[health-vn] New hopes over elimination of AIDS

[Vern Weitzel]

http://www.scidev.net/en/health/opinions/hiv-aids-a-new-hope.html

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 
costs.

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.