No use burying head in the sand on AIDS

0 Comments | New Straits Times, Jul 29, 2010 | by Adeeba Kamarulzaman

MALAYSIA has made significant efforts to tackle the AIDS scourge, which was acknowledged at an international conference in Vienna, but efforts must also be directed at addressing the problem among drug users and sex workers, writes ADEEBA KAMARULZAMAN.

After nearly three decades of the HIV pandemic and more than 33 million infections worldwide, more than 19,000 participants at the 18th international AIDS conference in Vienna last week were re- energised with some good news and new hopes in the search for effective prevention and treatment strategies.

Unveiled for the first time in Vienna were the results of a study on an anti-retroviral drug containing vaginal gel that could protect women against HIV infection. With up to 50 per cent of the global HIV infection occurring in women and rising rates of women becoming infected in Malaysia annually, this represents the most significant and promising result that will allow women to protect themselves from HIV during sexual intercourse.

Given that abstinence, using condoms and being faithful have been unsuccessful in preventing HIV infection, a vaginal microbicide gel is a critical step forward.

On the treatment front, although combination anti-retroviral therapy has changed what once was a universally fatal disease to a chronic disease, the need for life-long treatment makes this model not only medically unfavourable because of side effects and problems with compliance, but also financially unsustainable in the long run.

For all these reasons and given that candidate vaccines have thus far proven disappointing, the search for a cure becomes imperative.

Renewed hopes in the search of a cure have been ignited through better understanding of what happens to the virus once it enters the body. Coupled with discovery of new drugs that could eliminate latently infected cells, the feasibility of a “cure” by either eliminating the infection or a functional cure with complete suppression of the virus’s capacity to cause disease and to be transmitted seems more possible than ever before.

However, although the prospect of a cure is no longer improbable and a more effective microbicide has at last been found, both are still several years away from being commercially available and able to impact on what is already one of mankind’s greatest tragedies. Much is known about what works to prevent infection that can and should be employed immediately and to scale.

Of particular relevance to the Malaysian epidemic is that we know provision of clean needles and syringes and methadone treatment to drug users work. Here, Malaysia is leading the way compared with many other countries faced with similar drug injection epidemics
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