AIDS 2010 Follow-Up Coverage: Global HIV/AIDS Funding; HIV/AIDS Studies, Releases

Media outlets continued to reflect on news from the International AIDS Conference-AIDS 2010, which attracted over 19,000 participants from 197 countries to Vienna last week, according to the conference blog.

The Washington Post reports that "concerns about [the] costs" of global HIV treatment programs "dominated the talk" of the conference. The newspaper notes that some HIV/AIDS advocates used the conference as an opportunity to voice their criticisms of the Obama administration, which "many say is reneging on a commitment to continue big annual increases in global AIDS spending."

The article examines how under the Obama administration, global HIV/AIDS funding has been folded into the president's $63 billion, six-year Global Health Initiative [GHI]. Whereas, "[t]he portion devoted to HIV and tuberculosis, an infection to which AIDS patients are particularly prone, is $44 billion," the rest of the funds will be focused on malaria, maternal and child health and strengthening health systems, according to the newspaper. "Although larger than Bush's revolutionary President's Emergency Plan for AIDS Relief (PEPFAR), Obama's GHI is spread across more agencies. It is less a bullet aimed at the heart of AIDS than a net cast to capture a flock of health problems," the Washington Post writes.

Though the U.S. is "the biggest donor" to combat HIV/AIDS in developing countries, "last year providing 58 percent of the $7.6 billion given by governments," HIV/AIDS advocates point to flatlining of international HIV/AIDS assistance in 2008 and 2009 as a sign "big gains in generosity and economizing have mostly stopped."

According to the newspaper, "Although there's argument about the exact numbers, there's little doubt the Obama administration is on track to spend less than planned by either the GHI or the Lantos-Hyde Act of 2008, which renewed PEPFAR and authorized spending $48 billion from 2009 through 2013. Many other donor countries are taking a similar go-slower approach."

The article includes comments by Joanne Carter, director of the anti-poverty group RESULTS and board member of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Paul Zeitz, director of the Global AIDS Alliance; and references recent comments in defense of the president's global AIDS strategy made by Gayle Smith, Obama's special assistant for development and democracy, and Ezekiel Emanuel, the president's special adviser for health policy, published in two blogs last week (Brown, 7/29).

NPR's Talk of the Nation also examines the major news out of AIDS 2010, through conversations between host Tony Cox and Jon Cohen, a correspondent with Science magazine and Steffanie Strathdee, associate dean of global health at the University of California San Diego. Cohen and Strathdee discussed the results of the recent microbicide gel trial, where things stand on progress towards developing an HIV vaccine, the search for an AIDS cure, injection drug use and the aims of Vienna Declaration as well as funding for HIV/AIDS (Cox, 7/27).

Vaccines; Global HIV/AIDS Patient Survey

Meanwhile, Nature News/Scientific American examines "the results of a handful of successful, but small, early-phase clinical trials for therapeutic vaccines – once thought to be a dead end for tackling HIV" that were presented at AIDS 2010. "Normal vaccines are designed to prevent infections, but so far none has worked for HIV," the news service writes. "Therapeutic vaccines, in contrast, aim to treat infected people – in the case of HIV, by boosting ravaged immune systems."

The article examines the potential advantages a therapeutic vaccine could have over current HIV/AIDS treatments and details several approaches companies are taking towards the development of therapeutic vaccines.

"All of the vaccines, which were developed by several small biotechnology companies, modestly but significantly reduced viral levels in the blood of patients, who responded for months or longer," the news service writes. "In some cases, the vaccines also increased levels of CD4+ T cells – the vital immune-regulator cells that HIV depletes. In theory, the vaccines would only need to be administered every few months."

"The ultimate value of the vaccines will only become clear as larger phase III trials roll out over the next few years. For now, leaders in AIDS research are cautious about the results," Nature News/Scientific American continues. The piece includes comments by Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID), who expresses cautious optimism about the potential for therapeutic vaccines in treating patients with HIV/AIDS, and Carl Dieffenbach, head of the NIAID AIDS division (Abbott, 7/27).

In related news, "The AIDS Treatment for Life International Survey (ATLIS 2010) of more than 2,000 HIV-positive patients in 12 countries around the world, found that most respondents also had health conditions such as depression, hepatitis C or kidney disease, which could affect their antiretroviral (ARV) treatment, but less than half had ever discussed these with their healthcare providers," IRIN/PlusNews reports. "Similarly, about half the respondents said their ARV medication had had a negative impact on their lives, but only 43 percent had ever asked their doctor about new treatment options with fewer side effects," according to the news service. The survey, released at AIDS 2010 last week, also documented gaps in patient knowledge about drug resistance (7/26). According to a press release (.pdf), survey participants were interviewed "January-March 2010, via a combination of Internet, phone, and in-person recruitment methods" (7/20).