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EPIDEMICS
End of AIDS pandemic in sight: US expert
by Staff Writers
Washington (AFP) July 18, 2012


Conservatism threatens AIDS prevention in LatAm: UN
Brasilia (AFP) July 18, 2012 - AIDS is under control in Latin America and the Caribbean but a conservative wave threatens efforts to prevent the spread of the deadly HIV virus, UN experts said Tuesday.

An estimated 1.6 million lived with AIDS in Latin America last year, including 230,000 in the Caribbean, according to a global report by the UN agency UNAIDS which said 34.2 million contracted the disease.

"Latin America maintains a relatively stable epidemic and has made progress with respect to treatment," said Pedro Chequer, UNAIDS coordinator in Brazil.

The agency noted that last year, 99,000 people got infected with the HIV virus in the region where broad coverage in anti-retroviral treatment significantly helped reduce mortality rates.

In the early 2000s, 63,000 people died of AIDS every year due to the disease in Latin America, compared with 57,000 in 2011. The figure fell by half in Central America and the Caribbean, from 20,000 in 2001 to 10,000 last year.

With greater access to anti-retroviral drugs, AIDS has stopped being "a death sentence to become a chronic condition," Chequer said.

Despite the progress, the region in general faces a "worrying wave of conservatism, notably with restrictions to access to condoms, for example in schools," Chequer said without elaborating.

"Conservative religious groups, Catholic and non-Catholic, view the distribution of condoms as something wrong from a moral and religious standpoint," he noted.

And not enough is being done to bolster actions to denounce the stigmatization of the most vulnerable people.

"In Latin America, the epidemic is mainly among gays, men who have sex with men, transsexuals and sex workers and there is a certain reluctance to face this problem head-on," the UNAIDS official said.

Chequer said Brazil was one of the countries which records the biggest number of homophobic crimes in the world.

"In 2011 alone, there were 280 crimes, well ahead of Mexico and the United States," he added.

However UNAIDS underscored Brazil's role in spreading AIDS treatment.

This country produces 10 of the 20 AIDS drugs and distributes them to countries in Africa and Latin America.

Brazil also distributes half a million condoms free of charge every year.

Late this week, it will inaugurate in Mozambique a drug manufacturing plant for AIDS treatment in Africa, the region hardest hit by the scourge.

Three decades into the AIDS pandemic an end to new infections is in sight, according to Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases.

"We don't even know if a cure is possible. What we know is it is possible that we can end this pandemic even without a cure," Fauci told AFP in an interview ahead of the International AIDS conference July 22-27 in the US capital.

Some 34 million people around the world are living with human immunodeficiency virus, which has killed 25 million since it first emerged in the 1980s.

The theme of this conference, held every two years, is "Turning the Tide Together," and is based on experts sharing knowledge of the latest advances and how to best implement them in order to halt new cases of HIV/AIDS.

"We have good and effective treatments but we have to keep people on the treatments indefinitely in order to keep them well," said Fauci, referring to antiretroviral drugs which have transformed a deadly disease into a manageable condition.

"When you have a very marked diminution of the number of new infections then you reach what we call and AIDS-free generation."

Fauci said he did not expect any staggering breakthroughs to be announced at the conference, but that the gain would come though collaborating on ideas to speed progress by using the tools that practitioners have already at hand.

Otherwise, if progress continues at the present rate of reducing new infections worldwide by about 1.5 percent per year, the goal becomes too distant, he said.

Recent studies that tested antiretroviral drugs in healthy people as a way to prevent getting HIV through sex with infected partners have shown some promise, though getting people to take their medication daily had proven a challenge.

"The important thing is you have to take your medication," Fauci said, noting that average HIV risk reduction in a study of men who have sex with men was just 44 percent.

The approach of treating healthy people with antiretrovirals is known as pre-exposure prophylaxis, and "is not for everyone," Fauci said. "We have to selectively use it."

The US Food and Drug Administration on Monday approved the first pill for HIV prevention, Truvada, despite concerns by some in the health care community that it could encourage drug resistance and risky sex.

Novel ways to boost testing are also good news, particularly with the recent US approval of the first at-home HIV test.

"It is so important in the quest to ending the AIDS pandemic to get as many people tested as possible. You can link them to care and get them on treatment. Anything that makes that goal easier would be an important advance."

As far as an AIDS vaccine, Fauci said researchers have made "good progress" but "still have a long way to go."

Experts are examining a trial done in Thailand that showed in 2009 modest efficacy of just over 30 percent, but is still considered a breakthrough and offers clues for future study into why some were helped and others were not.

Fauci also said he did not expect much concern to be raised over upcoming reports of the extent of drug resistance to antiretrovirals.

"People may think I am taking it lightly but quite frankly it is not a serious problem," Fauci said.

He added that overall, AIDS research is "going well" even though "funding is restricted right now."

And he expressed pride in the United States' President's Emergency Plan for AIDS Relief (PEPFAR), "which has really transformed how you can get people in low income countries to get on treatment care and prevention."

The United States provides almost half the world's funding for international HIV assistance, according to UNAIDS.

The International AIDS Conference is returning to the United States after more than two decades away due to a ban on travel and immigration by people with HIV that was lifted in 2008 and signed into law in 2009.

Fauci called those restrictive laws "unfortunate" and "embarrassing."

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