World AIDS Day 2009: Where are we in the fight against AIDS?

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On December 1, we recognize the 16th annual World AIDS Day and the 33 million people living with HIV/AIDS worldwide.

President Barack Obama gives this statement for today’s day of rememberance: "Our Nation joins the world in celebrating the extraordinary advancements we have made in the battle against HIV and AIDS, and remembering those we have lost...On World AIDS Day, we rededicate ourselves to developing a national AIDS strategy that will establish the priorities necessary to combat this devastating epidemic at home, and to renewing our leadership role and commitments abroad."

We have come a long way since the discovery of the illness in the early 1980’s, but how close are we to a cure for the virus? Here are some recent milestones.

The Global AIDS Alliance (GAA) has given President Obama a minimally passing grade of D+ on his performance regarding the global AIDS crisis. In a statement from Dr. Paul Zeitz, the group’s executive director, the President is charged with ignoring the medical and epidemiological evidence that indicates that more funding is needed to treat AIDS around the world.

In 2008, President Bush signed the Lantos-Hyde Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act, which allows for an additional five years and $48 billion toward helping those in need through programs that address these infectious diseases. The group indicates that President Obama has not met this commitment, though through PEPFAR (The Presidents Emergency Plan for AIDS Relief), the US has spent more than $85 million this year on AIDS treatments around the world.

New research from North Carolina State University shows that many of the one million people in the United States that are infected with HIV/AIDS are minorities that do not have health insurance. Only 17% of the 90,000 patients studied had healthcare through an employer, 18% were on Medicare, and 64% on Medicaid. The study authors state that the study emphasizes the lack of a federal strategic plan to deal with the high number of uninsured and minority groups dealing with HIV infections.

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The US National Institute of Allergy and Infectious Disease has praised the President for PEPFAR, stating that the number of organizations helping people to get ART have increased and is responsible for a tenfold increase in treatment access over the past five years, especially in sub-Saharan Africa, where the majority of HIV-infected people live.

The World Health Organization (WHO) has issued two new reports on the AIDS pandemic. The reports have found that the number of people worldwide infected with HIV has remained unchanged for about 2 years. However, the reports also indicated that AIDS is the leading cause of death among women of childbearing years worldwide and less than one-third of the people around the world who need antiretroviral treatments (ART) for HIV in 2008 actually received them.

WHO has issued new guidelines to increase the number of people eligible to receive ART in 2010 by raising the minimum CD-4 count from 200 to 350 as a qualification to those receiving treatment. South Africa, where approximately 5.7 million people are infected, announced today that they will roll out life-prolonging ART drugs to more people infected with the virus over the next year, based on the new guidelines.

Poor countries in Southeast Asia are expected to experience a spike in HIV infections due to decreases in funding for education, testing, and ART programs, according to the National Centre in HIV Epidemiology and Clinical Research and published in a report in the journal Current HIV Research. To improve the economy through travel income, China is considering lifting a ban that bars people with HIV/AIDS from entering the country. The proposed move will be discussed for next year’s Shanghai Expo, expected to bring in over four million foreign visitors. The United States lifted a similar ban in October 2009.

2009 held promise for future treatments for HIV-positive patients. This past October, a study in the New England Journal of Medicine found that a combination of two vaccines brought about a 31% reduction in infection rates among 16,000 adult volunteers in Thailand. Another trial found a stem cell transplant to be effective in providing immunity to HIV in one patient with both HIV and leukemia. A topical gel was found this past year to decrease the risk of contracting the virus in African women by 30%. And researchers from the International AIDS Vaccine Inititive discovered two immune-system antibodies that could become targets for future vaccine research. Researchers at the Kimmel Cancer Center at Thomas Jefferson University released their findings from a study which found a mechanism to inhibit HIV-1 from entering cells.

Sources for this report include:

AVERT – an international AIDS Charity, http://www.avert.org/origin-aids-hiv.htm
US Agency for International Development , http://www.usaid.gov/
U.S. President's Emergency Plan for AIDS Relief (PEPFAR), http://www.pepfar.gov/
Foundation for AIDS Research (amfAR) , http://www.amfar.org/
AIDS Healthcare Foundation , http://www.aidshealth.org/
Global AIDS Alliance, http://www.globalaidsalliance.org

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