[health-vn] New hopes over elimination of AIDS
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Mon Mar 30 06:58:14 EST 2009
New hopes over elimination of AIDS
18 February 2009
Magazine issue 2696. Subscribe and get 4 free issues.
For similar stories, visit the Editorials and HIV and AIDS Topic Guides
AFTER 25 years battling the mother of all viruses, have we finally got the
measure of HIV? Three developments featured in this issue collectively give
grounds for optimism that would have been scarcely believable a year ago in the
wake of another failed vaccine and continuing problems supplying drugs to all
who need them.
Perhaps the most compelling hope lies in the apparent "cure" of a man with HIV
who had also developed leukaemia. Doctors treated his leukaemia with a bone
marrow transplant that also vanquished the virus (see "One shot to rid body of
HIV"). Now US company Sangamo Biosciences is hoping to emulate the effect using
gene therapy. If it works, and that is still a big if, it would open up the
possibility of patients being cured with a single shot of gene therapy, instead
of taking antiretroviral drugs for life.
Antiretroviral therapy (ART) is itself another reason for optimism. Researchers
at the World Health Organization have calculated that HIV could be effectively
eliminated in Africa and other hard-hit places using existing drugs. The trick
is to test everyone often, and give those who test positive ART as soon as
possible (see "How to eliminate AIDS"). Because the drugs rapidly reduce
circulating levels of the virus to almost zero, it would stop people passing it
on through sex. By blocking the cycle of infection in this way, the virus could
be virtually eliminated by 2050.
Bankrolling such a long-term programme would cost serious money - initially
around $3.5 billion a year in South Africa alone, rising to $85 billion in
total. Huge as it sounds, however, it is peanuts compared with the estimated
$1.9 trillion cost of the Iraq war, or the $700 billion spent in one go propping
up the US banking sector. It also looks small beer compared with the costs of
carrying on as usual, which the WHO says can only lead to spiralling cases and
The cost of a mass HIV testing and treatment programme is peanuts compared with
the Iraq war
The final bit of good news is that the cost of ART could keep on falling. Last
Friday, GlaxoSmithKline chairman Andrew Witty said that his company would offer
all its medicines to the poorest countries for at least 25 per cent less than
the typical price in rich countries (see "Big Pharma has a heart after all").
GSK has already been doing this for ART, but the hope is that the company may
now offer it cheaper still and that other firms will follow their lead.
No one doubts the devastation caused by AIDS. In 2007, 2 million people died and
2.7 million more contracted the virus. Those dismal numbers are not going to
turn around soon - and they won't turn around at all without huge effort and
investment. But at least there is renewed belief that, given the time and money,
we can finally start ridding the world of this most fearsome of viruses.
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