More than 20 years into the AIDS epidemic, with billions being spent on prevention, research and treatment, the world has not even begun to make a dent on the deadly virus, top experts said Thursday.
Global AIDS leaders said getting patients cheap drugs to fight the AIDS virus was the best answer to battling the global epidemic, but warned the window of opportunity was closing while debates rage over patents and pricing.
“We have the science, the technical capacity and the know-how, yet investments still have not begun to yield substantial and lasting impact on the AIDS epidemic,” they wrote in a commentary published in the journal Science before next month’s International AIDS Society meeting in Bangkok.
AIDS experts from around the world will meet there to compare notes and try to come up with a better agenda for fighting the incurable virus that infects more than 43 million people around the world and has killed more than 25 million.
Drug cocktails a top priority
Peter Piot, head of the United Nations’ UNAIDS agency, World Health Organization head Dr. Lee Jong-Wook and Dr. Richard Feachem of the Global Fund to Fight AIDS, Tuberculosis, and Malaria said a top priority should be cocktails of drugs that can suppress the virus enough to keep people healthy.
“To provide treatment to those who need it safely and effectively, we need to develop simplified drug treatments, based on fixed-dose combinations and co-packaging,” they wrote.
Arguments persist about the best way to fight the virus, with debates over whether it is proper and ethical to promote condom use, abstinence and needle exchange programs. Drug companies and governments debate the proper use and licensing of cheap, generic versions of the lifesaving drugs.
“In 2002 alone, there were 1 million new infections in the Asia Pacific region,” the three men wrote.
President Bush said this week Vietnam would become the 15th country targeted for an intensive, $15 billion, five-year effort. That surprised some experts, who felt India was the next natural target.
“The risk of the epidemic’s spreading in India raises grave concerns,” Piot, Feachem and Lee wrote.
“Already 10 percent of the world’s HIV-positive population lives in India -- more than 4 million people.”
Brazil cited as model
Brazil, with its extensive generic drug distribution program, set a good example for how to fight the epidemic, the men said.
“Brazil has the most advanced national HIV/AIDS treatment program in the developing world -- it is estimated that between 1994 and 2002, almost 100,000 deaths have been averted (a 50 percent drop in mortality) through the introduction of antiretroviral therapy,” they wrote.
Virtually every expert agrees a vaccine is the only real hope for defeating the virus.
But Dr. Emilio Emini and Dr. Wayne Koff of the International AIDS Vaccine Initiative said even though dozens of vaccine candidates were being tested, none yet promised to conquer the virus.
Experiments have shown the virus has weaknesses that can be attacked. The genetics of the virus must be studied more as well as the human body’s response when first infected, they wrote in a separate commentary.
“Addressing these issues will require a degree of collaborative scientific activity and commitment well beyond the current global effort,” they wrote.