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From: joya banerjee [ profile ]
Subject: FW: Reuters: U.S. considers new tools in global AIDS fight
Sent: Dec 20th, 2010 - 04:41:10

  Here's an update about US Govt AIDS activities in South Africa,
specifically on the new partially effective microbicide and PrEP
(pre-exposure prophylaxis).

I'd be interested to know GYCA members' opinions on PrEP in
particular. For me it's an exciting discovery, but in my personal
opinion- even now the majority of PLHIV who need meds globally are not
receiving them- I'm not sure it's ethical to begin rollout on a
piecemeal basis for groups at high risk while others are dying for
lack of treatment while other cheaper and more accessible methods such
as condoms, syringe exchange programs and medical male circumcision
exist.

Joya





U.S. considers new tools in global AIDS fight

By Andrew Quinn

WASHINGTON | Tue Dec 14, 2010 5:25pm EST



WASHINGTON(Reuters) - The U.S. global AIDS program may turn to new
tools such as microbicide gels and pre-infection treatment to slow the
epidemic in hard-hit countries, the program's director said on
Tuesday.

Eric Goosby said the President's Emergency Plan for AIDS Relief
(PEPFAR) was looking closely at both the gels, which can protect women
against infection during sex and "pre-exposure prophylaxis (PrEP),"
which involves giving AIDS drugs to people in high-risk groups before
they are infected.

"We would support PReP in terms of high risk populations," Goosby, the
U.S. Global AIDS coordinator, told Reuters, adding that various
country approval plans were already under internal consideration.

Goosby said microbicide gels -- a focus of hope since a South African
clinical trial this year showed at least one version lowered HIV
infection rates -- could also play a part once full regulatory
approval is obtained and more is understood about how they work.

"We haven't worked out the delivery system or the dosing or interval
of application," Goosby said. "We are absolutely positioned to engage
in it as soon as we know those."

Goosby spoke as PEPFAR signed a new five-year deal with South Africa
to bolster its AIDS fight, signaling a deepening cooperation between
Washington and a country once depicted as representing the wrong
approach to the AIDS epidemic.

"We are here at a moment when South Africa is turning the tide against
HIV/AIDS. It is exciting to see," said U.S. Secretary of State Hillary
Clinton, who signed the five-year deal with South Africa's visiting
Foreign Minister Maite Nkoana-Mashabane.

Goosby said the agreement would commit the United States to working
with South Africa as it identifies its own AIDS-fighting priorities,
with an emphasis on helping to build up the country's overall medical
infrastructure.

SOUTH AFRICAN TURNAROUND

The United States contributes around $560 million a year to South
Africa under PEPFAR, and Goosby said funding levels were expected to
remain roughly constant for the country, where 1,000 people die from
AIDS-related illnesses each day.

"We have developed a level of trust that is extraordinary," Goosby
said. "They are revealing needs and vulnerabilities, and their ability
to move forward has allowed us to have a heads up on where their areas
are that we can help."

South Africa was criticized under former President Thabo Mbeki, who
questioned accepted AIDS science and failed to make life-prolonging
AIDS drugs widely available.

Mbeki's successor, President Jacob Zuma, has taken a different
approach, promising drugs to more people and fighting the deep social
stigma attached to the disease.

South Africa has been approved for more than $300 million in support
from the Global Fund for AIDS, Tuberculosis and Malaria and devotes
more than twice that amount from its own budget to fighting the
disease.

The addition of PrEP and microbicide gels could represent a
potentially large new budget item for PEPFAR, the $18.8 billion
program launched by former President George W. Bush, but Goosby said
new efficiencies in both care and treatment were already streamlining
the overall bill.

He said South Africa had proposed using PrEP to treat uninfected
inmates in South Africa's prisons -- a major vector for HIV -- while
pilot projects elsewhere were looking at sex workers and men who have
sex with men.

Last month researchers showed that Truvada, a once-a-day pill
combining two Gilead Sciences Inc (GILD.O) (GILD.O) HIV drugs,
markedly reduced the risk of men contracting HIV. Gilead's tenofovir
was also used in the South African study that showed a microbicide gel
lowered the infection rate by 30 percent for women.

South Africa has sought to expand its purchase of generic drugs, and
Goosby said the United States actively supported efforts by developing
nations to buy cheaper versions of drugs to save money.

(Editing by Todd Eastham)



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