Monday, November 29, 2010

World AIDS Day - December 1st, 2010 - Universal Access

December 1, 2010 is the 13th annual commemoration of World AIDS Day. This year, for a change, there is actually some good news! A drug in use for treatment of HIV/AIDS since 2004, Truvada, has been shown to significantly reduce the risk of contracting HIV when taking preventatively. We're talking VERY significantly. When taken daily, it was more than 90% effective. Now of course the study only included gay men, but scientists are hopeful that it will prove equally effective in other populations at risk, such as women, intravenous drug users, etc. (And the company hasn't even announced if they will apply for approval from the FDA - at this point this is just very promising research.)

This discovery comes on the heels of another advance, this past summer, when a vaginal microbicide, long sought after as a realistic way for women to protect themselves against heterosexual transmission of HIV, finally proved effective, after many years of failure with other drugs. (The vaginal microbicide was 54% effective amongst women who used it regularly, and the testing process is proceeding slowly due to funding issues.)

So it would seem that we are making some real advances, at least on the pharmaceutical front. But drugs for prevention and treatment are absolutely useless if they do not reach the people who need them. Most of the people who get HIV/AIDS these days are not people of means, people with access to health care, people who are empowered around their sexuality. They are poor people, especially poor women, living in poor countries. They are children, who are not born in settings where mother to child transmission can be prevented. They are prisoners, and drug users who cannot get the means they need to protect themselves (condoms, clean needles). Which is why the theme of this year's World AIDS Day is Universal Access.

The key to ending the global health crisis of AIDS is access to prevention, treatment, and care. (I would include in this concept access to education and decent birthing conditions.) Only about 5 million of the 33 million people with AIDS actually receive anti-retrovirals. Every year 3 million children contract HIV, and another 330,000 children die from it. AIDS isn't the problem here. Lack of access is the problem. Just as malaria isn't really a problem - lack of bed nets and medication is the problem. And how many American or Canadian children do you know who die of diarrhea? The solutions are in our grasp.

Here is an interesting article from the NY Times about why exactly it took so long for researchers to figure out that this drug (actually a combination of drugs), which has been around for years, would be effective in a preventative way, and not just as a treatment.

For you science-loving people, here is the original study about the Truvada trial, from the New England Journal of Medicine.

And for World AIDS Day, here's a nice little video from the folks at the great UK AIDS/HIV organization Avert.

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