E-drug: NYTimes: Mixed Signals on AIDS
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[Copied as fair use from today's New York Times]
July 18, 2002
Mixed Signals on AIDS
The 14th annual AIDS conference, held last week in Barcelona, Spain, was
notable mainly for its disturbing dual message, offering hope for AIDS
patients in nations able to afford expensive new drugs and despair for
victims elsewhere. Of those afflicted with the AIDS virus, 95 percent live
in countries where the new therapies discussed are unavailable. Today these
people are found mainly in Africa, but this will change; research presented
at the conference indicates that Asia and the former Communist bloc may also
become overwhelmed by the disease and its attendant hunger and chaos.
Bridging the gap between rich and poor AIDS sufferers is imperative.
All is not entirely well in developed nations. In America, information about
AIDS and help with prevention are not reaching people who need them. AIDS is
increasingly a black disease in the United States; a majority of those newly
infected are African-American, and 75 percent of people who are infected
through heterosexual sex are black, two-thirds of them women. Another
unsettling finding is that 90 percent of young gay black men who have the
AIDS virus do not know it.
There was also some good news for AIDS patients in wealthy countries, as
researchers announced a new drug, known as T-20, that can diminish levels of
the virus in patients who have developed resistance to existing therapies.
The cost of adding T-20 to an antiretroviral AIDS cocktail, however, could
be more than $10,000 a year.
For most of the world's AIDS sufferers, though, the news about T-20 �
indeed, about any AIDS treatment � is virtually irrelevant. There will be 45
million new infections by 2010. By then, 6 percent of children in Africa
will be AIDS orphans. In many African nations, the infection rate is passing
5 percent � a point at which the epidemic detonates in the general
population. China, India, Russia and Indonesia are also seeing AIDS
explosions.
As research presented at Barcelona shows, prevention and treatment can work
in practically any setting. Even poor countries have contained epidemics,
although it gets much harder to do so when a high percentage of the general
population is infected. Programs in even the most remote and miserable
places are successfully providing antiretroviral therapy. But to go from
pilot projects to coverage for millions of people takes money, and rich
countries have not yet grasped the urgency.
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