December 1st: International day against AIDS

Yesterday was the International Day against Aids. Here you have some videos and a text for you to listen and read. I hope you like it!

    As World Aids Day is marked on Sunday 1 December, around 35 million people across the globe are living with HIV. Whilst it is encouraging to see that new cases of HIV infections and Aids continue to fall - in 2012, 2.3 million people worldwide became infected with HIV, a 33% reduction since 2001 - experts believe that starting treatment much earlier is the key to combatting the spread of infection. To achieve this, the international private sector is being urged to take the lead in demonstrating its commitment to combating the fight against HIV/Aids.

    "We know that investment in HIV/Aids prevention and treatment delivers tangible results," explains Dr Brian Brink, Anglo American's chief medical officer, vice-chair of the Audit and Ethics Committee of the Global Fund and a leading authority on the business response to HIV/Aids and TB.

"The downturn in new infections was largely due to the increased global investment in the HIV/Aids response from both PEPFAR (the US President's Emergency Plan for Aids Relief) and the Global Fund to fight Aids, TB and Malaria."

    The Global Fund is an innovative partnership platform uniting government, civil society and the private sector to direct increased funding to the poorest countries with the least access to care, support and treatment.

    "I want to urge all major British companies with a global presence to join forces and made an investment in the Global Fund to help end HIV/Aids across the world," says Brink. "We know it can be done – we are starting to see results – but we need more support to reach our end goal of zero new infections."

    Brink supports the UNAIDS proposition that scaling up HIV treatment in accordance with the newly announced World Health Organisation (WHO) guidelines could prevent up to 65 million deaths globally by 2050.

    "The biggest investment has been in treatment, and one of the most fundamental changes we have seen in recent years is that HIV itself is being treated rather than waiting for people to develop Aids. HIV treatment now is simpler and less toxic, so starting treatment even earlier could make a significant difference. Studies have conclusively shown that earlier treatment leads to a dramatic reduction in the number of new HIV infections, the primary reason being that HIV infected people receiving treatment are very unlikely to pass the infection on."

    The initiation of treatment is based on the CD4 lymphocyte count – the best indicator of the state of the immune system in an HIV infected person. A normal CD4 count falls in the range 600 – 1500 cells per microlitre, but with HIV infection it progressively drops below this range; a CD4 cell count below 200 is taken to define the onset of Aids in an HIV infected person. Under the new WHO guidelines, antiretroviral treatment should commence when the CD4 count drops below 500. Many believe that treatment should start as soon as possible – when a patient has been properly counselled and is prepared to commit to treatment – regardless of CD4 count.

    Brink cites the results of the 'HPTN052' trial released on 12 May 2011, which evaluated the risk of HIV transmission in discordant couples (where only person in the couple is infected with HIV). Half of the study group received HIV treatment and used condoms, whereas the other half only used condoms. After two years, new infections in treated couples was 96% lower than in untreated couples. The trial therefore showed that if an HIV positive person adheres to an effective antiretroviral therapy regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%.

    Earlier treatment, which could prevent up to 65 million deaths globally by 2050, requires scaling up of treatment to 23 million on treatment by 2025. This will need a huge commitment and investment from both the international private sector and a coordinated funding approach.