CategoriesWACI Health News

World-renowned researchers working on HIV discuss life sciences topics of international interest.

In addition to the many resources mobilized in response to COVID19, it is essential not to overlook other pandemics that still have a great and lasting effect and on which equally important and lifesaving work has been concentrated. A recent seminar series called Life Sciences Across the Globe focused on global experts discussing how to advance life sciences. World-renowned HIV researchers were among those presenting.

The Institute of Infectious Disease and Molecular Medicine (IDM) at the University of Cape Town (UCT) held its monthly seminar on 4 August. The series is a collaboration between the Howard Hughes Medical Institute and Janelia Research Campus.

The IDM’s Education Committee chair, Associate Professor JoAnn Passmore, emphasized the institute’s focus on diseases relevant to Africa and its commitment to training the next generation of African scientists.

“The world currently has more than 40 million [people] living with HIV, many of whom live in sub-Saharan Africa. HIV researchers have been focusing on the endgame: a cure for HIV. 

Strategies towards a cure

Sharon Lewin is a physician and basic scientist who specializes in infectious diseases. Lewin is the inaugural director of The Peter Doherty Institute for Infection and Immunity, a joint venture between the University of Melbourne and Royal Melbourne Hospital in Australia. In addition to developing clinical trials to develop a cure for HIV, she conducts research to understand why HIV persists despite treatment.

The goal of reaching 95% of people living with HIV on treatment by 2025 is a challenging one, given that 1.8 million new infections occur annually in the world.

Due to antiretroviral therapy, the face of HIV has changed dramatically. With a daily dose of one tablet, antiretroviral therapy is now more straightforward. Additionally, treatment is relatively cheap, mostly accessible, nontoxic, and available to at least 70% of the world’s population.

“People will have to inject themselves every other month just to keep their virus under control with new advances in antiretroviral therapy. Since antiretroviral therapy isn’t perfect, we need a cure,” she said.

HIV testing is a core strategy in HIV prevention. A person who tests positive and begins treatment gradually becomes less infectious. We are treating it as we prevent it.

Destigmatizing testing is key – HIV testing and COVID19 testing are two very different things. We need to normalize testing since people don’t like to get tested for many reasons. In contrast, testing people frequently, with their consent, and starting treatment [early] is very effective. Those actions have led to reductions in HIV over time.”

Bringing it home

Thumbi Ndung’u is a professor of infectious diseases and the Max Planck group leader at Africa Health Research Institute. The Females Rising through Education, Support, and Health (FRESH) cohort is under his care. FRESH aims to empower young women through the programme and to encourage participation and feedback in a bidirectional manner.

Ndung’u noted that the highest HIV prevalence is in KwaZuluNatal. According to Dr. Emily Wong’s research published in Lancet Global Health this year, 36% of males and 60% of females aged 25 to 44 are HIV positive.

“As someone living in a resource-limited environment, the most exciting approaches revolve around early diagnosis and early immune therapy and these approaches are probably more likely to be implemented in these settings,” said Ndung’u. “There’s also evidence that this is achievable. So combination approaches will likely form the first line of HIV cure strategies.

“We have a history where we have seen that developing interventions by themselves is not enough. Instead, we need to make sure that interventions are tailored to the communities that will benefit from them.”

Hope and healing

Over the past 30 years, of the 78 million people who have been infected with HIV, 39 million have died of it.

The evolution of the virus and the eras of despair, hope, and most recently, the hope that a cure might be in sight.

“The cure for HIV will come. We’ve got to be optimistic. We’ve got to believe.”

There are a variety of barriers that can make it difficult to continue treatment, continue at scale, and continue well. Politics, discrimination, stigma, accessibility, and specific regulations are some of these barriers. This epidemic is far from over.

Working with community advisory boards and including those served in terms of education is crucial to ensuring that the community has a voice.

“The best science is relevant science. Relevance asks, ‘What is the priority?’ Science then asks the right question. If asked and listened to, the community frames the context. And together, the community and science can find the right answer.”

CategoriesWACI Health News

Torch Caravan spreads hope across Africa.

The Torch Caravan, an initiative of the Global Fund@20, spreads light and hope throughout Africa.  In addition to passing the torch, eight countries reflected on the Global Fund’s impact on reducing disease burdens and building sustainable systems for health care. 

The highest level of participation has been achieved by civil society organizations, parliamentarians, and people dealing with the disease themselves. The Global Fund changed the narrative because before it came if someone had HIV, they would waste away and die. But since then, people have a new perspective.”   Maurine Murenga, Lean on Me Foundation, Kenya

There is much excitement and gratitude expressed by various countries. The Central African Region will receive the torch in September from the East African Region.

Peter Sands, Executive Director, the Global Fund: “We celebrate the people, the partners, the advocates and the communities who have led to this remarkable success.”

While providing supply support for the COVID-19 response to support overstretched healthcare systems and community health networks, Global Fund works tirelessly to protect lifesaving AIDS, tuberculosis and malaria programs. We are stronger when we work together. 

CategoriesWACI Health News

HIV, TB and Malaria programs take a back seat due to Covid-19.

Several health services have been negatively affected by COVID-19 outbreaks, partly due to overburdened systems. In low- and middle-income countries with high rates of HIV, tuberculosis, and malaria, disrupted services could result in premature deaths over the next five years.

 

During the largest epidemic in history, the WHO has warned against diverting funds from programs fighting HIV, TB, and malaria. Despite this, USD 1.7 billion is being diverted from health into security because of the Covid outbreak. This is equivalent to the amount needed to treat all three diseases over two years.

In light of rising COVID-19 mortality rates worldwide, it has become increasingly evident that vulnerable populations are disproportionately affected. Vulnerable people include those who live in densely populated areas, those with low socioeconomic status, migrants, and minorities. There are higher rates of comorbid chronic conditions in these groups, placing them at higher risk for infections and severe disease consequences.  

Services to prevent disease (voluntary medical male circumcision, pre-exposure prophylaxis, long-lasting insecticide-treated nets [LLINs], and seasonal malaria prevention) have been suspended or reduced; ongoing treatment (for HIV and tuberculosis) and new acute treatment (for malaria) have been cut by 25 to 50 per cent during peak demand periods, as well as treatment for those newly seeking care (HIV or tuberculosis testing and treatment). 

The Xpert MTB/Rif molecular diagnostic tool, intended to diagnose tuberculosis accurately, was potentially repurposed for COVID-19 diagnosis, further driving down diagnosis and treatment rates for tuberculosis. 

HIV experts and communities have often stepped up and provided support during the worst of the crisis. The worldwide response has drawn on decades of experience in combating AIDS. Globally, many countries responded quickly, addressing vulnerabilities, maintaining health services, and creating synergies between AIDS control and COVID-19. By doing so, HIV and COVID-19 threats are dealt with simultaneously.

Despite a decline of 23% in HIV-new infections since 2010, the COVID-19 pandemic may reverse this trend, and populations already behind may fall further behind. Recovery programs are therefore essential for areas with high HIV rates, as are programs for tuberculosis and malaria to reduce the health impact of the COVID-19 pandemic.

Priorities for reducing the effects of COVID-19 include maintaining services such as HIV and tuberculosis treatment (for new and existing patients), malaria prophylactic treatment, and LLIN distribution.

As a result of social distancing measures instituted by COVID-19, it is estimated that HIV transmission and tuberculosis transmission would be reduced by 10%.

Insufficient national and global investments in pandemic readiness are exposed by the recent HIV and COVID-19 pandemics and their responses. Health systems will need to be more resilient in the long run in order to handle shock events such as pandemics.

Together with HIV, TB and Malaria, COVID-19 should build synergies to make sure that they increase access to services, decrease the risk of infection and disease, and impact programme outcomes.

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