World AIDS Day marks progress
PARIS
In the face of growing complacency amid progress in treating and slowing the spread of the disease, activists sought to keep the battle against HIV in the public eye on World AIDS Day.
Even the Miss World beauty pageant on the Chinese holiday island of Sanya was enlisted to get out the message that the disease daily kills some 6,000 people.
Chinese President Hu Jintao appeared on the front page of major state-controlled newspapers shaking the hand of a woman HIV carrier the day after the United Nations warned up to 50 million Chinese are at risk of contracting HIV/AIDS.
December 1 has become a time of grim stocktaking as AIDS campaigners worldwide sound the alarm over the disease's rampage through Africa, the threat it poses to Asia and former Soviet republics, and the risks to vulnerable communities such as sex workers, drug users and gay men.
In Australia, campaigners warned that complacency after earlier success in fighting HIV/AIDS risked giving rise to a new wave of infections.
"This is the moment it all could go astray. This is the moment when it can become a pandemic," said AIDS-awareness educator Vince Lovegrove, calling for a new campaign aimed at a new generation.
Government figures show that by the end of 2006, 26,267 Australians had been diagnosed with HIV and 10,l25 people had been diagnosed with AIDS, with 6,723 having died.
Last month, UNAIDS announced that the prevalence of HIV or AIDS-the percentage of the world's population living with HIV or the disease it causes-peaked in the late 1990s. The agency also reduced its estimate of the number of people living with HIV or AIDS to 33 million from nearly 40 million after overhauling data collection methods. The tally of new infections has fallen, too, to an estimated 2.5 million in 2007 from 3.0 million in the late 1990s.
Meanwhile, the agonizing effort to bring antiretroviral (ARV) drugs to Africa, where more than two-thirds of the people with HIV/AIDS live, is now bearing fruit. At the end of 2006, more than two million people were getting the vital pills, a 54-percent increase over the previous year, according to the World Health Organization (WHO). The Global Fund to Fight AIDS, Tuberculosis and Malaria said the number of people on ARV it is funding has doubled in the past year to 1.4 million.
"Despite substantial progress against AIDS worldwide, we are still losing ground," said James Shelton of the US Agency for International Development (USAID) in a commentary in The Lancet. He said treatment is still only available to about 10 percent of those in need, while in developing countries, "the number of new infections continues to dwarf the numbers who start ARV therapy in developing countries."
Indonesia-which the UN said has the fastest growing HIV epidemic in Asia-marked the day with the launch of its first national campaign to promote the use of condoms, which currently account for less than one percent of contraception use. The campaign in the world's most populous Muslim nation aims to remove the stigma of condom use.
Stigma is also a concern for campaigners in South Korea, where the number of HIV/AIDS cases stood at 5,155 as of the end of September, the Korea Center for Disease Control and Prevention said. The rate of new infections has been falling from 14.2 percent in 2004 to 11.5 percent in 2005 and 10.4 percent in 2006.
But experts cautioned the real number of HIV/AIDS infections would be much higher as South Korea has a strong social prejudice against the disease. "Fixing the social prejudice is almost as urgent as fighting the disease itself," said Prof. O Myung-Don of the Seoul National University Hospital.
Chinese health minister Chen Zhu earlier raised the estimate of the number of HIV/AIDS cases in China to about 700,000.
One of the biggest areas of concern in the worldwide fight is funding. According to the UN, there is currently an eight-billion-dollar shortfall in resources to fight AIDS.
To meet the Group of Eight (G8) goal of providing universal access to ARVs by 2010, US$42 billion will be needed. So far, only US$15.4 billion is in the kitty.
UN Secretary General Ban Ki-moon called on governments to accelerate effort towards that goal. "I call for leadership among all governments in fully understanding the epidemic-so that resources go where they are most needed," he said in a speech in New York. "And I call for leadership at all levels to scale up towards universal access to HIV prevention, treatment, care and support by 2010."
US President George W. Bush also marked the day by repeating his call on US lawmakers to double support for anti-AIDS programs to US$30 billion over five years.
M AFP
Bird-flu pandemic could cost US$2T
NEW DELHI
The global cost of a possible bird-flu pandemic could be up to US$2 trillion, according to a joint report by the United Nations and the World Bank, which noted that the risk remains as great as it was two years ago despite improvements in the capacity of many countries to respond to the infection.
"The global economic costs could be between 1.5 and two trillion dollars," Peter Harrold, acting vice president of the World Bank, told a recent international conference on avian flu in New Delhi.
International donors have pledged US$2.3 billion to help countries combat the threat, and more than one billion dollars had been allocated to other groups involved in the fight, he said.
Experts fear a virus mutation that could result in severe and easily transmitted influenza in humans could create the next pandemic, with far-reaching consequences.
"About 20 percent of the global population will be affected during the next pandemic," said Margaret Chan, director general of the World Health Organization, adding that 28 million people may need medical care over a relatively short period and 35 percent of the work force may be absent from work.
But experts said considerable progress had been made in preparing for a pandemic.
"Ninety-five percent of the countries report that they have developed pandemic-preparedness plans," said David Nabarro, UN systems coordinator for avian influenza and one of the authors of the UN-World Bank report. But the response was still "patchy," and "entrenched" infection in some countries continued to pose a major threat to human health, Nabarro said.
Once the virus is entrenched, eliminating it becomes tougher and there is greater risk of humans contracting the infection, experts say.
The H5N1 strain of bird flu has killed more than 200 people worldwide since late 2003. But the number of human infections and deaths declined this year over last year.
Forty-eight people died of the infection in 2007, down from 71 in 2006, according to the WHO, and experts said outbreaks were also being detected more rapidly and responses have become more effective. Twenty-six countries reported flu outbreaks in birds in 2007, of which four-Bangladesh, Ghana, Saudi Arabia and Togo-experienced them for the first time.
M Parul Gupta, AFP
Tamiflu abuse can breed resistance
PARIS
Swedish scientists say that oseltamivir (Tamiflu)- the frontline weapon in any bird-flu pandemic-cannot be broken down by sewage systems and this could help the virus mutate dangerously into a drug-resistant strain.
Countries around the world are stockpiling Tamiflu in the belief it will help curb any future outbreak of H5N1 avian flu among humans.
Tamiflu is not a cure for flu but can ease its symptoms, thus aiding vulnerable patients such as the elderly, and reduce the time of illness, thus easing the burden on caregivers.
Scientists led by Jerker Fick, a chemist at Umea University, tested the survivability of the Tamiflu molecule in water drawn from three phases in a typical sewage system.
The first was raw sewage water; the second was water that had been filtered and treated with chemicals; the third was water from "activated sludge," in which microbes are used to digest waste material.
Tamiflu's active ingredient survived all three processes, which means that it is released in the waste water leaving the plant.
The finding is important because of the risk that Tamiflu, if overprescribed, could end up in the wild in concentrations high enough to let H5N1 adapt to this key drug, the authors say. Flu viruses are common among waterfowl, especially dabbling ducks such as mallards which often forage for food near sewage outlets.
"The biggest threat is that resistance will become common among low-pathogenic influenza viruses carried by wild ducks," said coauthor Bjoern Olsen, professor of infectious diseases at the University of Uppsala and University of Kalmar.
These avian viruses could then recombinate with ordinary human flu viruses, creating new strains that are resistant to Tamiflu, he said.
"Antiviral medicines such as Tamiflu must be used with care and only when the medical situation justifies it," Olsen warned. "Otherwise, there is a risk that they will be ineffective when most needed, such as during the next influenza pandemic."
The study, published by the open-access Public Library of Science, pointed the finger at Japan.
It quoted figures from Swiss maker Roche, which estimated that in the 2004 to 2005 influenza season, 16 million Japanese fell ill with flu, of whom six million received Tamiflu.
At such dosages, the amount of Tamiflu released into the Japanese environment is roughly equivalent to what is predicted in areas where the drug would be widely used in a pandemic.
Coincidentally, "Japan also has a high rate of emerging resistance to Tamiflu," the paper said. A 2004 study published in The Lancet found that among a small group of infected Japanese children, 18 percent had a mutated form of the virus that made these patients between 300 and 100,000 times more resistant to Tamiflu.
M AFP
Global Fund okays US$1-B in grants
GENEVA
The Global Fund to fight AIDS, Tuberculosis and Malaria said it has approved 73 new grants worth more than US$1.1 billion in developing countries over the next two years. The Fund, a public-private partnership set up by the then United Nations secretary general Kofi Annan in 2002, approved the grants during a board meeting in Kunming, China. The new grants mean the Fund's budget is now 32-percent higher than the US$846 million initially forecast for 2007.
AIDS projects make up 48 percent of the total, malaria 42 percent and TB 10 percent. Two thirds of the projects (66 percent) are in Africa, 13 percent in Asia, 13 percent in the Middle East, and 5 percent in Latin America.
"This is the largest funding round in the Global Fund's history. The board is pleased with the strength and high level of ambition of the new grants and is looking forward to scaling up in the fight against the three diseases," said board chair Rajat Gupta.
For malaria, some 62 percent of the proposals were approved and 19 countries will benefit from the new packages.
The Global Fund has said it needs between 12 and 18 billion dollars to fund its existing programs and initiate new ones between 2008 and 2010.
Meanwhile, Global Fund executive director Michel Kazatchkine has hailed "spectacular" progress against malaria, as the number of bed nets to protect against mosquitoes available rose by 155 percent. Some 46 million families at risk have received the nets so far this year, marking a rise of 155 percent from 18 million families in 2006.
The Global Fund also provided financing for effective drugs to treat 44 million people suffering from malaria over the course of the year. "These figures can and should give great hope to the world," Kazatchkine said.
He cited a recent study in Zanzibar which showed that insecticide-treated bed nets and effective medicinal treatment can cut malaria transmission in high coverage areas by as much as 90 percent.
"These figures are very positive. Insecticide-treated bed nets are one of the key tools to prevent malaria and it is important that everybody living in malaria endemic regions has access to one," said Awa Marie Coll-Seck, executive director of the Roll Back Malaria Partnership.
M AFP
Mosquitoes figure in fight v. malaria
ROCKVILLE, Maryland
A United States scientist is leading an international team of researchers using an army of blood-sucking mosquitoes to produce a potentially potent vaccine against malaria. Stephen Hoffman, 58, founded Sanaria Inc., a biotech firm solely dedicated to the production of a vaccine against malaria, a mosquito-borne disease that kills one million people a year, many of them African children.
Hoffman recently opened a manufacturing facility in Rockville, Maryland, where he said he aims to produce 75 to 100 million doses a year to vaccinate the 25 million infants born every in year in sub-Saharan Africa. "The opening of this facility is an important step in the process to develop a whole-parasite malaria vaccine," he said.
The scientist is optimistic the vaccine could be tested in clinical trials by late 2008. His goal, which has received US government support, was given a major boost in late 2006 when the Bill and Melinda Gates Foundation donated US$29.3 million through the PATH Malaria Vaccine Initiative.
Hoffman knows the debilitating effects of malaria all too well. In the 1980s, when he was director of the US Navy's malaria research program, he was so confident in a new vaccine that he reportedly let himself be bitten by mosquitoes carrying Plasmodium falciparum, the malaria parasite responsible for more than 95 percent of severe malarial illnesses and deaths worldwide.
Sure enough, he came down with malaria symptoms days after being bitten. The vaccine did not work.
Despite the failure of 20 years ago, the researcher has taken the same approach and hopes that a vaccine can be mass produced and maintain its potency. At his lab, researchers feed mosquitoes capable of transmitting malaria to humans with blood contaminated with P. falciparum.
Two weeks later, the parasites spread into the mosquitoes' intestines and then to their salivary gland. The mosquitoes are then delicately taken to a new chamber where they are briefly treated with radiation to weaken the parasites. Researchers extract the weakened parasites and purify them.
Used in the vaccine, the weakened parasites trigger an immune reaction powerful enough to protect against malaria more than 90 percent of the time for at least 10 months, Hoffman said, citing results of a trial conducted among 16 adults.
He said there is still much work to be done proving the treatment.
But through this system, the firm is "turning the mosquitoes into the production factories for the vaccine," he said, adding that each mosquito can produce two doses of the vaccine.
"We have a long way to go before we'll be able to license and deploy an effective vaccine to control and eventually eradicate malaria from the world, but most importantly to prevent the 3,000 deaths that will occur today among children and one million in a year."
M Jean-Louis Santini, AFP
Staph more common outside hospitals
CHICAGO
Drug-resistant staph infection is more prevalent than once believed, posing a serious health risk not just in health care facilities, but also in the community at-large, according to a medical study released Tuesday.
Staph infection not only seems to be more widespread, but also is more resistant to treatment with antibiotics than in the past, according to the report in the October 17 issue of the Journal of the American Medical Association (JAMA).
"Infections with significant antimicrobial-resistant pathogens, the types formerly seen only in hospitals, now have onset in the community. Old diseases have learned new tricks," the report read.
The study also found that infections from methicillin-resistant Staphylococcus aureus (MRSA) appear to affect certain people more often than others.
MRSA has become the most frequent cause of skin and soft tissue infections among patients in hospital emergency rooms across the United States, and can also cause severe, sometimes fatal invasive disease, according to the article.
The research, carried out by scientists at the Centers for Disease Control and Prevention, studied subjects in nine separate localities between July 2004 and December 2005. They identified 8,987 cases of invasive staph infection, most of which were "healthcare-associated."
Of those, 5,250 cases (58.4 percent) were "community-onset infections," while 2,389 (26.6 percent) were "hospital-onset infections." But 1,234 cases (13.7 percent) were deemed "community-associated" illnesses, while another 114 (1.3 percent) could not be classified.
Overall, the study found, the incidence rate of invasive MRSA for 2005 was 31.8 per 100,000 persons. Most at risk were people older than 65 (127.7 per 100,000), African-Americans (66.5 per 100,000), and males (37.5 per 100,000). Rates were lowest among children between the ages of five and 17 (1.4 per 100,000).
Of 8,987 observed cases of MRSA, 1,598 resulted in hospital deaths, the researchers said. Extrapolating from that figure, they estimated that some 94,360 invasive MRSA infections occurred across the United States in 2005, of which some 18,650 were fatal.
The researchers called for new collaborations between the public-health and medical communities to control antimicrobial resistance, and advocated "population surveillance ... by public-health personnel working with hospitals and laboratories."
"Clinicians also should be encouraged to report to the health department any new trends in antibiotic resistance that they identify," the study read.
M AFP
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