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Lights, camera, but where’s the ACTION? Criminalization of HIV on the AIDS 2014 stage

Posted 25 July 2014, 05:55 A, by Administrator

By Sharna Quigley, Advocacy Officer, Queensland Positive People.

As with any International AIDS conference, the eyes of the world will be turned to the host country and their HIV response will be put under the microscope. As the criminalisation of HIV proposes to be another big feature in the conference program, the 20th International AIDS Conference promises to provide another opportunity for the revision and reinvigoration of advocacy approaches surrounding the criminalisation of HIV.

With the 2012 United Nations Global Commission on HIV and the Law (link: http://www.hivlawcommission.org/resources/report/FinalReport-Risks,Rights&Health-EN.pdf)  concluding that any laws criminalising HIV transmission, exposure or non-disclosure of HIV status are counterproductive to HIV prevention, the patchwork of Australian transmission and disclosure laws falls short on various levels. Australia is currently living in the shadows by defying international guidance that compels states to ensure that HIV laws facilitate and enable effective responses to HIV prevention, care and treatment services. More...

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Now or Never: The Urgency of Closing the Treatment Gap for Children Living with HIV/AIDS

Posted 25 July 2014, 03:55 A, by Administrator

By Janice Lee, Program Manager of DNDi's Paediatric HIV Programme and Dr. Marc Lallemant, Head of DNDi's Paediatric HIV Programme

A recent comprehensive Global Burden of Disease study published in The Lancet reported that although global childhood mortality (under 5 years of age) has gone down since 1990, deaths due to HIV/AIDS among children have actually increased. This striking fact highlights the persistent neglect of children living with HIV/AIDS and belies the progress made over the past decade in wider access to antiretroviral therapy (ART).

An estimated 3.3 million children currently live with HIV, but only about a third of those in need of treatment receive it, compared with over half for adults. Without treatment, more than half of HIV-positive children will die before they turn 2, and 80% will die before the age of 5. Early diagnosis and treatment of babies with HIV is therefore an urgent public health priority – yet collectively we are failing in this area. While the World Health Organization's new HIV treatment guidelines recommend immediate ART for all children under 5, turning these recommendations into reality requires international and country-level political will and policy changes. More...

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Synergy

Posted 25 July 2014, 02:45 A, by Administrator

By Associate Professor Edwina Wright, President of the Australasian Society for HIV Medicine (ASHM)

ASHM is the local scientific partner for AIDS 2014 and is very much looking forward to the synergistic outcomes that typically arise when science-meets-society at these wonderful World AIDS meetings.  ASHM is a peak organisation of health professionals in Australia and New Zealand who work in HIV, viral hepatitis and sexually transmissible infections. In the blog below ASHM’s president, A/Prof Edwina Wright, looks over the key new HIV health messages for Australia.

The embrace of a society- its land, people, cultures, religions, laws and economic and scientific progress- may be cordial or disarmingly cold when it comes to the issue of HIV and other stigmatizing infections that are transmitted from human to human. Australia has a complex past characterized by a brutal period of British colonization and repression of its First People. Following this, waves of migration have brought people from the UK and countries of Europe, Asia and Africa to Australia, which can now boast that over 25% of its current population was born overseas. This is what has made our society marvelously rich and diverse. More...

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Financing the New Global HIV Treatment Vision – Advocacy and Economics

Posted 24 July 2014, 12:24 P, by Administrator

By Arin Dutta, Senior Economist, and Ron MacInnis, Deputy Director for HIV
Health Policy Project, Futures Group

MELBOURNE, Australia–Here at the 2014 International AIDS Conference, UNAIDS has put forward a vision for global HIV treatment – “ 90-90-90 by 2020 “ – 90% of those living with HIV diagnosed, 90% of all those living with HIV on sustained antiretroviral therapy (ART), and 90% of those on ART successfully suppressing the virus. The world must prepare the resources needed for this type of effort, which would contribute significantly to halting the spread of HIV.

Formal estimates from UNAIDS on what this would cost are expected by September, but the USAID- and PEPFAR-funded Health Policy Project’s (HPP) own estimates of the global costs of reaching extremely high levels of ART coverage in low and middle-income countries suggest that between U.S.$5.5 to $9 billion might be required annually to meet this goal by 2020.  This price tag includes adult and pediatric ART, inclusive of the costs of antiretrovirals, laboratory diagnostic management, personnel, and facility-level overhead costs. This would sustain a combined patient population of 23 to 31 million adults and children on treatment per year by 2020, with the adoption of high levels of coverage against the revised WHO 2013 guidelines for ART in a set of 93 low and middle-income countries.

Can we afford the 90-90-90 Vision? HPP’s estimates suggest that given optimistic projections of resources from the Global Fund and PEPFAR – the two largest funders of HIV treatment – a gap as large as $2 to $5 billion annually might emerge by 2020 for the costs of antiretrovirals and laboratory tests alone. This presents a serious challenge to sustainability, and echoes a drumbeat that has been heard for some time. Indeed, UNAIDS highlights in its recent report the findings from Williams et al. (2012) that projected ART costs rise to unsustainable percentages of the GDP (as high as 5% to 8%) in high-burden countries such as Malawi, Lesotho, and Zimbabwe.

A major theme at this week’s conference in Melbourne is the idea of “shared responsibility,” where governments in HIV-affected countries contribute domestic resources to the fight, alongside the investments from multilateral institutions (such as the Global Fund) and bilateral institutions (such as PEPFAR). Encouraging data from Asia suggest that in countries such as Malaysia, Thailand, and China, more than 80% of the costs of the HIV response are now met by domestic resources. As the Global Fund suggested in its update on the status of its programs, the institution expects country “counterpart financing” at about 5% of the allocation from low-income countries, and higher proportions, up to 60% in middle-income countries. As has been the case at the past several international AIDS conferences, advocates from HIV-affected countries in Africa have made their call for their governments to contribute a “fair share” to the response strongly heard.

But more money will not be enough to meet our expanded responsibilities. In the spirit of PEPFAR Ambassador Deborah Birx’s call for better and targeted and more efficient programs, prioritizing what she calls “the right things in the right places,” country programs are placing a stronger emphasis on using economic, geographic, and local epidemiological evidence to target HIV treatment services. Countries will need to use more detailed and localized data to allocate resources better and to reduce the cost of delivering services.

While overall financing for HIV globally declined slightly between 2012 and 2013, the Global Fund has seen an upturn in its pledges. Compared to the 2011-2013 replenishment, the 2014-2016 conference led to pledges of $12.3 billion, with strong increases in non-US funders. Importantly, HIV-related disbursements from the Global Fund rose in 2013 to $2.1 billion from $1.76 billion in 2012.

Along with a reported rise in domestic financing of the HIV response across the globe, and new innovative financing mechanisms in development in Kenya and Tanzania (and already in place in Zimbabwe), there is the hope that the ambitious targets can be met. It will take funding to reach the “90 90 90 Vision.” Globally and at country level, AIDS leaders, civil society, and governments around the world need to scale up advocacy that aims to increase funding from all sources. Advocates will need to be informed by better understanding of treatment and associated costs, program efficiency gains, data on effectiveness of interventions, innovative financing mechanisms, and broader economic analysis at all levels of the response.

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Dr. Dutta presented at a talk at the July 20 satellite session on “Efficiency and Effectiveness (E2): Impact and Way Forward for E2 in the Global HIV and AIDS Response” in Melbourne. The session was co-organized by the Health Policy Project/Futures Group, the International AIDS Society (IAS), the International AIDS Economic Network (IAEN), and the World Bank.

For more information on the Health Policy Project’s work on health financing and costing, see http://www.healthpolicyproject.com/index.cfm?id=topics-HealthFinance.

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AIDS 2014: How UNITAID’s HIV/AIDS Response is Evolving

Posted 24 July 2014, 09:54 A, by Administrator

By Philippe Duneton, Executive Director a.i., UNITAID

For those of us involved in the global HIV response, UNITAID’s name is synonymous with innovative ways to raise money: almost 65% of our funds are raised through a small tax on airline tickets in nine countries, including France, Chile, South Korea and several African countries. Many in the AIDS community are also familiar with UNITAID’s work to reduce the prices for paediatric and second-line antiretrovirals, adapted for resource-limited settings. More...

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Online Medical Education and Information: New Strategies to Overcome the Barriers

Posted 24 July 2014, 07:54 A, by Administrator

By Edward King, Chief Innovation Officer and Samantha Parsons, General Manager, inPractice Africa, www.inPracticeAfrica.com

In resource-rich settings, the Internet has transformed both the form and function of much medical education and information. Textbooks are often out of date even before they appear on bookshelves, given the long lead times for print publishing, and therefore many online digital textbooks have emerged that can be updated instantly. Likewise, older forms of pre-service and in-service medical education have been transformed by digital education approaches that are highly responsive to new data and use interactivity such as case studies, test questions, and simulated patient encounters. Digital resources that aggregate, index, and interpret the accumulated body of medical knowledge have made it faster and easier than ever for clinicians and researchers to learn what their colleagues have discovered. More...

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Dr. Rik Schrijvers - Winner of AIDS 2012 IAS/ANRS Young Investigator Award

Posted 24 July 2014, 04:54 A, by Administrator

By Emily Shaw, Research Promotion Intern, International AIDS Society

Each year, the International AIDS Society (IAS) awards scientific prizes to recognize outstanding research in the field of HIV/AIDS, including the Women, Girls and HIV Investigator’s Prize. The US$2,000 prize is awarded to a researcher who has demonstrated excellence in research and/or practice that addresses women, girls and gender issues related to HIV, and it specifically aims to encourage such research in low- and middle-income countries. The award is sponsored by the IAS and UNAIDS with support from the International Centre for Research on Women and the International Community of Women Living with HIV/AIDS. More...

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Partnering for the Future of HIV Treatment

Posted 24 July 2014, 02:54 A, by Administrator

By Greg Perry, Executive Director, Medicines Patent Pool

The international community has come a long way since the first AIDS conference in 1985.  Although we are still waiting for an effective HIV vaccine and a functional cure, ART innovation and scale-up has made a significant difference in changing the landscape of the global response to HIV/AIDS.

Over the past 31 years, 29 new chemical entities have been approved for the treatment of HIV. The discovery of HAART, unveiled at the 11th annual IAC in 1996, was a game changer in moving HIV/AIDS from a death sentence to a chronic condition. In 2001, triple fixed-dose combinations brought together various ARVs into single tablet regimens. Now, as we enter the fourth decade of HIV, we can once again see the promise of new medicines that will help improve today’s regimens, with drugs that appear to have higher barriers to resistance and better safety profiles.More...

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Now or Never: The Urgency of Closing the Treatment Gap for Children Living with HIV/AIDS

Posted 23 July 2014, 04:00 A, by Administrator

By Janice Lee, Program Manager of DNDi's Paediatric HIV Programme and Dr. Marc Lallemant, Head of DNDi's Paediatric HIV Programme

A recent comprehensive Global Burden of Disease study published in The Lancet reported that although global childhood mortality (under 5 years of age) has gone down since 1990, deaths due to HIV/AIDS among children have actually increased. This striking fact highlights the persistent neglect of children living with HIV/AIDS and belies the progress made over the past decade in wider access to antiretroviral therapy (ART).

An estimated 3.3 million children currently live with HIV, but only about a third of those in need of treatment receive it, compared with over half for adults. Without treatment, more than half of HIV-positive children will die before they turn 2, and 80% will die before the age of 5. More...

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'The law can be an awful nuisance in the area of HIV/AIDS': Michael Kirby

Posted 23 July 2014, 02:47 A, by Administrator

By Michael Kirby

Watch the Honourable Michael Kirby, visiting professorial fellow at UNSW Australia, talk about how the law impacts HIV.

Michael Kirby is a former justice of the High Court of Australia, serving from 1996 to 2009 and a former member of the Global Commission on HIV and the law.

He spoke to us at the AIDS2014 Conference in Melbourne about the many ways in which the law affects the spread of HIV by marginalising men who have sex with men, sex workers, injecting drug users, prisoners and refugees. And about how we need to change international intellectual property law if we are to get ahead in public health. More...

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