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EPIDEMICS
US unveils road map to AIDS-free generation
by Staff Writers
Washington (AFP) Nov 29, 2012


S.Africa seals record deal for low-cost ARVs: minister
Johannesburg Nov 29, 2012 - South Africa, home to the world's largest population of people living with HIV, said Thursday it had secured a deal to buy a key anti-retroviral (ARV) drug at the lowest price ever. The country is the world's largest consumer of the life-saving drugs, at 21 percent of the world market. Health Minister Aaron Motsoaledi announced the country had used this massive market share to negotiate a record-low price on a three-in-one, fixed-dose combination drug. The once-a-day tablet will cost patients 89.37 rand a month ($10, eight euros), the minister said. "This is now the world's lowest price for this product," he said. "In pursuit of affordability and using innovative methods we have been able to (achieve) a massive saving." Motsoaledi said the government had awarded a two-year, 5.9-billion-rand ($671-million, 517-million-euro) tender to three pharmaceutical companies for the drug, down from an original cost of 8.1 billion rand. Aspen Pharmacare, Cipla Medpro and Mylan pharmaceuticals are the three companies that won the tender. The government plans to expand the treatment to reach 2.5 million people in the next two years. Patients have been taking three pills a day, but the new regimen reduces them to one and the combination has fewer side effects. South Africa once refused to roll out ARVs under former president Thabo Mbeki, whom activists have condemned as an "AIDS denialist". But the country now has the largest anti-retroviral (ARV) programme in the world, serving 1.7 million of its 5.6 million HIV-positive people. Demographers reported recently that life expectancy in South Africa had shot up by six years to 60 over the past few years thanks to ARV treatment. The country has one of the world's highest HIV infection rates, at 17.8 percent of 15- to 49-year-olds. Doctors Without Borders (MSF) praised the deal, saying the government had used its negotiating power to buy the fixed-dose combinations at "extremely competitive prices". Patients "now finally have access to simpler and improved treatment options -- which significantly cuts down their daily pill burden from three to five pills down to just one," said Gilles Van Cutsem, the aid group's medical coordinator in South Africa.

Secretary of State Hillary Clinton unveiled Thursday an ambitious US blueprint on how to realize the dream of an AIDS-free generation, aiming to see virtually no babies born with HIV by 2015.

"Scientific advances and their successful implementation have brought the world to a tipping point in the fight against AIDS," the 54-page document says.

Speaking at a launch to mark World AIDS Day, Clinton stressed that challenges still exist as the global community seeks to "change the course of this pandemic and usher in an AIDS-free generation."

But although HIV may still be around into the future, "the disease that it causes need not be," Clinton said.

Antiretroviral drugs have been hugely successful in cutting the rate of HIV transmission from pregnant women to their unborn babies or via breast-feeding, as well as in helping HIV-positive patients from developing AIDS.

Some 1.7 million people still die every year from AIDS-related illnesses.

But in the vision of an AIDS-free generation, almost no child is born with HIV; as they grow up, they are at lower risk of becoming infected; and if they do get HIV, they have access to treatment to halt its progression towards AIDS.

New HIV infections among children and adults around the world have fallen by 19 percent over the past decade, and AIDS-related deaths by 26 percent since a peak in 2005.

"As we continue to drive down the number of new infections, and drive up the number of people on treatment, eventually we will be able to treat more people than become infected every year. That will be the tipping point," Clinton said.

"We will then get ahead of the pandemic and an AIDS-free generation will be in our sight."

In a message for World AIDS Day, President Barack Obama said the global community should come together "to remember those we have lost, and to renew our commitment to end the pandemic once and for all."

He praised the "great strides" made in combating the disease and stressed that in the United States testing and prevention remained priorities, particularly among the worst hit communities -- gay men, Latinos and African Americans.

US Global AIDS coordinator Eric Goosby told AFP that some 390,000 children are born at the moment every year with HIV, primarily in about 22 countries, mostly in sub-Saharan Africa.

Taking a cocktail of three antiretroviral drugs cut the risk of a mother transmitting HIV to her baby to less than two percent, he said. It also allowed her to breast-feed and protected her in future pregnancies in countries where many women had between five to seven children.

"Now we will not get to zero," Goosby warned, saying many women in developing countries never enter prenatal care. But he hoped by 2015 that the numbers of babies born with HIV would drop globally below 40,000.

In a moving speech at the launch of the blueprint, South African Florence Ngobeni-Allen, an ambassador for the Elizabeth Glaser Pediatric AIDS Foundation who is HIV-positive, spoke of losing her own daughter and husband to AIDS.

"Losing a child to AIDS is the worst thing that a mother can go through. I've told this story so many times, but it still feels like yesterday," she said.

Her pain turned to joy, once she had remarried and gave birth to two HIV-negative sons, the oldest of whom is now six.

"Let's not give up, for the fight is far from over... I dream of a generation born free of HIV. I know it's real because my children are part of it. I'm proof of it, and I am proud of that," she said.

Under the road map drawn up by the President's Emergency Plan For AIDS Relief (PEPFAR), the United States will:

-- work towards the elimination of new HIV infections in children by 2015 and keeping their mothers alive;

-- increase its coverage of HIV treatment to cut the number of deaths from AIDS and boost HIV prevention, including antiretroviral drugs. Obama has set a goal of treating some six million people with such drugs by the end of 2013;

-- increase the numbers of men that get circumcisions. By the end of fiscal year 2013, PEPFAR aims to have supported such operations for some 4.7 million men in eastern and southern Africa;

-- step up access to testing and counseling, as well as to condoms and other prevention methods.

The blueprint stressed though that underpinning all these efforts would be scientific advances, adding the US will support innovative research.

"In every setting, in every country, really in every city... we are on a continuum towards an AIDS-free generation," Goosby said.

"There's an aggregate and a kind of cumulative reflection of that for a country, and a world. But it is an individual march for each person and for each population."

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