Good News and Bad News in the Global Fight Against HIV/AIDS

The 2010 International AIDS Conference in Vienna continues to draw the world's attention to the global HIV/AIDS epidemic. The scientific discoveries are encouraging, but questions of how to pay for all the drugs AIDS patients require worldwide remains a challenge.

Start with the science: About two weeks ago, National Institute of Health scientists said they discovered two potent human antibodies that can stop more than 90% of HIV. And on Monday, a study was released on a vaginal gel that can cut women's infection risk by 50%.

Powerful Cocktails

Another study, conducted in British Columbia, Canada, and published over the weekend in the Lancet, shows that new HIV diagnoses dropped by more than half since the introduction of AIDS drug "cocktails" -- the highly active antiretroviral therapy (HAART) -- for HIV-infected patients. This suggests the therapy not only helps patients live longer, but also helps them stop spreading the infection further.

Meanwhile, a new study shows that the combination of Merck's (MRK) AIDS drug Isentress with Abbott Laboratories' (ABT) Kaltera suppressed HIV as successfully as the older regimen of Kaletra and Gilead Sciences' (GILD) Truvada.

Since Kaletra and other protease inhibitors have been linked to an increase in cholesterol, and Viread, a component of Truvada, may cause kidney damage or bone loss, the research may spur Merck's Isentress sales as doctors search for safer alternatives to the older generation of AIDS drugs.

A separate study, which contradicts earlier research, finds that switching to Isentress from Kaletra or similar drugs may be just as effective an option, with less of the cholesterol-related side effect. Abbott is considering developing a new combination pill consisting of either Kaletra plus Isentress.

In general, pharmaceuticals, including Big Pharma, and biotechs have stepped up efforts to offer AIDS therapies. The size of the market and the cost of the drugs make the field attractive. But despite all the scientific breakthroughs and pharma interest, not all is well. The financial picture remains challenging.

Who Will Pay?

Because of the global economic crisis, overall support for global AIDS efforts from donor nations flattened, UNAIDS said. "In 2009, the Group of Eight nations, European Commission (EC) and other donor governments provided US$7.6 billion for AIDS relief in developing nations, compared with US$7.7 billion disbursed in 2008." Similarly, UNAIDS warns that "flat funding for HIV prevention research may limit researchers' ability to quickly move promising approaches forward."

There has been improvement, with 1.2 million people starting treatment in 2009, made possible by the emergence of affordable generic drugs and the commitment of donor countries, the World Health Organization said. But with an estimated 15 million people recommended for HIV treatment, the funds needed for HIV treatment in 2010 will be about $9 billion.

"The HIV/AIDS epidemic is a tragedy for millions of people and a costly time-bomb for families, governments and donors," said Alvaro Bermejo, executive director of the International HIV/AIDS Alliance. "For every two people who get treatment, 5 others get infected. At this rate, spending for HIV will raise from $13 billion now to between $19 and $35 billion in just 20 years time."

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