AIDS 2012: HIV, HCV & TB advances not reaching those most in need

HIV i-Base and the Treatment Action Group (TAG) reveals the deepening gulf between new scientific advances in HIV, HCV and TB & access to treatment. KC Ishdeep Kohli reports from AIDS 2012.

At the XIX International AIDS Conference in Washington DC (AIDS 2012), activists, implementers, policy makers, and scientists must to work together to turn the tide so that everyone who needs high-quality treatment and prevention interventions for the global HIV, hepatitis C virus (HCV), and tuberculosis (TB) pandemics receives them.

A new report by the UK’s HIV i-Base and the US’s Treatment Action Group (TAG) reveals the deepening gulf between new scientific advances –which make it possible to prevent, treat, and in some cases cure people living with HIV, HCV and TB – and those who are most in need of these interventions being able to access them.

Indeed, the report’s lead authors, Polly Clayden of i-Base and Mark Harrington of TAG, state that “the abundance of promising advances in HIV/AIDS prevention and treatment documented in this year’s ‘Pipeline Report’ may seem unattainably out of reach to many of the millions of people who need them most.”

Pointing to recent, dramatic findings that earlier anti-HIV therapy can reduce transmission of the virus by 96% among stable sexual partners with differing HIV status, Clayden and Harrington say: “Three papers published in the past year provide the scientific, public health, and policy framework for accelerating the response to the HIV pandemic such that within a few years the spread of HIV can be reversed, saving millions of lives and billions of dollars, using existing antiretroviral therapy earlier and more broadly around the world. The only thing holding us back is the lack of economic and political leadership at the highest levels.”

The authors point out that while seven million people are receiving lifesaving HIV treatment, the new scientific results indicate that up to 27 million more will need such therapy to realise the promise of earlier treatment for both individuals and public health.

More preliminary results also back up the premise that targeting HIV treatment for high-risk HIV-negative individuals can also prevent transmission, when administered in well-organized and comprehensive prevention programs, as indicated by the US Food and Drug Administration (FDA) approval earlier this month of the first two-drug combination licensed for HIV prevention.Still more preliminarily, a single patient, Timothy Brown, has been cured of HIV infection after receiving an immune system transplant with stem cells genetically resistant to HIV. Brown has remained off HIV treatment for more than five years with no ongoing HIV replication detected.

Moving to the HCV pandemic, which affects over 160 million people worldwide and is the leading cause of death among people with HIV in America and Europe, research from TAG’s Tracy Swan and Karyn Kaplan, which forms part of the report, provides a sweeping overview of the explosive developments in HCV combination therapy and cure. Swan and Kaplan caution that current infrastructure and reimbursement mechanisms to cover treatment and care costs for people with HCV are lacking almost everywhere, and must be rapidly expanded to treat and cure the millions living with HCV.

TB research has undergone a renaissance, particularly in TB drugs and regimens. TAG’s Erica Lessem, another contributor to the report, states finds significant progress in new TB drug and regimen development but slow progress in TB diagnostics and vaccine research revealling investment in TB research is far too low to permit rapid progress.

The report calls on political leaders worldwide to step up implementation of these new scientific discoveries to bridge the global and domestic prevention and treatment gaps.

HIV i-Base is a London-based HIV treatment activist organization and works to ensure that people living with HIV are actively engaged in their own treatment and are included in policy discussions about HIV treatment recommendations and access. TAG is an independent AIDS research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS.