A ray of hope

Just last week, the world marked World AIDS Day. Unlike in previous years, this year’s event offered a vision of hope following the release of the latest report from the United Nations Program on HIV/AIDS. It shows that we might see an AIDS-free world within the lifetime of a majority of the world population.

This is no mean feat, considering that AIDS had killed 30 million people worldwide already in just over 30 years. (The disease was discovered in the early 80s). According to this report, the number of people around the world who are newly infected with HIV, the virus that causes AIDS, has dropped dramatically - by 30 percent - over the past several years. 

Dr. Anthony Fauci at the U.S. National Institutes of Health has spent the past three decades trying to stem the pandemic. He says the biggest reason for the decline is that more people are getting treated. Moreover, the drugs are getting cheaper to the point where even patients in developing countries can largely afford them.

The cost of anti-retroviral AIDS drugs has dropped from $10,000 per year to about $140, Dr. Fauci says. This would enable more HIV infected people to live longer.

The other factor is that massive media and education campaigns have helped people change their sexual and substance usage behaviour. The idea is to prevent people from exchanging blood or semen, two of the most common methods for the spread of HIV. The Report says that new infections have dropped in all age groups, with the greatest difference seen among children. 

More pregnant women are also receiving anti-viral medicine, which reduces the risk of passing HIV to their children.

Dropped

Over the past 10 years, the number of children infected with HIV has dropped by 50 percent. Health officials are actually talking about reaching a "tipping point” in the battle against AIDS whereby the number of people who go on therapy becomes greater than the number of people who get newly infected.

Right now, for every person who gets into treatment, up to two more are newly infected. (There are 35 million people living with HIV and two million more are infected every year). Unfortunately, not all of them have access to the life-saving drugs, and not all people know how vulnerable they really are.

This is an issue that the World Health Organisation (WHO) and individual Governments have to address without delay especially in the context of the availability of cheaper drugs.

However, nature is unpredictable at best and our efforts to stem the tide of AIDS may be frustrated by such occurrences. Swedish researchers have recently identified a new strain of HIV in West Africa, which progresses to AIDS more quickly.

The A3/02 strain combines the two most common HIV strains in Guinea-Bissau and develops into AIDS within five years, up to two-and-a-half years faster than either of its parent strains, said Angelica Palm, one of the scientists behind the study published in the Journal of Infectious Diseases.

This type of strain, a recombinant, appears when a person becomes infected by two different strains, allowing DNA to fuse and create a new one.

Scientists thus face several challenges in dealing with HIV/AIDS. They have to formulate even more responsive drugs to keep any new strains at bay. There is still no total cure for HIV/AIDS in sight, even though the death rate has gone down. But the greatest challenge will be developing a vaccine, which may finally help eradicate the disease from the face of the planet, a la polio and smallpox.

More than 20 years of intense research into finding a vaccine that could inoculate humans against HIV and prevent AIDS so far has failed to come up with an answer.

The failure has been in large part because the virus has evolved a complex and elusive protein envelope that allows it to enter cells. Once it gets past the cell’s immune system, the outer envelope of the virus falls apart. It is a shape shifter, a fact that has frustrated efforts to study its structure and find a means to fight it.

Teams of scientists from various countries are overcoming these obstacles and racing to develop an HIV/AIDS vaccine. The Euroneut 41 program is one of the most ambitious, involving 17 European partners. Its goal is to block HIV from entering the body by using an innovative vaccine based on GP41, a protein present in the virus. In France, the company Px Therapeutics has synthesised an enhanced version of this protein to obtain the best possible immune response. Scientists in the US are also trying to create a vaccine, backed by pharma companies and universities.

Initiatives

Funding may prove to be one of the stumbling blocks to the success of the AIDS eradication program, though AIDS is one of the few diseases to get its own Global Fund.

Private foundations such as Bill and Melinda Gates Foundation have also been active in this sphere. However, funding may have to be increased to accelerate the anti-HIV/AIDS drive especially in Africa. Sri Lanka is one of the few developing countries where AIDS has not reached alarming levels, but more efforts (and funding) are required to further reduce the incidence of AIDS worldwide.

If the rich countries can contribute even a fraction of their defence budgets to fight diseases such as HIV/AIDS, the world will certainly be a better place.

As outlined above, education is the key to preventing the spread of the disease. If more people especially in developing countries have a clear idea of how and why the disease spreads, chances are that they will avoid getting into situations which may lead to HIV.

Although the electronic media can do a lot in this regard, sometimes they may not reach the intended audiences in remote areas. Street theatre has proved to be one of the most effective - and cost effective - ways of conveying this message in an uncomplicated manner. More such initiatives are needed to ensure an HIV-AIDS free world.