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US FDA approves unique
3-in-1 antiretroviral pill
13th July 2019 |
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The United States Food & Drug Administration has approved the first
ever antiretroviral tablet to contain drugs made by two separate
pharmaceutical companies.
ATRIPLA™ combines the drugs SUSTIVA® (efavirenz) made by Bristol-Myers
Squibb and Truvada® (a combination of emtricitabine and tenofovir
disoproxil fumarate) made by Gilead Sciences. Taken together, these
three drugs represent one of the most potent and popular
antiretroviral regimens currently available in the US, and scientists
hope that by cutting the pill burden to just one pill, taken once a
day, it will greatly improve adherence and thus reduce levels of
acquired drug resistance.
It has taken collaborating scientists from the two companies several
attempts to arrive at a suitable formulation for their new tablet.
Their first tries at combining the drugs resulted in a product that
melted into a sticky mess within a few hours. However, eventually
they hit upon the solution of keeping the two ingredients in separate
layers to ensure stability.
ATRIPLA™ will become available to patients in the US within 7 working
days, although it could take far longer for it to reach HIV+ people in
other parts of the world. Price may also be an issue. Combining the
drugs has not reduced the cost, and the pill is expected to be sold
for the sum of its two separate components ($1,150.88 for a 30-day
supply). When it is eventually marketed to poorer countries, it will
probably cost around $800 per person per month, approximately
four-times the price of the cheapest regimes currently available.
When combination antiretroviral therapy was first introduced 10 years
ago, some people had to take up to 30 pills a day to control their
HIV. The new multi-vitamin sized one-a-day pill represents something
of a revolution therefore. "People were talking about once-a-day as a
magical, wonderful, far-off moment,” said Craig E. Thompson of the Los
Angeles AIDS project “It was one of those things we were waiting
for, and we've done a great job in getting there." |
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AIDS orphanage inundated with donations
11th July 2019 |
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An AIDS orphanage in Soweto, South Africa, has been inundated with
public donations after thieves stole over R50,000 (£3,800) of goods
from the centre.
Four armed robbers broke into the Ikageng Itereleng Aids Ministry
Centre on the night of Sunday 2nd July. The men took over 50 pairs of
shoes destined for distribution to local children, several computers,
two printers, a fax machine and a safe containing R1,500. What they
couldn’t steal they then smashed or broke, leaving the centre
wondering how it could afford to care for the children in its charge.
After the South African newspaper, The Star, featured the story on the
front page however, donations came pouring in from across South
Africa.
"The response from the public has been amazing," said Carol Dyantyi,
founder of the centre, which offers financial and emotional support to
children who have lost their parents to AIDS.
So far the centre has received over R40,000 in cash as well as large
quantity of food, shoes, clothing and toys. The printer manufacturer
Kyocera Mita South Africa also donated three printers to replace those
that had been stolen. |
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Sex Workers in India join HIV testing reward
scheme
10th July 2019 |
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Sex workers in the Southern Indian city of Mysore are to be given
special discount "Smart Cards" as part of a new project to encourage
sex workers to tackle HIV and AIDS.
The cards will be issued to local women working in the sex industry on
the proviso that they attend a sexual health check-up every three
months. The cards can then be used to obtain discounts in local
grocery stores, clothes shops and a few restaurants, and will also
carry medical details of the owner. The scheme, which is the first of
its kind, is being funded by the Bill and Melinda Gates foundation as
a pilot project. If successful, it could be extended across India.
Sushena Reza-Paul, a representative of the Karnataka Health Promotion
Trust who are running the scheme, said it had been warmly welcomed by
local sex workers. “They tell me that only rich people can normally
have these kind of cards -- so it gives them a sense of pride and
belonging," she said. "We are already getting calls from different
places. Once the pilot project is completed, we will tabulate the
findings and see how the scheme can be implemented." Opponents have
however said the scheme could make sex work more appealing to women in
the area who may see the cards as a 'perk' of the job. Card owners
also risk being singled out as prostitutes and discriminated against,
which may result in few women actually using the card in practice.
5.7 million people are living with HIV in India,
the largest population of HIV+ people in any country anywhere in the
world. |
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Criminal Transmission of HIV in the news again
4th July 2019 |
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The issue of criminalising the transmission of HIV has received
significant attention in recent weeks. First it was the case of Sarah
Jane Porter, a UK woman who caused outrage among the tabloids after
being found guilty of ‘recklessly’ transmitting HIV (see 'UK
woman sent to jail for transmitting HIV').
Last Thursday, the Malaysian government announced it was amending laws
so that anyone who donates blood when they know they have HIV can be
imprisoned.Then on Sunday, the Ugandan government announced that it
was tabling a law that would impose a death sentence on anyone who
knowingly transmitted HIV to someone under the age of eighteen.
Now, the Supreme Court in the US State of California has ruled that an
individual can be sued for passing on HIV, even if they do not know
they have the virus.
While all these decisions have evolved from different legal systems
and different cultures, they all represent a growing trend towards the
identification of people who transmit HIV as legally ‘guilty’ and the
people who acquire it as ‘innocent victims’. This sort of delineation
is something that HIV organisations have worked hard to counteract for
many years, and while it is understandable that people want justice
when they have been deceived and infected by someone else, in some
cases, it also has the potential to seriously damage the already
fragile positive public image of people with HIV.
In Uganda, the aim is to prevent young people from being ‘preyed upon’
by older people who either believe that their AIDS can be cured by
sleeping with a virgin, or who are engaging in transactional sex
(whereby they provide gifts or money in exchange for sex). This goal
is laudable, but the penalty seems excessively harsh, given how
frequently this sort of transmission probably takes place.
In California, the recent ruling has arisen from a court case brought
by a married couple, both HIV+ who each accuse the other of giving
them the virus. The man in this particular case argued that he had
never received a positive HIV test, and therefore could not have known
he had HIV even if he was the person who had it first. Under current
Californian law (which makes non-disclosure of known HIV status to
sexual partners illegal), this defence would be valid. The court
however ruled to change the law, so that ‘not knowing’ could not be
used as an excuse – having had unprotected sexual encounters in the
past was deemed sufficient for an individual to be aware of the risk
that they had HIV, and could therefore pass it on.
This has been welcomed by some as a measure to counterbalance the risk
that people could be put off testing if they believed they may be
prosecuted at a later date. Others, most notably the Californian
judge Justice Moreno, believe it is a step too far, saying the change
"potentially licenses invasions into the sexual privacy of all
sexually active Californians and may even invite abuse of the judicial
process… One can easily foresee a spate of 'shakedown' or vengeance
lawsuits brought by plaintiffs whose motivation is not so much to
discover how they contracted H.I.V. as to force lucrative settlements
or embarrass a former sexual partner by exposing that person's sexual
history." |
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US FDA approves first generic three-in-one AIDS
drug
3rd July 2019 |
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The US Food and Drug Administration has tentatively approved its first
generic three-in-one Fixed Dose Combination (FDC) antiretroviral drug
for use under the US President’s Emergency Plan for AIDS Relief
scheme.
The new pill, which combines the common anti-AIDS drugs zidovudine,
lamivudine and nevirapine, needs to be taken just twice a day to
effectively suppress HIV. Manufactured by the Indian generic drugs
firm Aurobindo Pharma Ltd, the drug is the first complete ‘all-in-one’
pill to be licensed for use in developing countries by the FDA.
Three-in-one FDCs such as this have been available to those funding
treatment schemes through sources other than PEPFAR for a number of
years. However, the US government dictates that no drug can be
purchased with PEPFAR money that has not been approved by its own
FDA. As generic drugs containing products that are still under patent
cannot legally be sold in the USA, the FDA has to issue special
‘tentative’ licenses to ensure they are available for purchase
elsewhere. To date, the FDA has approved 23 such products, a number
of which are suitable for use in children.
The addition of this latest FDC has been warmly welcomed by those who
are currently running PEPFAR-funded treatment schemes in developing
countries. If governements and AIDS organisations are ever to meet
the All by 2010 treatment goal (which aims to get as close as possible
to universal treatment access by 2010), such simplified and
cost-effective regimens must become more widely available. Treatment
simplicity is also essential in ensuring that people with HIV adhere
to their drug regimens. If doses are missed, it gives HIV a chance to
mutate and become resistant to the medication, making it far harder to
prevent the virus from multiplying. |
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Uganda running out of life-saving drugs
30th June 2019 |
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Uganda has one the largest antiretroviral treatment programmes in
Africa, with more than 70,000 people
relying on the medicine to keep them alive. Now AIDS activists warn
that drug stores are running perilously low, and could be exhausted by
August.
According to souces contacted by the Daily Monitor newspaper, the
crisis has arisen because of sloppiness in procurement combined with
overspending on administrative costs. New funding from the Global Fund
to Fight AIDS, TB and Malaria, which supports around half of those on
treatment, has been delayed. Last year the Fund suspended all payments
to Uganda, and since the ban was lifted in November there has been no
new procurement of drugs.
“Even national referral hospitals would be running out of
antiretroviral drugs because the support from the Global Fund has been
delayed by procurement,” said Tonny Takenzire of the NGEN+ network. He
said that some treatment centres had already stopped recruiting new
patients.
This claim was confirmed by an anonymous official at the Bethlehem
Medical Centre, who said their programme had reached "full capacity",
and was not enlisting any more clients.
Dr Sam Okuonzi, programme coordinator for Ernst & Young, the caretaker
managers for the Global Fund, acknowledged that drug supplies were
running low. He said that arrangements were underway to procure more
drugs but the process was being delayed because there was only one
supplier.
It is essential that people who have started taking antiretroviral
treatment continue to receive an uninterrupted supply of medication.
If the drugs are not taken daily then HIV can become resistant to
their effects. |
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South African HIV/AIDS drama has significant
impact on teen behaviour
29th June 2019 |
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A South African TV drama that focuses on a group of young people in a
rural area of the Eastern Cape has shown success in reducing risky
sexual behaviour among teens.
The drama, which was developed and produced through a collaboration of
The South African Broadcasting Corporation (SABC), Curious Pictures,
the Centre for AIDS Development Research and Evaluation (CADRE), and
the Health Communication Partnership (HCP), is broadcast in the local
Nguni language, but has English subtitles to make it accessible to
non-Nguni speakers.
Tsha Tsha, as the drama is
known, is broadcast weekly and focuses on the lives of several young
people dealing issues of sex, relationships and HIV, as well as the
more mundane dilemmas of everyday life in rural South Africa. It
attracts over 1.8 million viewers every week and is accompanied by a
modified radio version that reaches 6 million listeners on community
radio. Many schools and community centres broadcast the drama for
those who do not have televisions at home.
Research conducted on Tsha Tsha’s
impact uncovered positive results. When comparisons were made between
those who had watched the drama and those who hadn’t, they discovered
that Tsha Tsha viewers were
more likely to practice safer sex activities and to have a more
positive and less stigmatizing view of HIV. 44%
of viewers of the drama said they were faithful to their partners,
compared to 27% of non-viewers. 51% of viewers also said they used
condoms to avoid HIV, compared to 38% of non-viewers.
Interestingly, the researchers were also able to use new statistical
techniques to control for ‘propensity to view’. This meant that the
differences found were almost exclusively due to the actual programme
itself, rather than the fact that those who had access to a television
and were watching Tsha Tsha
were more likely to be practicing safer sex in the first place.
Media projects like this are believed to be effective because young
people strongly identify with and aspire to be like the characters
they see on television. However, not everyone in South Africa has
access to a television or watches the show, so other HIV prevention
initiatives will always be necessary to help fight the illness at all
levels of society. |
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Gates Foundation to receive $31 billion from one
of world's richest men
27th June 2019 |
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Warren Buffet, one of the richest men in the world, has agreed to hand
over 80% of his $44 billion fortune to the Bill and Melinda Gates
Foundation, it was announced on Monday.
Mr Buffett, a 75-year-old financier from Omaha in the USA, told
reporters at the donation ceremony that he though Mr Gates “would do a
better job of giving it away than I can,” before signing a pledge that
would see a total of around $31 billion given to the Gates Foundation
in annual instalments.
Since its inception, The Gates Foundation has granted over $5.8
billion to global health programmes, $1.1 billion of which went
towards HIV and AIDS. $ 2.6 billion has also gone towards improving
education in the U.S.
In Botswana, Gates is supporting one of the biggest AIDS drug
distribution programmes in the world, which has so far put more than
40,000 people on antiretrovirals. A number of universities and
scientists have also received grants from the Foundation to further
their research into an HIV vaccine. Buffett’s gift, the largest in US
history, will enable the Gates Foundation to spend nearly $3 billion a
year on overseas and US-based projects; a sum equivalent to one
quarter of the entire United Nations annual budget.
Commenting on Mr Buffett’s donation, Bill Gates said, “It’s almost
scary. If I make a mistake with my own money it just doesn’t feel the
same as making a mistake with Warren’s money.”
Gates’ fear is perhaps well founded. Distributing the huge sums
acquired in this deal in a viable and effective way is going to be
major challenge for the Foundation. Finding projects that have the
capacity to absorb and efficiently spend the grants that they make has
already proved difficult, and the extra money is likely to make things
even harder.
Both Buffett and Gates have acknowledged as much, and say they have
begun to seriously talk about the problem. Both men are also
personally committed to finding a solution: Bill Gates recently
announced that he will soon be stepping down as the head of Microsoft
to dedicate his time to his philanthropic work, and Warren Buffett
will be joining the Foundation’s Executive Committee to oversee how
his money is spent. |
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US prepares for National HIV Testing Day
26th June 2019 |
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27th June 2005 marks National HIV Testing Day in the United States,
with hundreds of hospitals and organisations working together to
highlight the importance of knowing your HIV status.
Around 250,000 Americans are currently believed to be unaware that
they are infected with HIV, which represents approximately a quarter
of those living with the virus nationally. The organisers of National
HIV Testing Day, the National Association of People with
AIDS (NAPWA), hope to reduce this number
by encouraging people to "Take the Test and Take Control". Many
hospitals, clinics and community centres across the country will be
offering free HIV tests, some of which may provide results in as
little twenty minutes. HIV and AIDS charities and organisations are
also working together to stage events and awareness campaigns in many
major towns and cities.
In Washington D.C., city officials are taking National HIV Testing Day
particularly seriously. They have launched one of the biggest testing
campaigns in the history of the epidemic, with the aim of encouraging
every resident aged between 14 and 84 to test for HIV. The plan is to
make HIV testing kits available at all medical care facilities so that
receiving an HIV test can be as routine as having a blood pressure
check. Hundreds of thousands of free oral testing kits are now being
dispensed to local clinics and doctor’s surgeries around the city. If
successful, the “Come Together DC, get screened for HIV” programme
will mean every resident of the city will know their HIV status by the
end of 2019. |
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Disclaimer:
This content is reviewed periodically and
is subject to change as new health information becomes available. The
information provided is intended to be informative and educational and
is not a replacement for professional medical evaluation, advice,
diagnosis or treatment by a healthcare professional. If you have or
suspect you may have a health problem, consult your healthcare
provider.
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