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Asian AIDS crisis, prevention in focus at Bangkok
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By Darren Schuettler
BANGKOK (Reuters) - Asia's rapidly growing AIDS crisis, the latest advances in anti-HIV drugs, and stalled efforts to get existing drugs to millions of people in need will dominate a global conference opening in Thailand on Sunday.
With a cure and vaccines still years away, prevention will be high on an agenda showcasing Thailand's success against a disease that threatens a region home to 60% of humanity, conference co-chairman Joep Lange said in an interview.
The July 11-16 International AIDS Conference, expected to draw a record 15,000 scientists, activists and people living with the disease, would also take a hard look at the pledges made at the last meeting in Barcelona two years ago, he said.
"I hope this conference will be about accountability, where all the statements and declarations are going to be closely looked at," Lange told Reuters.
UNAIDS said this week that spending on AIDS had jumped 15-fold since 1996 to $4.7 billion last year, but that is still less than half of what is needed for care and prevention in developing countries by 2005.
While the price of antiretroviral drugs in developing countries has fallen by more than 90%, only 440,000 of the six million people in the developing world in urgent need of treatment are getting drugs.
The Bangkok meeting would hear appeals for action and more money, Lange said, but poor health systems in hard-hit nations were a major barrier.
"There are countries in Africa that have grants to put people on treatment and not a single person has been put on treatment. If you have a public sector that is not functioning, you are not going to solve the problem by shoving money at the public sector," he noted.
The debate over generic versus brand-name drugs and the issues of patents and trade agreements are due to get a full airing. Thailand, a generic drugs producer, is under pressure not to give its rights away in free trade talks with Washington.
CALL FOR LEADERSHIP
Big drug makers will showcase their latest advances and significant progress is expected on microbicidal vaginal gels or creams that could give women more power to protect themselves against infection, Lange said.
But with no major news expected on a vaccine, a key theme will be boosting prevention against a disease infecting 38 million people worldwide, of whom roughly a fifth live in Asia.
Infection rates in Asia are low in percentage terms compared to sub-Saharan Africa, with less than 1% in India compared to 35% for some Africa nations. But huge populations in India and China -- each home to more than one billion people -- translate into staggering numbers if rising infection rates go unchecked.
"Asia is a big part of the global economy and if Asia gets larger numbers, the impact on the world will be much greater," Lange commented.
A new pillar of the conference this year is a leadership program to encourage political, business and community leaders to take on a bigger role against the disease.
Lange noted that some African leaders had already shown the way, unlike their Asian counterparts, some of whom declined to attend a Thai-organized leaders' summit on the sidelines of the meeting. "It would have been an enormous statement if they had come."
The conference has changed over the years from a mainly scientific gathering to a forum for political activism as well.
"There is a lot of blah, blah like everywhere where you have all these organizations together. But it serves a purpose. I actually think it's good that it has changed in a way into a talk show or circus, because things do come out and have an impact."
Host Thailand's success in preventing a full-blown epidemic in the 1990s by targeting its notorious sex industry with a "100 percent" condom campaign would be studied closely, he said.
New infections in Thailand have dropped yearly to 19,000 in 2003 from a peak of 143,000 in 1991, but experts fear complacency and waning political commitment will lead to a resurgence.
Recent incidents of discrimination against people with HIV/AIDS in Thailand will highlight the struggle against fear and intolerance. But Lange did not expect any trouble for delegates in Bangkok, which he ranked safer than Barcelona where 900 conference-goers were victims of petty crime in 2002.
U.S. HIV/AIDS Official to Visit Vietnam
The Associated Press
HANOI, Vietnam (AP) - The U.S. government's point man on HIV/AIDS will examine how Vietnam is tackling the disease as it spreads from high-risk groups to the general population during a three-day trip to Hanoi, the Foreign Ministry said Thursday.
Global AIDS Coordinator Randall Tobias will meet with government officials and visit HIV/AIDS hospital wards, ministry spokesman Le Dung said.
The visit was arranged following President Bush's decision last month to include Vietnam on a list of 15 nations eligible for funding from America's $15 billion global AIDS plan, he said.
Tobias, who was scheduled to arrive late Thursday, will travel to Bangkok on Saturday for the 15th International AIDS Conference that begins the next day.
Bush announced last month that Vietnam would be the first country outside Africa and the Caribbean to be included in the five-year anti-AIDS plan unveiled last year. The decision was a surprise to some, given that India and China have much higher numbers of infected patients. It has not been determined how much funding Vietnam will receive.
Washington defended its decision to include Vietnam, saying it felt the money could make a difference in a nation where AIDS is on the brink of becoming an epidemic and where it predicts the number of cases will rise to 1 million by 2010.
Tobias will meet with Minister of Health Tran Thi Trung Chien and Deputy Prime Minister Pham Gia Khiem during his visit.
Vietnam has recorded a total of 81,206 HIV-positive cases, of which 12,684 have developed full-blown AIDS and 7,208 have died of the disease, according to the Ministry of Health.
However, health officials admit the actual number of HIV carriers is probably closer to 200,000.
Most of Vietnam's HIV/AIDS cases have been among intravenous drug users and sex workers, but the United Nations says new infections have started to appear in the general population.
'AIDS Corps' needed to help poor nations - panel
By Maggie Fox
WASHINGTON (Reuters) - An "HIV/AIDS corps" of medical and technical specialists modeled on the U.S. Peace Corps is needed to expedite drugs and testing in countries hardest-hit by AIDS, experts said on Wednesday.
The Institute of Medicine panel joined the United Nations and numerous AIDS groups in saying immediate action is required to tackle the AIDS pandemic, which now affects more than 40 million people worldwide.
The Institute report, issued on the eve of a major international AIDS conference in Bangkok, also called for the distribution of cheap HIV drugs to people who need them. But it supported the controversial U.S. position that generic versions of these drugs must be proved safe.
"Of the 40 million people worldwide infected with HIV, an estimated 6 million are in need of immediate, life-sustaining antiretroviral therapy. Yet fewer than 400,000 people in low-and middle-income countries have access to such treatment," the report said.
Drugs must be distributed at once in poor countries, said the Institute, which advises the federal government on health issues.
"Effective scaling-up of antiretroviral therapy will require tens of thousands of well-trained health care and management personnel. Such a workforce does not exist in most of the poorest nations," the report added.
"Solving the AIDS crisis will take more than just inexpensive drugs," said Dr. Haile Debas, director of global health sciences at the University of California San Francisco and a chairman of the panel.
"Success now hinges more on having adequate infrastructures to distribute therapies, and sufficient numbers of trained health care workers in developing countries." A program to distribute AIDS drugs requires a huge, permanent support structure, the panel said. Patients must be tested, and their drugs monitored for perhaps decades.
Prevention programs that teach how the virus is transmitted and how to avoid it will also be needed.
"Even if we had enough money right now to buy all the necessary drugs to treat every infected individual, global expansion of treatment and prevention could fail just because of the scarcity of trained personnel," Debas said in a statement.
The report also said strong tuberculosis control programs should run alongside HIV and AIDS treatment because one-third of people infected with HIV also have TB.
The experts backed the United States, which has hesitated to support the Word Health Organization's decision to distribute cheap, multiple-dose generic versions of HIV drugs.
"While costs are a factor, what is most important is that any drugs used are of proven quality and efficacy," said Dr. James Curran, dean and professor of epidemiology at Emory University's School of Public Health in Atlanta.
Thailand warned about complacency in AIDS fight.
BANGKOK (Reuters) - Complacency and waning political commitment could trigger a resurgence of AIDS in Thailand, one of the developing world's few success stories in curbing the spread of the virus, the United Nations said on Thursday.
"The epidemic is evolving and there are now clear warning signs of a possible new wave of infections," Robert England of the United Nations Development Programme told a news conference.
"Past success must not turn into complacency and inaction in the future."
The annual incidence of new HIV infections has fallen dramatically in the Southeast Asian nation, from a peak of 143,000 in 1991 to 19,000 in 2003, making it arguably the most successful country in the world in fighting AIDS.
However, the mass public information campaigns that formed the backbone of Thailand's fight against the virus in the 1990s have all but faded away, leading to a reduction in public concern about the risks of HIV infection, the U.N. said in a report.
Only 20% of sexually active young Thais now use condoms consistently, and HIV prevalence among injecting drug users, the target of a bloody government crackdown last year, has risen to as much as 50% from 30% in 1994.
Thailand's "war on drugs", in which more than 2,000 people died, has compounded the problem by alienating injecting drug users, who are among those most at risk from AIDS, and driving them away from sources of help, the U.N. said.
Human rights groups say Prime Minister Thaksin Shinawatra's tough line against drug users makes a mockery of Thailand's hosting of next week's 15th International AIDS conference.
"It's a scandal that Thailand is hosting the International AIDS conference while it persecutes people at high risk of HIV," said Jonathan Cohen, a researcher for New York-based Human Rights Watch.
"Thailand's drug policy is tarnishing its reputation for HIV prevention."
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