UNAIDS reports today that new HIV infections dropped by more than a quarter (25%) in 22 of the most affected countries in sub-Saharan Africa between 2001 and 2009.
UNAIDS Executive Director Michel Sidibé states: “For the first time change is happening at the heart of the epidemic. In places where HIV was stealing away dreams, we now have hope.”
“The data shows that countries with the largest epidemics in Africa—Côte d’Ivoire, Ethiopia, Nigeria, South Africa, Zambia and Zimbabwe—are leading the drop in new HIV infections,” the organisation states in a press release.
“The number of new HIV infections is steadily falling or stabilising in most parts of the world.”
The number of people on AIDS treatment has increased 12 times in the past six years, with an estimated 5.2 million people now on the life-saving drugs.
“There were 200,000 fewer deaths in 2008 than in 2004,” UNAIDS declares.
The global HIV/AIDS body observes that “South Africa is rapidly accelerating efforts to achieve universal access to HIV prevention, treatment, care and support.”
“New HIV infections among adults and young people have dropped by more than 25% and record numbers of women are accessing treatment to prevent mother-to-child transmission of HIV from previous years.
“The country has also significantly increased its domestic investments for the AIDS response in the current fiscal year.”
But the organisation warns the lack of resources in many low- and middle-income countries is obstructing the expansion of HIV/AIDS programmes.
UNAIDS released this progress report ahead of the UN Summit on the Millennium Development Goals on 20-22 September 2010.
Children who were exposed to nevirapine (to prevent mother-to-child-transmission of HIV) benefit from switching back to a nevirapine regimen after they have achieved viral suppression using a protease inhibitor, an important study shows.
Protease inhibitor (PI) therapy is recommended initally to achieve viral suppression for infants with HIV who have been exposed to nevirapine for PMTCT.
This randomised controlled trial tests whether young children switched back to nevirapine can maintain viral suppression.
The new study published this week in JAMA (Journal of the American Medical Association) – with Dr Ashraf Coovadia the lead author and Dr Louise Kuhn the corresponding author – demonstrates the “many advantages” of putting these children back onto nevirapine.
The trial was conducted at a Johannesburg Hospital from April 2005 to May 2009 among 195 children who had achieved viral suppression, from a cohort of 323 nevirapine-exposed children who initiated PI-based therapy before 24 months of age.
The results showed that the children switched back to nevirapine achieved lower rates of virus in the blood (lower viremia) compared to the children who stayed on ritonavir-boosted lopinavir.
Coovadia listed the limitations PI-regimens (based on ritonavir-boosted lopinavir) for children as:
- unpleasant taste which makes long-term adherence difficult for young children
- concerns about metabolic toxicities during children’s development and
- more expensive than nevirapine and thus a barrier in low-resource settings
The researchers said their results “suggest that a majority of nevirapine-exposed children who are successfully treated with initial regimens…could benefit from the switch strategy.”
The switch group also had a better CD4 cell response.
The South African Medical Association CEO, Dr Norman Mabasa, has supported the decision yesterday to suspend the public workers strike.
The national strike, which disrupted health services and hospitals, among other public services, was put on hold yesterday for unions to consult their members about a final wage agreement.
Government has offered a 7.5% pay increase and R800 housing allowance but unions have demanded an 8% increase and R1000 housing allowance.
All workers are expected to be back on duty by tomorrow, following the report backs from unions. They will not receive pay for the days they did not work.