomerantz, Senior Vice President and Head of Infectious Disease at Merck & Co., Inc.

The second panel, Challenges in Translation and Implementation, featured five international leaders in HIV/AIDS: Mark R. Dybul, MD, former U.S. Global AIDS Coordinator and now Co-Director of the Global Health Law Program at Georgetown University's O'Neill Institute for National and Global Health Law; Christine Lubinski, Vice President of Global Health for the Infectious Diseases Society of America; Gregory Pappas, MD, Ph.D., Director of Washington, DC's HIV/AIDS, Hepatitis, Sexually Transmitted Diseases and Tuberculosis Administration; Art Reingold, MD, Professor at the University of California, Berkeley School of Public Health; and James Rooney, MD, Vice President of Clinical Affairs for Gilead Sciences, Inc. The session was moderated by John G. Bartlett, MD, Professor of Medicine in the Division of Infectious Diseases at The Johns Hopkins University School of Medicine and co-chair of the Forum's Executive Committee.

About The Forum for Collaborative HIV Research

Now part of the University of California (UC), Berkeley School of Public Health and based in Washington, D.C., the Forum was founded in 1997 as the outgrowth of a White House initiative. Representing government, industry, patient advocates, healthcare providers, foundations and academia, the Forum is a public/private partnership that organizes roundtables and issues reports on a range of global HIV/AIDS issues. Forum recommendations have changed the ways that clinical trials are conducted, accelerated the delivery of new classes of drugs, heightened awareness of TB/HIV co-infection, and helped to spur national momentum toward universal testing for HIV. http://www.hivforum.org

SOURCE Forum for Collaborative HIV Research

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