There is good news out of South Africa on HIV/AIDS. A report released yesterday showed that the HIV epidemic has leveled off at a prevalence of 10.9% for those aged two and over, infections among 20-year-olds are down from 2.2% in 2005 to 1.7% in 2008, and new infections among 18-year-olds have been halved since 2005.

Excerpts below, full piece here

The number of new HIV infections among the country’s teenagers has dropped significantly due to condom use, giving rare hope to the country with the world’s biggest HIV-positive population.

“There is clearly light at the end of the tunnel,” said Dr Aaron Motsoaledi, the health minister. “There is real light.”

The report also said that HIV prevalence in children between two and 14 fell from 5.6% in 2002 to 2.5% last year, mainly thanks to the spread of drugs to prevent women passing on the virus to their children.

-Rena Pacheco-Theard

Did you know – despite everything we’ve learned about HIV, the number of new infections each year is close to what it was in the mid-1990s: the total figure today is 2.7 million? Antiretroviral treatment (ART) helps keep HIV at low levels within the body, but ART can have side effects and must be taken every day for a lifetime. What’s more, access to life-saving treatment can be an issue for people living with HIV in developing countries. Thanks to programs like the Global Fund and PEPFAR, treatment is increasingly available, but it still only reaches a third of people who need it to survive.

We must continue to extend current prevention, care and treatment options to as many people as possible to mitigate AIDS here and now, but we must also invest in the future to bring the epidemic to an end. Continued investment in prevention research, to include new tools like vaccines, microbicides and pre-exposure prophylaxis (PrEP), will produce net savings in the long term – and save lives.

In fact, only vaccines have historically ended major viral epidemics. They are proven to be cost-effective and practical. There will be an AIDS vaccine in our lifetime, and we must continue the search.

So today, on HIV Vaccine Awareness Day, I urge you to become informed about AIDS vaccine research. We all have a role to play whether it is as advocates, volunteers, health professionals or researchers.

• Checkout NIAID’s information hub around HIV Vaccine Awareness Day
• The International AIDS Vaccine Initiative (IAVI) has a new website, which features an interview with Dr Anthony S. Fauci (Director, NIAID)
• Global Health TV recently posted four interviews with leading AIDS advocates about their commitment to finding an AIDS vaccine
• IAVI President & CEO, Seth Berkley, recently gave a talk at the Center for Strategic and International Studies (CSIS) as part of their Global Health Policy Center’s speaker series

For those of you reading this blog who are already involved – today (and every day) is an opportunity to say thank you!

-Nicole Schiegg, International AIDS Vaccine Initiative–Washington, D.C.

Here’s a little known fact. Hardest hit by the AIDS epidemic, developing countries are also hard at work on new tools to prevent HIV. Those who bear the biggest burden of the AIDS pandemic are doing their part to ensure that we have a vaccine for future generations. HIV Vaccine Awareness Day is an occasion to thank the thousands of volunteers, community members, health professionals, and scientists who are working together to find a safe and effective AIDS vaccine. It is also an opportunity to underscore that supporting science and technology are core elements of good development policy.

Dr. Seth Berkley, IAVI’s President and CEO, blogged yesterday “that the Obama administration should extend its fervor for science to its foreign aid policy, putting science and technology at the heart of U.S. assistance to the developing world.” The full post can be found here.

For those of you in the Washington, DC area today, May 11th please come listen to leading African scientists talk about the novel research they are doing to help advance AIDS vaccine science. The Global Health Council, the International AIDS Vaccine Initiative (IAVI) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) are co hosting a congressional briefing on Capitol Hill at 2 PM in the Dirksen Senate Office Building, Room 419. For more information, please contact: Sara Jane Muratori at smuratori@iavi.org.

If you are not in DC, please checkout Global Health TV. Leading AIDS advocates share their commitment to finding a vaccine: Dr David Kihumuro Apuuli, director-general of the Uganda AIDS Commission and Dr Seth Berkley, IAVI. Additional interviews will be posted leading up to HIV Vaccine Awareness Day.

-Nicole Schiegg, International AIDS Vaccine Initiative – Washington, DC

The Washington Post writes how diseases, from influenza to tuberculosis to cholera and now swine flu, are spreading ever more quickly in an increasingly globalized world. But so, too, are the tools necessary to combat outbreaks of disease: expertise, medicine, money and information.

Washington Post—Diseases Travel Fast, but So Do Tools to Fight Them

Dr. Eric Goosby, a pioneer in the fight against AIDS, is President Obama’s choice to run the American effort to combat the disease globally, the White House announced this week. “The Pepfar program has already saved millions of lives in sub-Saharan Africa and other hard-hit areas around the world,” Dr. Goosby said in a statement. “But significant challenges relating to the prevention and treatment of H.I.V. remain.”

NY Times—Obama Picks Leader for Global AIDS Effort

Zimbabwe’s leaders this week failed for the fourth time in a fortnight to resolve a series of contentious issues threatening to paralyze the country’s shaky coalition government. The crisis talks remained deadlocked after long hours of intense discussions, signaling a serious political problem besetting the new government. A fierce power struggle is raging behind the scenes as President Robert Mugabe and Prime Minister Morgan Tsvangirai intensify their battle for political control.

Business Day (South Africa) – No Aid for Zimbabwe as Leaders Struggle to Overcome Political Impasse

Growing evidence indicates battle-hardened extremists are filtering out of safe havens along the Pakistan-Afghanistan border and into eastern Africa, bringing sophisticated terrorist tactics that include suicide attacks. The alarming shift, according to U.S. military and counterterrorism officials, is fueling concern that Somalia is increasingly on a path to become the next Afghanistan — a sanctuary where al-Qaida-linked groups could train and plan attacks against the West.

Associated Press – Terrorists filter into Africa

-Steve Wilson

We noted last week that donors met in Spain from March 31 to April 1 to review the progress and funding needs of the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Here are some highlights from the communiqué.

Results show the Global Fund is having a significant impact: Michel Kazatchkine, the Global Fund’s Executive Director said that the Global Fund “is affecting the course of these three epidemics.” With commitments reaching $15 billion since inception in 2002, the Global Fund has provided support for more than 600 programs in 140 countries. The Minister of Health from Nigeria, the Honorable Babatunde Osotimehin, presented findings on Nigeria’s malaria prevention and control efforts, including contributions from the Global Fund of 4 million long-lasting insecticide treated nets and 18 million doses of ACTs. Burkina Faso’s Minister of Health, the Honorable Seydou Bouda, described many gains in malaria, tuberculosis, and HIV/AIDS supported by the Global Fund, including 1.2 million children under five receiving ACTs, among others. (Stay tuned for more on Global Fund results coming later this week!)

Donors agreed that with the growth of Global Fund programs, long-term sustainability becomes even more important. Increased domestic financing for health from Global Fund recipients was one area emphasized as a way to improve sustainability. Nigeria and Burkina Faso both pledged full commitment to this. On the Global Fund side, participants asked that cost effectiveness and efficiency opportunities be pursued so that results can be maximized with available funding.

Demand for funding has increased so much that the Global Fund now estimates there is a $4 billion gap between resources currently available and those needed to meet the $13.5 billion demand from countries for 2008-2010. With what is currently available, Round 8 could be fully funded, but there is only $0.9 billion for Round 9 and subsequent rounds. The Global Fund Board will begin approving new grants in November of this year, so there is an urgent need for donors to address the funding gap. Spain has already shown its commitment, and was congratulated for increasing its contribution to $213 million. Other donors confirmed that that they expect to meet the commitments made in Berlin 2007. ONE is hoping they will in fact follow through on their commitments so the Global Fund can continue to support countries in their efforts to fight AIDS, TB, and malaria.

-Lisa Fleisher

Last night PBS’ “NewsHour with Jim Lehrer” began airing their new Global Health Unit, a three-part series funded by the Bill & Melinda Gates Foundation. The series “examines efforts to address HIV/AIDS, the increase of HIV/tuberculosis coinfections and the impact of HIV/AIDS on children.”

In conjunction with the Global Health Unit, PBS has also launched a fantastic new website with excellent resources, streaming video, photo galleries, and slide shows. Definitely worth checking out when you have a chance.

-Chris Scott

Reports from ONE staff who recently returned from Ghana and Nigeria are still coming in, and today Aaron Banks talks about their visit to an AIDS clinic in the Nigerian capital of Lagos. Click here to read more about this ongoing series on the ONE Blog.

America’s response to global AIDS is saving lives and we got to see that up-close during our visit to the Lagos State University Teaching Hospital (known as LASUTH) in Lagos, Nigeria. LASUTH is a leading HIV/AIDS facility in Nigeria and it helps coordinate HIV/AIDS treatment across Nigeria.

Nigeria is a target country under PEPFAR (The President’s Emergency Plan for AIDS Relief), an initiative to combat global HIV/AIDS, tuberculosis, and malaria. Since it was announced in 2003, PEPFAR has put 2.1 people on lifesaving antiretroviral treatment, provided 10.1 million people with care, and provided 57 million people with testing and counseling services, to name a few of this amazing program’s successes. ONE members were an important part of the movement to reauthorize and expand these efforts to stop HIV/AIDS in some of the world’s most vulnerable countries, and in July of last year, President Bush signed the five year reauthorization, committing $48 billion to combat not only HIV/AIDS, but also malaria and TB, while building health systems capacities and workforces in targeted countries.

At LASUTH, we met doctors, nurses, administrators and support staff who in a few short years of working with PEPFAR and the Harvard School of Public Health, have transformed AIDS treatment at their clinic in the hospital and at secondary and tertiary sites across Nigeria.

Our tour took us to a lab, housing state-of-the-art testing equipment that is being used to accurately diagnose HIV and save lives. Watch Dr. Ekong and Dr. Akanmu from LASUTH talk about the impact of PEPFAR funding on HIV testing and diagnosis in Nigeria.

Afterwards, I spoke with ONE’s Zita Lloyd about the effects this PEPFAR-funded testing is having on HIV-related infant and child mortality.

After visiting the clinic’s pharmacy and seeing the software they use to track patient health and adherence, we had the opportunity to hear from Saiau Ahmed, an AIDS patient and leader of LASUTH’s patient support group. His words are an inspiring reminder of the incredible progress being made in the fight against this global killer.

-Aaron Banks

Yesterday long-time ONE member Debra Goldenberg presented the 2009 ONE congressional packet to Maha Ibrahim, congressional aide to Representative Barbara Lee. Champion Lee – as some refer to the congresswoman in the 9th district – has been a leader on issues of global poverty and disease for years.

As a demonstration to her on-going commitment to end global poverty and preventable disease around the world, the congresswoman’s office is always eager to hear the concerns from their constituents who are ONE members. In fact, in the lobby of her office, Congresswoman Lee provides a four-page document titled Global Fight Against HIV/AIDS, which addresses the very issues advocated by ONE and many of our partners. The document catches everyone’s attention not only because it is the most centered document in the lobby, but also because it was printed on bright yellow paper! The pamphlet begins with Congresswoman Lee’s own words:

“AIDS is the greatest humanitarian crisis of our time. It is literally killing millions of people and crippling economies… Many developing nations are also being ravaged by HIV/AIDS. According to the United Nations Joint Commission on HIV/AIDS (UNAIDS), over 33 million people are living with AIDS worldwide, and estimates indicate that 25 million have already died. We have a moral responsibility to use every tool at our disposal to address this global pandemic.”

Further the document states “As Chair of the Congressional Black Caucus (CBC) Task Force on Global HIV/AIDS, Congresswoman Barbara Lee is dedicated to creating and supporting legislation that [among other things]:

• Maintains a strong commitment to the Global Fund to Fight AIDS, Tuberculosis, and Malaria and proves the United States’ fair share of funding of $2 billion.
• Authorizes $50 billion over 5 years to fight the global AIDS, Tuberculosis and Malaria pandemics.
• Ties increased debt relief and debt cancellation to increased spending on HIV/AIDS and the health sector.
• Addresses the immediate needs of women and girls to reduce their vulnerability to HIV infection.
• Supports HIV vaccine development and programs that would ensure global vaccine access.

California Bay Area ONE members thank Congresswoman Lee for being ONE of our Champions in D.C.

-Roscoe Mapps, California Field Organizer

In an editorial at CNN.com today, Senator Bill Frist provides some analysis and commentary on President Bush’s work in the fight against HIV/AIDS during his 8 years in office. He also writes about the trip he took to Rwanda this summer with ONE and how that impacted his own personal support of global AIDS relief efforts.

Excerpts below, full piece here

I was in the first row in the House chamber when three quarters through his State of the Union address, the president boldly said: “I ask the Congress to commit $15 billion over the next five years … to turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean” and “lead the world in sparing innocent people from a plague of nature.”

And lead the world we did. No president in history had made such a commitment against a single disease. Those words and the action that followed meant that instead of another 30 million people dying from HIV infections, maybe just another 20 million will.

…Six months ago, Tom Daschle, Mike Huckabee, John Podesta, Cindy McCain and I (yes, we five of different persuasions do work together!) went to Rwanda on a fact-finding trip.

Our visits with villagers all over the country opened our eyes to how Bush’s five-year, $1.2 billion effort to combat malaria has provided 4 million insecticide-treated bed nets and 7 million life-saving drug therapies to vulnerable people. Yes, George Bush the healer.

Future historians will also note what today’s pundits ignore: total US government development aid to Africa quadrupled from $1.3 billion in 2001 to more than $5 billion in 2008. What’s more, the Bush administration doubled foreign aid worldwide over the past eight years. You have to go back to the Truman years to match that.

And the president revolutionized the way we give aid with the creation of the Millennium Challenge Corporation, now active in 35 countries. This $6.7 billion public-private partnership for the first time ties aid to accountability based on a country’s governing well, fighting corruption and commitment to economic freedoms.

-Chris Scott

Last Friday, I went to a meeting of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) Expert Panel on Prevention of Mother-to-Child Transmission of HIV (PMTCT), which was created to aid the government by reviewing PMTCT activities and providing recommendations for scaled-up efforts. What could have been just another long meeting (9am-5pm), proved to be an engaging showcase of current PMTCT efforts, barriers to implementation, collaborative partners, and the science behind the treatments.

Mother-to-child transmission of HIV (during pregnancy, delivery, and breastfeeding) is responsible for well over 90% of the 700,000 new HIV infections in children around the world each year. Interventions (like antiretroviral prophylaxis) exist that can decrease the likelihood of transmission for HIV-infected mothers, who otherwise have a 35% risk of transmitting the virus to their child. However, by the end of 2007, only 31% of pregnant women infected with HIV in Southern and Eastern Africa received PMTCT treatment. One presenter observed that this failure to treat is due to lack of implementation, rather than scientific knowledge; effective technologies and medicines exist, but poor funding and capacity prevent their delivery.

Creative thinking is helping to get results. I was impressed with the innovative solutions the Panel discussed for PMTCT activities, including home visits by horseback for remote areas of Lesotho, and the utilization of existing newspaper routes in Kenya to ensure delivery of blood samples to testing centers. Through novel solutions and better funding, PMTCT coverage can, and should be, increased.

-Rena Pacheco-Theard