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The Bill & Melinda Gates Foundation will give an additional $80 million to Avahan, a foundation initiative launched in 2003 for HIV prevention programs in India, Bill Gates said on Thursday, the Seattle Times blog, “Business of Giving” reports. Previous foundation commitments to the program, “which involves more than 100 non-profits in six Indian states,” total $258 million, the blog writes (Heim, 7/23).

According to the Times of India, Gates and Indian Health Minister Ghulam Nabi Azad “will discuss gradual transition of Avahan to the government. Avahan has already awarded more than $100 million in grants for this transition.” Gates said, “It’s not that the foundation is leaving India. The amount we spend in India on health and development will actually go up but will focus on other things like nutrition, maternal and child health and vaccines,” the Times of India reports (Sinha, 7/24).

The Telegraph reports that the Foundation plans to support other health issues, including vaccines to prevent pneumonia and viral diarrhea and drugs to treat visceral leishmaniasis, said Gates, who is in India to receive the Indira Gandhi Prize for Peace, Disarmament and Development on behalf of the foundation. According to the Telegraph, “Avahan-supported programmes have reached an estimated 220,000 commercial sex workers, 80,000 gays and about 5 million men at risk of becoming infected with HIV” (7/23).

Gates, who received the peace prize on Saturday, said, “The Indian government must accelerate its progress toward its health spending targets, so that innovations benefit the poor people who really need them,” the International Business Times reports. He also reiterated the foundation’s long-term commitment to helping India deal with a variety of health issues, saying, “India bears a massive burden of disease. But in the next five years, it can make more progress on health than it has made in any other five-year-period in its history” (7/26).

The Seattle Times reports that “Avahan has begun handing over the reins to the government-run National AIDS Control Organisation [NACO]. During the transition, ‘Avahan will provide financial and technical support to ensure that prevention programs can be sustained over time,’” according to the foundation (7/23). In a written statement, K. Sujatha Rao, Secretary and Director General of NACO said, “Our collaboration with Avahan has made it possible to reach far more people with proven HIV prevention interventions. This strong partnership will continue as key aspects of Avahan transition to the government in the coming years” (Gates Foundation release, 7/23)

While in India, Gates also met with the state of Bihar’s chief minister, Nitish Kumar, via video conference about polio and visceral leishmaniasis eradication efforts in the area, the Hindu reports (Banerjee, 7/25). Gates told Kumar, “We are ready to work with your government and all partners in the polio effort to stop transmission in Bihar and ultimately assure all parents that their children are safe from this crippling disease,” the Bihar Times reports (7/24).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

Not satisfied with simply thwarting its host’s defensive maneuvers, HIV actually twists one to its advantage, based on new findings from Kyei et al. in the July 27, 2009 issue of the Journal of Cell Biology. Vojo Deretic and colleagues suggest that autophagy - a stress response process - helps HIV to proliferate and that conversely, blocking autophagy lessens HIV production.

Reduced HIV levels were accompanied by a blockade in the processing of Gag - a key precursor protein for HIV assembly. Gag in fact localized to complexes containing an autophagy protein, LC3. “It looked paradoxical,” says Deretic. “But only if you didn’t know something else. And that is a finding in yeast that autophagy is not only degradative, but can also serve in some biosynthetic pathways,” including the trafficking of the Cvt protein to the vacuole. Together, the results suggest that Gag may piggyback on autophagosomes or their components, perhaps for locomotive services, to complete its maturation.

The group then sought the viral agitator that blocks autophagosome maturation and allows Gag processing. Their primary candidate was HIV protein Nef, which interacts with the vacuolar proton ATPase and might thereby block acidification steps necessary to make a degradative organelle. Using a mutant virus, the group showed that HIV lacking Nef no longer profited from increased autophagy and was instead degraded. It is not yet clear exactly how Nef blocks autophagosome maturation.

Clinical applications may be far down the road. If the idea is to kill the virus using drugs such as rapamycin, which induces autophagy, it will first be necessary to block Nef, notes Deretic. The idea is not without natural support. “There were cases in Australia involving HIV strains that lacked Nef,” he says. “And these people would not progress to AIDS, meaning the virus is disabled.”

Deretic has other exciting ideas. Highly active anti-retroviral therapy often does a smashing job clearing viral loads from the blood. But the pathogen can persist in particular locales such as gut lymphoid tissue. “My hope,” says Deretic, “is to go after these reservoirs and chew up the virus that for some reason is not readily accessible or susceptible to the anti-retroviral therapy. I have great hope that autophagy will help us with that. This is something we didn’t have on our radar screens just five years ago.”

Source:
Rita Sullivan

Rockefeller University Press

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In Chicago, 17.4 percent of gay men are estimated to be HIV-positive, compared with 1.2 percent of the general male population, according to a new report by the Chicago Public Health Department, the Chicago Sun-Times reports. The report is based on data collected from 570 Chicago men through the National HIV Behavioral Surveillance system, and found that half of the men with HIV were unaware they were infected (Thomas, 7/25). “Health officials said Friday, information in the report on HIV infection mark the first time Chicago health officials have used blood-testing to determine infection rates among men,” the AP/Chicago Tribune reports. In the past, estimates have relied on interviews with gay and bisexual men, according to Christopher Brown, the Public Health Department assistant commissioner. The report also found that “black men who have sex with other men have double the HIV infection rates of white and Hispanic men,” the AP/Tribune reports (7/24).

This information was reprinted from dailyreports.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily U.S. HIV/AIDS Report, search the archives and sign up for email delivery at dailyreports.kff.org.

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