Advocates Highlight Challenges, Urge Governments To Sustain Support For HIV/AIDS On World AIDS Day

Main Category: HIV / AIDS
Article Date: 02 Dec 2008 - 4:00 PDT

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On the 20th anniversary of World AIDS Day on Dec. 1, advocates worldwide discussed numerous challenges facing HIV prevention efforts and called on governments to follow through on pledges to support HIV/AIDS care, prevention and treatment, AFP/Yahoo! News reports. The organizers of World AIDS Day 2008 -- which focuses on the themes of leadership, self-responsibility and advocacy -- said that many people in developing countries still lack access to affordable and effective HIV/AIDS treatment and that people who are resistant to first-line drugs require even more costly medications. "We have effective treatments," Jean-Francois Delfraissy, head of the French National Research Agency on AIDS and Viral Hepatitis, said, adding, "We have no other choice than to offer [drugs] to all those who need them" (Courcol, AFP/Yahoo! News, 11/29).

In addition, the International AIDS Society ahead of World AIDS Day called on the Group of Eight industrialized nations to sustain its commitment to providing universal access to antiretroviral treatment by 2010. IAS said the G8 had pledged $22.2 billion for global HIV programs between 2008 and 2010, which is 36% of the UNAIDS-estimated $61 billion needed for HIV/AIDS efforts during this time period. According to AFP/Google.com, three million people had access to antiretrovirals by the end of 2007, but this number is still two-thirds short of the target of achieving universal access by 2010 (AFP/Google.com, 11/28).

UNAIDS Releases Report Ahead of World AIDS Day
In related news, UNAIDS on Friday released a report that offers perspectives on how and why current HIV transmissions are occurring. The report recommends that countries expand efforts to address HIV/AIDS by adopting flexible prevention policies that combine numerous approaches. The report also recommends targeting the highest-risk populations, such as injection drug users and men who have sex with men. Karen Stanecki, senior advisor for UNAIDS, said the "message" of the report "is that countries need to tailor their prevention programs to the epidemics in their own specific countries." Stanecki added that UNAIDS recommends "a combination-prevention process" because "one prevention program isn't going to do it all" (Bryant, VOA News, 11/28)

During a Friday press briefing on the report, Peter Piot, outgoing UNAIDS executive director, said an improved understanding about the history and current challenges of HIV/AIDS could "help prevent the next 1,000 infections in each community." He added that it could "make money for [HIV/AIDS] work more effectively and help put forward a long-term and sustainable [HIV/AIDS] response." Piot said there is "no single magic bullet for HIV prevention," adding that health officials "can choose wisely from the known prevention options available so that they can reinforce and complement each other." Paul De Lay -- UNAIDS director of evidence, monitoring and policy -- said that "combination prevention" strategies can include behavioral, biomedical and structural approaches to HIV/AIDS treatment. Behavioral approaches could include the promotion of condom use and discouragement of multiple sexual partners, and biomedical approaches could include male circumcision or antiretroviral treatment to prevent mother-to-child HIV transmission. "The epidemic is constantly changing," De Lay said, adding that HIV incidence must be analyzed "at regular intervals" (AFP/Google.com, 11/28).

The report is available online (.pdf).

De Lay Urges Governments To Sustain HIV/AIDS Funding
Global HIV prevalence could increase if governments and international aid organizations reduce funding for HIV prevention programs because of the current economic situation, De Lay said. According to De Lay, governments must sustain funding levels or there could be a "resurgence" in HIV cases during the next four or five years, "and we won't be able to scale up the treatment that is clearly going to be needed." Although treatment programs currently reach almost four million HIV-positive people, 9.7 million people are still in need of antiretroviral medications, De Lay said.

According to De Lay, antiretroviral medication is becoming less expensive and easier to take. He added that integrase inhibitors -- a new class of drugs that includes Merck's antiretroviral Isentress -- "will continue to improve patients' response and make it easier and easier to take the drug regimens." De Lay said that clinical trials for integrase inhibitors will examine how the drugs function in combination drug regimens and reduce the number of pills needed. The new drug regimens could be rolled in "probably about a year to two years," De Lay said (Nebehay, Reuters, 11/28).

PEPFAR Meets Target of Treating 2M HIV-Positive People, Official Says
President Bush on Monday is expected to announce that the President's Emergency Plan for AIDS Relief has met its target of treating two million HIV-positive people by the end of the year, White House spokesperson Dana Perino said in a statement, AFP/Google.com reports. According to Perino, PEPFAR by Sept. 30 had supported the provision of antiretrovirals for more than 2.1 million people living with HIV, including more than two million people in sub-Saharan Africa. She added that about 9.7 million HIV-positive people -- including almost four million children -- in the 15 countries targeted by PEPFAR had received "compassionate care" by that date. In addition, PEPFAR has helped prevent MTCT for almost 240,000 infants, Perino said.

Perino said that PEPFAR is "the largest commitment by any nation to combat a single disease," adding that about 50,000 people in sub-Saharan Africa had access to antiretroviral medication before Bush launched PEPFAR in 2003. Bush in July 2008 signed legislation that reauthorized PEPFAR at $48 billion. According to AFP/Google.com, Bush and first lady Laura Bush on Monday plan to join the Rev. Rick Warren in a forum discussing the fight against HIV/AIDS AFP/Google.com, 11/30).

French First Lady Bruni-Sarkozy Named Global Fund Ambassador
French first lady Carla Bruni-Sarkozy on Monday will be named the first ambassador for the Global Fund To Fight AIDS, Tuberculosis and Malaria and said that she plans to use the position to promote awareness of MTCT. Bruni-Sarkozy, whose brother died of AIDS-related causes in 2006, said she is "very sensitive to the issue of [HIV/AIDS]" and plans to "put all of the media coverage" directed towards her "to the service of a useful cause." She added that she will make herself "available to all those who are working on the ground" with the Global Fund and would like to "communicate directly" with women and children affected by the disease. Michel Kazatchkine, executive director of the Global Fund, said Bruni-Sarkozy will be a powerful "advocate" for preventing MTCT by raising awareness on the need for more programs and additional information for pregnant women (Landry, AFP/Tocqueville Connection, 11/30).

Some Experts Question Funding Levels for HIV/AIDS Programs
Some health experts are "growing more outspoken" in their argument that global efforts against HIV/AIDS have expended significant resources and funding while other health needs are not being met, the AP/Arizona Daily Star reports. Jeremy Shiffman, who studies health spending at Syracuse University, said HIV/AIDS is "a terrible humanitarian tragedy, but it's just one of many terrible humanitarian tragedies." Roger England of Health Systems Workshop said in an article published earlier this year that the "global HIV industry is too big and out of control," adding that he believes UNAIDS should be disbanded. According to England, eliminating UNAIDS would allow $200 million to be spent on other health challenges, such as pneumonia. The Global Health Council reports that HIV/AIDS programs account for 80% of U.S. funding for health and population issues.

De Lay said that although it is valid to question health spending priorities, progress in treating HIV/AIDS is recent and the disease is not yet under control. "To suddenly pull the rug out from underneath" the fight against HIV/AIDS "would be disastrous," De Lay said. In addition, many advocates argue that funding for HIV/AIDS helps strengthen health systems by providing basic services. Margaret Chan, director-general of the World Health Organization, said, "We cannot afford, in this time of crisis, to squander our investments" (Cheng, AP/Arizona Daily Star, 12/1).

Reports, Initiatives
The Kaiser Family Foundation on Wednesday announced several new media productions developed in coordination with partner organizations.

• BET: As part of BET and the Kaiser Family Foundation's Rap-It-Up partnership, BET will air a television show titled "Are You Positive?" confronting the stigma surrounding HIV/AIDS in the black community.
  
  
• MTV: As part of MTV's ongoing campaign with the Kaiser Family Foundation titled "It's Your (Sex) Life," MTV will dedicate all on-air promotion time between Nov. 24 and Dec. 1 to public service announcements promoting safer sex and HIV testing. MTV also will run "on-screen takeovers" on Dec. 1 during programming to refer viewers to additional IYSL resources. MTV on Dec. 1 also will air a documentary titled "The Diary of Kelly Rowland" describing the recent travels of singer Kelly Rowland to Kenya, South Africa, Tanzania and around the U.S. to meet with young people affected by HIV/AIDS.
  
  
• Univision: Univision on Dec. 8 will devote a special episode of "The Cristina Show" to promoting awareness of the impact of HIV/AIDS on the Hispanic community. The program will feature Hispanics living with HIV and their families, many of whom are currently profiled in the campaign "Soy ... (I am...)" launched this fall by Univision and the Kaiser Family Foundation.
  
  

Regional media partners of the Global Media AIDS Initiative -- a project conceived and run by the Kaiser Family Foundation with support by the United Nations to mobilize media around the world in response to HIV/AIDS -- also announced new programs in observance of World AIDS Day. Summaries appear below.

• African Broadcast Media Partnership Against HIV/AIDS: ABMP will launch a new series of public service announcements under its "Imagine an HIV-Free Generation ... It Begins With YOU" campaign, which uses soccer to promote healthy lifestyles and responsible choices.
  
  
• Asia Broadcasting Union: In partnership with the Asia-Pacific Media AIDS Initiative, ABU will offer rights-free television programs on HIV/AIDS to broadcasters in the region.
  
  
• Caribbean Broadcast Media Partnership on HIV/AIDS: CBMP's public information campaign, "LIVE UP. Love. Protect. Respect," will air a special World AIDS Day edition of the television magazine program (Kaiser Family Foundation release, 11/26).
  
  

In addition, several other HIV/AIDS organizations announced new initiatives. Summaries appear below.

• AIDS Healthcare Foundation: AHF hosted a 24-hour marathon of no-cost, rapid HIV testing from Nov. 29 - Nov. 30 in Hollywood, Calif. The testing program is part of AHF's "One Million Tests" campaign, which is a coalition of organizations collaborating to provide one million no-cost HIV tests in conjunction with World AIDS Day (AHF release, 11/27).
  
  
• Global Fund: The Global Fund on Friday announced that programs supported by the fund helped provide treatment for two million HIV-positive people, an increase of 43% from the previous year (Global Fund release, 12/1).
  

Broadcast Coverage

• NPR's "Weekend Edition Sunday": The program on Sunday examined HIV among children and teenagers. The segment includes comments from Khadijah Tribble, executive director of Pediatric AIDS/HIV Care in Washington, D.C., and an HIV-positive teenager and her grandmother (Chang, "Weekend Edition Sunday," NPR, 11/30). Audio of the segment is available online.
  
  
• CNN's "International Correspondents": The program on Friday examined the challenges faced by journalists who cover HIV/AIDS. The segment includes comments from Larry Altman, medical correspondent for the New York Times; Sarah Boseley, health editor for London's Guardian; and photojournalist Gideon Mendel (Newton, "International Correspondents," CNN, 11/28). Video of the segment is available online.
  

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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