30 December 2010

HIV/Aids: Top 10 for 2010

2010 has been an exciting year for the fight against HIV, with dramatic developments in biomedical HIV prevention.


This has been an exciting year for the fight against HIV, with dramatic developments in biomedical HIV prevention and a record five million people receiving life-prolonging treatment. It has also been a year fraught with funding difficulties and the continued discrimination against people living with HIV/Aids and other marginalised groups. Here are the picks from PlusNews coverage:

Microbicide breakthrough - After years of disappointing results, this year saw the first clinical evidence that a vaginal gel - known as a microbicide - could help to prevent sexual transmission of HIV. Such a preventative tool in the hands of women would radically reduce the level of new infections, analysts say.

ARVs for prevention - A new study found that daily oral pre-exposure prophylaxis (PrEP) - the use of ARVs to prevent HIV in high-risk groups - reduced HIV infection risk among participants who took the ARV Truvada by an average 43.8%.

Two-hour TB test - In December, the UN World Health Organisation endorsed a new rapid test for TB that could potentially save millions of lives through earlier diagnosis.

Treatment 2.0 - In July, UNAIDS launched a new approach to HIV treatment aimed at simultaneously achieving two holy grails of the Aids response: drastic reductions in Aids-related deaths and new HIV infections. "Treatment 2.0" aims to drastically scale up testing and treatment using current best practices and future innovations in antiretroviral (ARV) drugs and diagnostics, with the aim of averting 10 million deaths by 2025, and reducing new infections by one-third.

Patent pool's first licence - In October, the US National Institutes of Health (NIH) became the first patent holder to join the recently created Medicines Patent Pool. By licensing the ARV Darunavir to the patent pool, it made the technology to produce it available for the benefit of low- and middle-income countries.

UNITAID, the international health financing agency that established the pool, is optimistic many of the large pharmaceutical companies will soon follow the NIH by licensing their own patented ARVs.

Easier travel - New rules allowing HIV-positive people to travel freely to the US came into effect early in 2010, ending a 22-year-old ban that had been widely criticised by Aids activists as discriminatory and stigmatising. China and Namibia also lifted HIV-related travel restrictions in 2010, but another 51 countries still have restrictions in place.

Universal Access - At the 2006 UN General Assembly High-Level Meeting on Aids, world leaders expanded their commitment to include universal access to prevention, care and support and agreed to set national targets by the end of 2010. While a few African countries achieved universal access to treatment - Swaziland, Zambia, Namibia, Botswana and Rwanda - most did not. UNAIDS's new vision is: "Zero new infections. Zero discrimination. Zero Aids-related deaths."

Funding crisis - The Global Fund to fight Aids, Tuberculosis and Malaria reported a US$1 billion funding shortfall over the next three years. This upsets plans to dramatically increase HIV treatment numbers and puts people already on treatment at risk of drug resistance should funding affect the supply of their medicines.

Anti-MSM sentiment - Crackdowns on African MSM increased in 2010, leading Aids activists to urge tolerance. Uganda continued to pursue its anti-gay bill, while Malawi arrested a gay couple who got engaged and Kenya's Prime Minister Raila Odinga called for the arrest of gays. Fears of legal action or public outing often lead MSM to avoid health facilities where they could receive treatment and care and prevent governments from including MSM programming in their national strategies.

Threats to India's generics industry - India, widely thought of as the pharmacy of the developing world, has stood firm against attempts by large pharmaceutical firms to insist on patents on ARVs, allowing the country to continue manufacturing cheap generics. In 2010, however, activists warned of multiple threats to the nation's generics industry, including "Special 301", an annual review process led by the Office of the US Trade Representative, which has placed India on a "priority watch list" for failure to properly enforce intellectual property rights, and a Free Trade Agreement between India and the European Union. Activists claim the EU is using it to circumvent India's public health protections and boost its own pharmaceutical industry, putting millions of HIV-positive people's lives at risk. - (PlusNews, December 2010)


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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