2023-11-30 21:00:38
New drugs are revolutionizing the treatment of HIV. An end to the deadly pandemic is conceivable. But negligence and discrimination against sick people jeopardize the goal.
If it were purely about pharmacological achievements, the end of the HIV/AIDS pandemic, which has killed more than 40 million people in the past 42 years, could have come in six years at the latest. But negligence, discrimination and ultra-conservative views – including in the USA – threaten to jeopardize this goal. The global response to HIV/AIDS is at risk because of an “unprecedented backlash” against human rights and the “stigmatization of the people most affected by the pandemic”, warned the Executive Director of the UN organization UNAids, Winnie Byanyima, on the occasion of the World AIDS day on December 1st.
In repressive states with discriminatory legislation against non-heterosexual people, prostitutes and drug addicts, the number of new infections continues to rise, Byanyima continued. In contrast, it is declining in countries with liberal legislation – also as a result of pharmacological advances. This year’s report from the UN agency shows that in countries where people’s sexual orientation is not regulated, knowledge of one’s own HIV status is eleven percent higher and the use of antiretroviral medication is eight percent higher.
UNAids’ goal is to achieve the 95-95-95 formula by 2030: that at least 95 percent of all HIV-infected people are aware of their infection. That at least 95 percent of all infected people are treated with retroviral drugs. And that in at least 95 percent of all those treated, the number of viruses can no longer be measured – in this case they are practically no longer contagious. According to UNAids, 39 million people worldwide were living with HIV last year, of which 1.3 million were newly infected this year. Around 5.5 million people did not know that they had been infected. 30 million infected people were treated with antiretroviral drugs, and in 630,000 deaths the cause of death was due to HIV infection. “We now have the knowledge and the tools to end the pandemic,” says John Nkengasong, head of the US government’s AIDS control program.
The most important pharmacological milestone this year was the development of the prophylactic drug cabotegravir (CAB-LA), which only needs to be injected every two months and is said to reduce the risk of infection by 99 percent. Until now, the only options available to prevent infection were tablets that had to be taken daily and were less effective than CAB-LA. Each injection of the new prophylaxis still costs $3,500 and is unaffordable for a large portion of the world’s population. However, the manufacturer ViiV agreed to grant several pharmaceutical companies a license to produce a generic version. But its production is so complicated that details of the production process also have to be passed on. ViiV has not yet granted a license for this.
Despite all efforts, there is still no vaccination against the HIV virus. Because the virus is constantly changing and hiding its DNA in immune cells, developing a serum is much more difficult than in the case of the coronavirus, says South African AIDS researcher Glenda Gray.
While the stigmatization of the immune deficiency disease is still strong in large parts of Africa and the criminalization of non-heterosexual people is increasing, ultra-conservative circles in the USA have zeroed in on the Pepfar program initiated by George W. Bush. The program, established ten years ago, invested more than $100 billion to provide antiretroviral drugs to 20 million infected people in 50 countries. The program was nevertheless extended in a weaker form. Ending it would undo “two decades of unimaginable progress in combating AIDS,” criticized former President Bush.
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