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During a briefing on the eve of World AIDS Day Monday, Secretary of State Hillary Rodham Clinton said that the International AIDS Society (IAS) has chosen Washington, D.C., to host the 2012 International AIDS Conference (IAC) now that the “decades-old ban on HIV-positive visitors” to the U.S. has been lifted, Agence France-Presse reports (11/30).

The conference - which will attract thousands of HIV/AIDS experts, advocates and policymakers - will mark the first on U.S. soil since 1990, according to Reuters. “We have to continue to seek a global solution to this global problem,” Clinton said at the briefing, held to discuss the Obama administration’s commitment to HIV/AIDS (Quinn, 11/30).

“The return of the conference to the United States is the result of years of dedicated advocacy to end a misguided policy based on fear, rather than science,” IAS President-elect Elly Katabira said in an IAS press release. “The ban on foreign nationals with HIV/AIDS visiting the United States will effectively be lifted early next year,” AFP writes (11/30).

Washington Post: “‘We are absolutely delighted,’ Robin Gorna, [IAS] executive director, said of Congress’s repeal, to take effect Jan. 4, of travel restrictions on HIV-positive foreigners. ‘It has been a matter of great distress to many of us that we have not been able to hold the conference in the United States because of discriminatory laws.’” Although “[t]he organizers of the conference do not ask attendees about their health status,” Gorna estimates in recent years the conferences have drawn “‘a couple of thousand, at least,’ … [who are] infected with the virus” (Brown, 12/1).

The IAS “urged other nations that maintain bans on HIV-positive visitors to follow suit,” according to Reuters (11/30).

“Twelve nations ban travel by people infected with HIV including China, which is reconsidering its policies as a result of the U.S. decision, Gorna said. Other nations include Malaysia, Qatar, Russia, Saudi Arabia, Singapore, South Korea and the United Arab Emirates, Bloomberg/Boston Globe reports. “This is a real moment in history to put an end to the AIDS crisis and we can only do that if we learn from each other,” said Gorna (12/1).

The Chicago-Tribune examines the history of the U.S.’s HIV travel ban (Rubin, 12/1).

Newsweek Examines PEPFAR Under Obama, Advocates Grade President’s HIV/AIDS Efforts

Newsweek examines the future of PEPFAR under the Obama Administration: “[A]fter years of steady gains in funding, health experts say PEPFAR’s funding will likely flatline under the Obama administration. At the same time, they expect the gap between the number of people who need treatment and the number getting it to widen,” the magazine writes.

“Up until now, PEPFAR was defined by the ‘E’ in its name: emergency. The emphasis was on starting up strong and making a big impact, which often meant bypassing local governments to get as many people on treatment as possible, as quickly as possible. But while that has produced impressive results, the approach is far from sustainable.”

The magazine continues that if the number of new infections does not decrease rapidly, “PEPFAR risks becoming a black hole of an entitlement program, committed to funding treatment indefinitely as more and more patients live longer and longer. … The way out of this conundrum, according to policy experts Shift more resources over to prevention efforts. Transfer programs to local ownership and put national governments on the hook for delivering services. Monitor and evaluate which programs are working, then report the results.”

The article looks at how this approach is part of U.S. Global AIDS Coordinator Eric Goosby’s agenda for PEPFAR and includes information on the risk and benefits associated with changing PEPFAR (Paul, 11/30).

Clinton said at Monday’s World AIDS Day event that “President Obama is dedicated to enhancing America’s leadership in the fight against global AIDS, with PEPFAR serving as the cornerstone of our global health initiative to promote better and more sustainable health outcomes,” ABC’s “Political Punch” blog reports.

The blog also examines a report card released by Health GAP, Africa Action, Treatment Action Group and the Global AIDS Alliance that gave President Obama’s HIV/AIDS efforts during his first year in office a “D+.” Among the greatest concerns of the group, the blog writes, is funding: “Despite repeated public commitments to expand funding for successful global AIDS programs, the first budget request to Congress prepared by President Obama, for FY2010, would for the first time essentially flat-fund U.S. global AIDS investments - it will not even keep pace with global medical inflation, estimated at 4-10% this year,” according to the report (Miller, 11/30).

Despite Gains, UNICEF Report Highlights Impact Of HIV/AIDS On Children

Despite some progress in HIV prevention and treatment targeting children, an annual report by UNICEF, the WHO and U.N. Population Fund (UNFPA), released Monday, finds efforts still needed to connect children living with HIV/AIDS with treatment and protect children orphaned by HIV/AIDS, PlusNews reports.

The report examines progress “in four key areas in 2008: prevention of mother-to-child transmission (PMTCT), paediatric HIV care and treatment, prevention of HIV among adolescents and young people, and protection and support for children affected by HIV and AIDS,” finding the greatest progress in PMTCT, “with 45 percent of HIV-positive pregnant women globally receiving antiretroviral (ARV) treatment to prevent them passing HIV to their children; up from 24 percent in 2006,” the news service writes (11/30).

“According to UNICEF, infant diagnosis in the first two months of a newborn’s life and early initiation of [ARV] can substantially decrease child mortality, but globally, the report cited that only 15 percent of children born to HIV positive mothers are being tested within the first two months,” Xinhua/People’s Daily reports. The report also noted that “positive diagnosis of HIV on its own does not guarantee a child access to life-saving treatment,” the news service writes (12/1).

Leaders Call For Global Attention In Fight Against HIV/AIDS

Ahead of World AIDS Day, U.N. Special Envoy on AIDS in Africa, Elizabeth Mataka, called for emphasis on sustained HIV prevention programs targeting women and girls - a population “more vulnerable to HIV infections,” the Times of Zambia/allAfrica.com reports. Mataka also called attention to the need for enhanced prevention of mother-to-child transmission (PMTCT) across the continent (12/1).

The BBC features an interview with French First Lady Carla Bruni-Sarkozy - also an ambassador for the Global Fund to Fight AIDS, Tuberculosis and Malaria - where she addresses the importance of targeting women and children in the fight against HIV/AIDS (Dreaper, 12/1).

UNESCO Director-General Irina Bokova on Monday addressed the need for the international community to maintain its commitment to HIV/AIDS despite the state of the global economy, Xinhua reports. Bokova “called for cooperation within a framework of respect for human rights as a cornerstone of effective and equitable national responses to ensure genuine multisectoral responses to the AIDS epidemic,” the news service writes (12/1).

News Outlets Examines The Stigma Associated With HIV/AIDS

VOA News examines how despite the recent report that the number of new HIV infections worldwide has gone down, health experts worry that fear over the disease continues to “[bar] the path to more comprehensive prevention.” The article includes comments by several health experts on stigma and the need for improved HIV prevention programs (Hennessy, 11/30).

Reuters examines the impact of HIV/AIDS on children living with the disease in China: “Heavy stigma still surrounds the disease in China, and children - probably the most vulnerable group among AIDS patients - are almost invariably barred from schools and even abandoned by their parents and relatives.” The article continues, “China’s total HIV cases number about 740,000, of which about 100,000 have full-blown AIDS. … Some 10,000 children in China are HIV-positive, due mainly to botched blood transfusions or mother-to-child transmission,” the news service writes. The article also includes information about where the highest percentages of children living with HIV live and efforts to help them access treatments (Chan, 12/1).

Media Examines Country-Level Responses To HIV, World AIDS Day

• Stabroek News examines PEPFAR’s efforts in Guyana (12/1); while the Accra Daily Mail reports on how the U.S. program is partnering with Ghana (Boafo, couldn’t find date).
• Kenya Broadcasting Corporation: Kenya marks World Aids Day (Kola/Wangui, 12/1).
• Inter Press Service: INDIA: Towards an AIDS-Free Society, But at What Price (Lal, 12/1).
• Bloomberg: Zambia’s HIV-Infection Rate May Have Increased 18% in Two Years (Simwanza, 12/1).
• The Independent: Uganda reflects on World AIDS Day (Rubin, 12/1).
• PlusNews: UGANDA: Government boost for PMTCT, paediatric services (12/1).
• Agence-France Press: AIDS epidemics risk being generalized In Ukraine (11/30).
• Daily Observer/allAfrica.com: Ghana: The Country to Observe World Aids Day Tuesday (Faal, 11/30).

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.

In a World AIDS Day speech on Tuesday, South African President Jacob Zuma announced a new national policy that would provide HIV-positive children and pregnant women with broader, earlier access to antiretroviral medications, the New York Times reports (Dugger, New York Times, 12/2). The announcement marks a “dramatic step forward” for South Africa, which has the highest rate of HIV-positive people in the world, and signals a significant break from the policies of Zuma’s predecessor, President Thabo Mbeki, according to the Christian Science Monitor (Baldauf, Christian Science Monitor, 12/1). During nearly a decade in office, Mbeki questioned whether HIV leads to AIDS and suggested that antiretrovirals could cause harm. According to a 2008 Harvard University study, Mbeki’s delays in providing antiretrovirals to prevent mother-to-child transmission led to the death of 35,000 infants. The researchers estimated that 330,000 premature deaths occurred for lack of treatment under Mbeki.

The new policy on pregnant women aligns with guidelines released on Monday by the World Health Organization (New York Times, 12/2). The WHO guidelines recommend that pregnant women with HIV be given antiretrovirals earlier and while they are breastfeeding. Experts hope that the new policy will improve survival rates for infants in South Africa, one of a handful of countries in which child mortality has increased since 1990 (Bryson, AP/San Francisco Chronicle, 12/2).

Zuma also said that by April the government would begin providing treatment for HIV-positive people with tuberculosis earlier, when their immune systems are stronger, which WHO says will help reduce death rates. According to the Times, TB is a leading killer of people with HIV in South Africa (New York Times, 12/2). Treatment for HIV patients with TB would begin when their CD4 levels drop below 350, compared with 200 now. In addition, all children younger than age one who are HIV-positive will receive treatment regardless of their CD4 levels (AP/San Francisco Chronicle, 12/2).

Donald Gips, the U.S. ambassador to South Africa, said that the U.S. will contribute an additional $120 million over the next two years to meet the higher demand for antiretroviral drugs. The U.S. already has committed $560 million in fiscal year 2010 for fighting HIV/AIDS (New York Times, 12/2). However, some HIV/AIDS experts expressed concern that the new policy would add pressure on South Africa’s health care system. Andy Gray, a consultant pharmacist to the Centre for the AIDS Programme of Research in South Africa, said that the health system “is already creaking” and that the South African government will need to search for new methods of funding to meet the new policy goals (Govender, Reuters, 12/1).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

Two studies published this month in the Journal of Clinical Investigation provide a significant advance in understanding how some species of monkeys such as sooty mangabeys and African green monkeys avoid AIDS when infected with SIV, the simian equivalent of HIV.

Using comparative genomics of SIV infection, researchers at the University of Pennsylvania School of Medicine, with collaborators from University of Minnesota, the University of Toronto, and Emory University, looked at sooty mangabeys, and a second group at the Pasteur Institute in France, looked at African green monkeys to identify possible genes related to disease progression or resistance.

“Sooty mangabeys are able to rapidly shut down the immune response after the initial SIV infection, and remain healthy. The mangabeys respond to SIV in a manner similar to rhesus macaques, which get sick, or to humans infected with HIV, but the mangabeys do not get sick,” says first author Steven E. Bosinger, PhD , a postdoctoral fellow in the Department of Pathology and Laboratory Medicine.

“The Penn study is a step forward in understanding why some African monkeys do not get sick when they are infected with SIV, which is a key question in contemporary AIDS research,” says senior author Guido Silvestri, MD, associate professor of Pathology and Laboratory Medicine and Director of Clinical Virology.

The Penn study compared changes induced by SIV infection on the overall profile of gene expression in two species of monkeys: rhesus macaques, which undergo an AIDS-like disease when infected with SIV, and sooty mangabeys, which, in stark contrast, remain AIDS-free despite life-long infection. Sooty mangabeys, which are native to Western Africa and infected naturally in the wild, were previously believed by some to remain asymptomatic because of a genetic inability to mount innate immune responses to SIV, and in particular, to produce type I interferons.

However, the current studies change the way AIDS researchers think about human versus simian AIDS infection. The sooty mangabeys’ robust antiviral immune response upon SIV infection, including a massive up-regulation of interferon response genes, or ISGs, indicates production of type I interferons in the mangabeys. Of note, this antiviral response is transient, as seen in sooty mangabeys, lasting for about four weeks, but remains constant over time in rhesus macaques, which may contribute to the immunodeficiency seen in this species. SIV induces a massive activation of immune molecules in both species, but only sooty mangabeys are able to bring the response under control.

In addition, by comparing the changes induced by SIV infection on the overall profile of gene expression of rhesus macaques versus sooty mangabeys, the research teams identified genes whose expression may be responsible for disease progression or, alternatively, disease resistance. These genes may provide novel targets for AIDS therapy.

Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $3.6 billion enterprise.

Penn’s School of Medicine is currently ranked #3 in U.S. News & World Report’s survey of research-oriented medical schools, and is consistently among the nation’s top recipients of funding from the National Institutes of Health, with $367.2 million awarded in the 2008 fiscal year.

Penn Medicine’s patient care facilities include:

– The Hospital of the University of Pennsylvania the nation’s first teaching hospital, recognized as one of the nation’s top 10 hospitals by U.S. News & World Report

– Penn Presbyterian Medical Center named one of the top 100 hospitals for cardiovascular care by Thomson Reuters

– Pennsylvania Hospital the nation’s first hospital, founded in 1751, nationally recognized for excellence in orthopaedics, obstetrics & gynecology, and behavioral health.

Additional patient care facilities and services include Penn Medicine at Rittenhouse, a Philadelphia campus offering inpatient rehabilitation and outpatient care in many specialties; as well as a primary care provider network; a faculty practice plan; home care and hospice services; and several multispecialty outpatient facilities across the Philadelphia region.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2008, Penn Medicine provided $282 million to benefit our community.

Source: University of Pennsylvania School of Medicine