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About Just out. (Portland, OR) 1983-2013 | View Entire Issue (July 17, 1998)
ITTÎTÏÏïlTm news A L o n g R o a d A h ead : Two reports from Geneva show there's still much to do in the battle against HIV and AIDS Reasons for Hope The Specter of AIDS by The AIDS Writers Group by Bob Roehr ens of thousands of attendees viewed thousands of presentations during the 12th World A ID S Conference, held June 27 through July 3 in Geneva. Every two years the conference unites re searchers and clinicians, activists, and A ID S service workers to search for solutions to the pandemic caused by the human immunodefi ciency virus. Presentations given at the 1996 gathering in Vancouver, British Columbia, suggested revolu tionary changes were taking place in the fight against HIV. Reports at this year’s conference, on the other hand, indicate that, despite those advances, there is still a long way to go before progress will be made against the virus on a worldwide scale. There are more than 30 million people with HIV throughout the world. Despite the best efforts of public health and prevention agencies around the globe, new diagnoses continue to increase at a rate of 16,000 a day. “Millions of people are becoming infected in the developing world every year— 10 million since we last met two years ago,” said Dr. Bernard Hirschel, the conference chairman. W ithin the United States, an estimated 700,000 to 940,000 people are living with HIV, with 40,000 new cases reported each year. Thus far, the epidemic has left 400,000 dead in the United States and almost 12 million dead worldwide. W ith 16,000 people contracting HIV every day, a safe, effective vaccine remains the Holy Grail of HIV research. Seemingly countless vac cine candidates now exist, with several of them in clinical trials. Unfortunately, no data report ed in Geneva verified the safety or effectiveness of any of these vaccines. Some researchers, such as David Baltimore, who leads U .S. vaccine research, claim it may be as long as a decade before one of these candidates is proven to work. Margaret Johnson, who is with the recently formed International A ID S Vaccine Initiative, is critical of the slow progress being made. “T he world is not on track to meet the goal of a safe and effective A ID S vaccine in the next decade,” she said. T ^ two In an attempt to hasten the pace of vaccine development, IAVI announced a new plan of action to accelerate research. With Rinding from various sources— including the Levi Strauss Foundation and Microsoft founder Bill Gates— IAVI plans to create research teams to speed up testing of promising vaccines. “This program will not only put us back on track, it will put us on the fast track,” said Johnson. he theme of the 11th World A ID S Conference in ’96 was One World, O ne Hope. T h at concept highlighted a hope that new sci entific break throughs in treating H IV would be shared throughout the world. T he theme of this year’s conference was Closing the G ap, which in essence acknowledged that the challenge of global sharing still exists. A n example of the gap can be found in the contrast between the rela tively small number o f H IV treatment “haves" in devel oped northern con tinents and the increasing popula tion o f treatment “have nots” in poorer Southern Hemisphere countries. T he estimated cost for a year-long course of triple antiviral therapy is around $14,000. “W ith our living standard in our country, who can afford that.7” asked Ugandan A ID S T Continued on next page T 1 ^ | y% t j 1 1 a v /* he 12th World AIDS (Jonterence was a sober reminder of the chal lenges that remain in combating HIV and AIDS. the working-age population dies and leaves chil dren and grandparents who try to cope, said Angelo D’Agostino, who runs an orphanage in Kenya. Average life expectancy in Africa, which In some villages of Botswana rose from 40 years in 1950 to 63 in 1990, has and Zimbabwe, for example, more than half of fallen across the continent this decade, accord all pregnant women test positive for HIV. A ing to the World Bank. T he worst example is recent study by the World Health Organization Zimbabwe, where average life expectancy has plummeted by 20 years, erasing all of the gains estimates 680,000 babies are bom with HIV of the postwar decades. each year, and, in many nations of sub-Saharan Africa, a quarter to a third of all adults may be On the domestic scene, the miracle of pro tease of inhibitors led to some gay men to let HIV-positive. The pattern infection has seems be at the start of down their guard when it comes to safer sex. They think— according to conventional wis the same upward dom at the Geneva conference— “Infection curve in many isn’t so bad now that we have drugs that can nations of Asia. control the virus.” T he United Nations recently Researchers now have proof that people are being newly infected with HIV that is resistant began a pilot pro to protease inhibitors. One of the 35 people gram to treat studied in San Francisco’s post-exposure pro 30,000 pregnant gram was infected with a virus that has four women with AZT mutations that resist the effects of reverse tran during the last few scriptase inhibitors and seven mutations that weeks of pregnan reduce its susceptibility to protease inhibitors. cy to reduce the That man, said Dr. Frederick Hecht, who is likelihood of helping run the program at San Francisco transmission of General Hospital, appears to have acquired the HIV to their ba virus through a single act of unprotected recep bies. tive anal intercourse during which his partner It may be a withdrew before ejaculation. Six months of noble effort a but is not even stop triple-combination therapy, begun just days after gap in the context exposure, failed to completely suppress the virus. of Africa. A C T UP Paris called Meanwhile, Dr. Sabine Yerly of the University Hospital in Geneva, recounted how the program an “orphan factory.” another gay man who was infected through unprotected anal intercourse is now resistant to Perhaps a quar ter of newborns four protease inhibitors. will carry the In both examples, the sexual partner had been on multiple therapies over the years, often virus; perhaps another 10 percent will acquire it through with poor compliance to the regimen. “It’s like you were time-warped back to 1983, breast-feeding. And the rapid course of the dis where there were no drugs at all,” said Anthony ease in Africa, where sustained therapy is simply Fauci, director of the National Institute for not affordable, means infants who do not die of Allergies and Infectious Diseases. their own HIV will likely be orphaned at an The hope for a preventative vaccine, mean- early age. There are 8 million orphans to AIDS and the number will balloon still further. 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