Posted for Asher Mullard
Ahead of World AIDS Day on December 1st the papers are abuzz with AIDS news.
A paper in the Lancet says universal testing could reduce the number of people developing AIDS by 95%. An Indonesian state is pushing for micro-chipping of HIV positive people. Infections are up in the UK. And researchers have estimated that over 300,000 lives could have been saved if South Africa had started distributing antiretroviral drugs sooner.
Full details below the fold.
Universal testing for AIDS, followed by immediate treatment, would slash the number of people developing AIDS by up to 95%, scientists from the World Health Organization report in the Lancet.
If everyone over 15 was tested yearly for HIV and given antiretroviral therapy when sick, rates of mortality would fall from current rates of 20 cases per 10,000 people to 1 case per 10,000, scientists at the WHO estimated using mathematical modelling.
“Our model suggests that only universal voluntary HIV testing and immediate initiation of antiretroviral drugs could reduce transmission to the point at which elimination might be feasible by 2020 for a generalized epidemic, such as that in South Africa,” the authors write in the Lancet.
As yet, however, the strategy does not seem feasible — health care systems are not yet up to the task and much more funding would be needed.
An even more extreme control strategy — a bylaw enabling microchiping of patients with AIDS — is under consideration in Papua, an Indonesian province.
Legislators John Manangsang told Associated Press that by implanting microchips under the skin of “sexually aggressive” patients, authorities could identify, track and punish those who deliberately spread AIDS.
Speaking out for the local health workers and AIDS activists who find the bylaw “abhorrent”, Papuan activist Tahi Ganyang Butarbutar responded, “People with AIDS aren’t animals; we have to respect their rights.”
Nafsiah Mboi, the secretary of Indonesia’s National AIDS Commission, says that Papua’s Governor is unlikely to approve the bylaw even if it is passed by Papua’s parliament (ABCNews).
The UK evidently needs a better control programme. There are now 77,400 people in the UK with HIV, with 6% more new diagnoses in 2007 than in 2006, the Health Protection Agency announced. The number of people who acquire HIV through heterosexual contact has nearly doubled in the past 4 years.
Valerie Delpech, Head of HIV surveillance at the HPA’s Centre for Infections, told the BBC, “We need to improve availability of HIV testing in a number of healthcare settings, including general practice, to improve diagnosis of this infection. Without this we will not see the reduction in transmission that we need to see, or a further fall in serious disease.”
Finally, Harvard researchers have estimated that hundreds of thousands of premature deaths in South Africa could have been prevented if President Thabo Mbeki’s denial of a link between HIV and AIDS had ignored and antiretrovirals distributed.
In JAIDS, they write:
At the peak of the epidemic, the government, going against consensus scientific opinion, argued that HIV was not the cause of AIDS and that antiretroviral (ARV) drugs were not useful for patients and declined to accept freely donated nevirapine and grants from the Global Fund.
…
More than 330,000 lives or approximately 2.2 million person-years were lost because a feasible and timely ARV treatment program was not implemented in South Africa. Thirty-five thousand babies were born with HIV, resulting in 1.6 million person-years lost by not implementing a mother-to-child transmission prophylaxis program using nevirapine. The total lost benefits of ARVs are at least 3.8 million person-years for the period 2000-2005.
Barbara Hogan, South Africa’s current health minister, told the NY Times, “I feel ashamed that we have to own up to what Harvard is saying. The era of denialism is over completely in South Africa.”