HIV in Africa
Big data is buzzing in the healthcare sector. As more and more data becomes available, analysts are looking for ways to improve the healthcare industry. While developed nations, with their multitude of activity trackers and smart devices, are better positioned to leverage big data, developing nations are also taking advantage of the rapidly growing pool of information being recorded.

The International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University was clearly aware of the value of data when it proposed the Population-based HIV Impact Assessment (PHIA) Project. In partnership with the Centers for Disease Control and Prevention (CDC), ICAP has been gathering data to measure the level of success against HIV in Africa. With the help of the ministries of health in the affected countries, they have been conducting surveys and diagnostic tests to measure national HIV incidence, pediatric prevalence and viral suppression. Zimbabwe, Malawi and Zambia were the first countries to release their survey and test results. Over the next several years, 17 other countries will participate in the project and publish their findings.

So far, the results have been encouraging. The data indicates that the US President’s Emergency Plan for AIDS Relief (PEPFAR) is achieving success against HIV in Africa. PEPFAR is the largest commitment by any nation to combat any single disease internationally. If the results from Zimbabwe, Malawi, and Zambia are early indicators, then the PEPFAR has been well worth the investment.

The initial results of the PHIA Project indicate that these countries are on track to achieve the 90-90-90 targets set by United States Agency for International Development (USAIDS). The goal is to have 90 percent of HIV patients diagnosed, 90 on antiretroviral therapy and 90 percent with adequate viral suppression by 2020. Models predict that the AIDS epidemic can be ended by 2030 if these goals are reached.

In Zimbabwe and Zambia, the treatment and viral suppression goals are almost a reality; more than 85 percent of patients are on treatment and virally suppressed. In Malawi, the viral suppression target has already been reached. The percentage of patients on treatment is just shy of 90 percent. Ninety percent and 86 percent of women and men, respectively, are on treatment. In all three countries, though, improvements in diagnosis are needed. Three out of every 10 patients are unaware of their status.

However, these early indicators of success against HIV in Africa are not signs that there is no more work to be done. Rather, in the words of Dr. Wafaa El-Sadr, the director of ICAP, “Now more than ever, we have to keep our foot on the pedal and push even harder.”

Rebecca Yu

Photo: Flickr

HIV Vaccine Trial Begins in South Africa
A new HIV vaccine trial has begun in Johannesburg, South Africa where experts are cautiously optimistic about its potential for success.

The trial, which is funded by the National Institutes of Health, is based on a trial that took place in Thailand and yielded moderately successful results. Thailand trial’s results were controversial because it was tested on a segment of the population with a low risk for infection. The trial in South Africa hopes to remedy this by using members of their own population which have a uniquely high rate of infection and thus puts wider swaths of the population at risk.

The HIV/AIDS death rate has greatly decreased with the increasingly widespread availability of antiretrovirals, yet infection rates continue to increase. Scientists and doctors believe that a vaccine is the only possible measure to successfully eradicate the disease, and many of them believe that this trial could be the beginning of the end for a disease which continues to infect more than 1,000 people daily in South Africa alone.

CNN reports that an estimated one adolescent becomes infected every two minutes worldwide. According to Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Diseases, there is no reason to believe that the HIV/AIDS crisis is over. In the U.S., infection rates have remained steady for the past 15 years in spite of prevention efforts.

Because of the high HIV infection rate in South Africa, scientists believe that an effectiveness rate of 50-60 percent would be sufficient to enter negotiations with drugmakers, although this is significantly lower than most other vaccines.

The study will enroll 5,400 sexually active men and women between the ages of 18 and 35 who are not infected with HIV. They will receive five shots of the vaccine and three boosters over the course of the study, which is expected to yield results in 2020. It aims to provide greater protection from infection and has been adapted for the HIV subtype that is found in southern Africa.

This trial, which is the first HIV vaccine trial in nearly a decade and is only the seventh full-scale human trial in the world, has been met with both skepticism and optimism. Glenda Gray, the president of the South African Medical Research Council, is leading the study. Although she admits that there is no guarantee that the trial will be successful, she remains optimistic about the results.

The HIV vaccine trial in Thailand was run by the U.S. Army, whose Dr. Nelson Michael called the trial “A signpost for vaccine development. This was a yes-we-can moment: the opportunity to become enthusiastic. The door has cracked open. We are all going to try to collectively crash through it.”

Kenya, who will be monitoring the trial closely, is expected to begin a similar trial early next year.

Eva Kennedy

Photo: Flickr

HIV/AIDS in Angola
On Aug. 5, the United Nations Development Programme (UNDP) and the Global Fund announced a $30 million grant to prevent the spread of HIV/AIDS in Angola, as well as improve coverage of therapy and treatment.

In 2014, there were 300,000 people in Angola living with HIV and 26 percent of adults received antiretroviral treatment coverage. The grant for HIV/AIDS seeks to solve challenges like the elimination of mother-to-child transmission, adherence to antiretroviral treatment and prevention for young people.

The grant for HIV/AIDS in Angola will also increase coverage in several areas like antiretroviral therapy, testing and counseling and the promise of long-term treatment. Antiretroviral therapy recently proved itself to be an effective way to suppress the HIV Virus and prevent the disease from progression and transmission to more people.

This course of treatment is particularly effective at reducing death and infections when performed in a regimen.

The grant also seeks to include key populations into its strategy for HIV/AIDS in Angola. The grant has a strong focus on sex and reproductive health education and rights including HIV for adolescents, youth and girls. According to the WHO, the strategy is to increase the amount of “HIV-positive pregnant women on antiretroviral therapy.”

The national strategic plan for key populations in Angola also includes “sex workers and men who have sex with men.” The grant includes funds for a legal environment assessment and will propose steps for strengthening the human rights environment to create a more effective HIV response. According to the UNDP, training is provided for “health workers, prison workers and police to reduce stigma and discrimination” towards these key populations.

The grant for HIV/AIDS in Angola will run from July 2016 to June 2018 with a focus on preventing future spread of the disease within the country and lowering the numbers of people living with HIV/AIDS.

Taameen Mohammad

Photo: UNDP

https://www.flickr.com/photos/ana_raquel/8363643633/in/faves-100442662@N03/UNAIDS Partnered With Faith-based Organizations to Strengthen HIV Response
UNAIDS and United States President’s Emergency Plan for Aids Relief (PEPFAR) collaborated with faith-based organizations (FBOs) in East Africa to launch a two-year initiative to strengthen their capacity to respond to HIV.

On Sep. 15, 2015, in the seventieth session of the United Nations General Assembly in New York, it was revealed that the five focus areas of the U.S. $4 million program are: collecting, analyzing and disseminating data; challenging stigma and discrimination; increasing demand for HIV services and retaining people in care; improving HIV-related service provision; and strengthening leadership and advocacy.

This new program is the result of suggestions made by faith leaders at a deliberation in April 2015. The conference hosted over 50 faith leaders from Kenya, Rwanda, Uganda and the United Republic of Tanzania.

The faith leaders called for more access to data, heightened accountability and better collaboration between FBOs and international partners.

The report, Building on Firm Foundations, which was released by the United Nations General Assembly, UNAIDS, PEPFAR and Emory University last month, highlights the impact of faith-based responses to epidemics in the four East African countries.

FBOs provided a majority of health services and sustained collaborative communities which maintain a disease-free environment for future generations.

PEPFAR’s partnership with FBOs has allowed them to reach 7.7 million people with lifesaving antiretroviral treatment, and treat 14.2 million pregnant women, thus decreasing mother-to-child transmission of HIV.

The recently launched PEPFAR 3.0 – Controlling the Epidemic: Delivering on the Promise of an AIDS-free Generation set the ambitious goal of 90-90-90.

By 2020, PEPFAR aims to achieve: 90 percent of people living with HIV who know their status, 90 percent of people who know their status and are receiving treatment and 90 percent of people on HIV treatment who have a suppressed viral load.

Thus it is important to strengthen partnerships with FBOs, as they are primary health providers for many communities, and allow UNAIDS and PEPFAR to expand their impact.

Luiz Loures, UNAIDS Deputy Executive Director, stated that “Faith-based organizations are essential partners, particularly in the areas of health service delivery and addressing stigma and discrimination. The partnership with faith-based organizations is critical to ending the AIDS epidemic and making sure that no one is left behind.”

Marie Helene Ngom

Sources: UNAIDS, PEPFAR Report
Photo: Flickr

UNLV’s New Research on HIV

Researchers from the University of Nevada Las Vegas have begun working on new research on HIV, human immunodeficiency virus, by finding ways to stop the virus from infecting human cells.

UNLV has already earned several financial grants for the research, including one from the National Institutes of Health.

The researchers are looking at genetic codes called minimotifs that direct cellular function. Their goal is to understand how the codes can help cells fight off HIV by blocking the virus from interacting with the cells.

“We chose HIV as our model system because we know viruses depend solely on cells to live,” said Kiran Mathew, a researcher at UNLV, in an interview with the Las Vegas Review Journal. “It’s a great model system we can use to test out the effects of (the codes) in the cell.”

According to the U.S. Centers for Disease Control and Prevention, about 1.2 million Americans were infected with HIV as of 2012, with roughly 50,000 new cases each year.

By the end of 2014, close to 37 million people were living with HIV/AIDS worldwide and about 15 million people living with HIV were receiving antiretroviral therapy. The World Health Organization cites sub-Saharan Africa as the most affected region by HIV/AIDS globally with 26 million people infected in 2014. The region also accounts for almost 70 percent of the global total of new HIV infections.

There is currently no cure for HIV. The Food and Drug Administration has approved more than 25 antiretroviral drugs to help fight infections and improve quality of life for patients. With successful treatment, HIV infection can become a chronic, manageable disease. But therapy must be life long and there are limitations to diagnosis, treatment and care in geographical areas that are most heavily affected.

The promising new research coming out of UNLV might help develop new HIV drugs, code for other diseases and make personalized drugs specific for a patient’s genetic makeup. But first the findings must be published and patented before pharmaceutical companies could begin the process of bringing it to market where patients can benefit.

Megan Ivy

Sources: Review Journal, CDC, WHO
Photo: Flickr