AIDS--1 DEC

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World AIDS Day


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Date: 1 December 2006
Place: Observed worldwide


The slogan of the World AIDS Campaign in 2001–2010 remains "Stop AIDS. Keep the Promise". As part of this, World AIDS Day 2006 will emphasize the theme of accountability.

People and organizations around the world are expected to campaign on 1 December 2006 to promote enhanced accountability from leaders on their commitments and generate greater public awareness and engagement on the problem of AIDS worldwide.

WHO and UN agencies will hold a public event at the WHO/UNAIDS Headquarters in Geneva, Switzerland. On 1 December, WHO regional and country offices will join partner events throughout the world.

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Global AIDS epidemic continues to grow

New data also show HIV prevention programmes getting better results if focused on reaching people most at risk and adapted to changing national epidemics

GENEVA, 21 NOVEMBER 2006 -- The global AIDS epidemic continues to grow and there is concerning evidence that some countries are seeing a resurgence in new HIV infection rates which were previously stable or declining. However, declines in infection rates are also being observed in some countries, as well as positive trends in young people's sexual behaviours
According to the latest figures published today in the UNAIDS/WHO 2006 AIDS Epidemic Update, an estimated 39.5 million people are living with HIV. There were 4.3 million new infections in 2006 with 2.8 million (65%) of these occurring in sub-Saharan Africa and important increases in Eastern Europe and Central Asia, where there are some indications that infection rates have risen by more than 50% since 2004. In 2006, 2.9 million people died of AIDS-related illnesses.

New data suggest that where HIV prevention programmes have not been sustained and/or adapted as epidemics have changed—infection rates in some countries are staying the same or going back up.

In North America and Western Europe, HIV prevention programmes have often not been sustained and the number of new infections has remained the same. Similarly in low- and middle-income countries, there are only a few examples of countries that have actually reduced new infections. And some countries that had showed earlier successes in reducing new infections, such as Uganda, have either slowed or are now experiencing increasing infection rates.
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“This is worrying—as we know increased HIV prevention programmes in these countries have shown progress in the past—Uganda being a prime example. This means that countries are not moving at the same speed as their epidemics,” said UNAIDS Executive Director Dr Peter Piot. “We need to greatly intensify life-saving prevention efforts while we expand HIV treatment programmes.”

HIV prevention works but needs to be focused and sustained

New data from the report show that increased HIV prevention programmes that are focused and adapted to reach those most at risk of HIV infection are making inroads.

Positive trends in young people's sexual behaviours—increased use of condoms, delay of sexual debut, and fewer sexual partners—have taken place over the past decade in many countries with generalized epidemics. Declines in HIV prevalence among young people between 2000 and 2005 are evident in Botswana, Burundi, Côte d’Ivoire, Kenya, Malawi, Rwanda, Tanzania and Zimbabwe.

In other countries, even limited resources are showing high returns when investments are focused on the needs of people most likely to be exposed to HIV. In China, there are some examples of focused programmes for sex workers that have seen marked increases in condom use and decreases in rates of sexually transmitted infections, and programmes with injecting drug users are also showing progress in some regions. And in Portugal, HIV diagnoses among drug injectors were almost one third (31%) lower in 2005, compared with 2001, following the implementation of special prevention programmes focused on HIV and drug use.

Addressing the challenges: Know your epidemic

In many countries, HIV prevention programmes are not reaching the people most at risk of infection, such as young people, women and girls, men who have sex with men, sex workers and their clients, injecting drug users, and ethnic and cultural minorities. The report outlines how the issue of women and girls within the AIDS epidemic needs continued and increased attention. In sub-Saharan Africa for example, women continue to be more likely than men to be infected with HIV and in most countries in the region they are also more likely to be the ones caring for people infected with HIV.

According to the report, there is increasing evidence of HIV outbreaks among men who have sex with men in Cambodia, China, India, Nepal, Pakistan, Thailand and Viet Nam as well as across Latin America but most national AIDS programmes fail to address the specific needs of these people. New data also show that HIV prevention programmes are failing to address the overlap between injecting drug use and sex work within the epidemics of Latin America, Eastern Europe and particularly Asia.

"It is imperative that we continue to increase investment in both HIV prevention and treatment services to reduce unnecessary deaths and illness from this disease,” said WHO Acting Director-General, Dr Anders Nordström. “In sub-Saharan Africa, the worst affected region, life expectancy at birth is now just 47 years, which is 30 years less than most high-income countries."

The AIDS Epidemic Update underlines how weak HIV surveillance in several regions including Latin America, the Caribbean, the Middle East, and North Africa often means that people at highest risk—men who have sex with men, sex workers, and injecting drug users—are not adequately reached through HIV prevention and treatment strategies because not enough is known about their particular situations and realities.

The report also highlights that levels of knowledge of safe sex and HIV remain low in many countries, as well as perception of personal risk. Even in countries where the epidemic has a very high impact, such as Swaziland and South Africa, a large proportion of the population do not believe they are at risk of becoming infected.

“Knowing your epidemic and understanding the drivers of the epidemic such as inequality between men and women and homophobia is absolutely fundamental to the long-term response to AIDS. Action must not only be increased dramatically, but must also be strategic, focused and sustainable to ensure that the money reaches those who need it most,” said Dr Piot.

UNAIDS, the Joint United Nations Programme on HIV/AIDS, brings together the efforts and resources of ten UN system organizations to the global AIDS response. Cosponsors include UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, UNESCO, WHO and the World Bank. Based in Geneva, the UNAIDS Secretariat works on the ground in more than 75 countries worldwide.

As the directing and coordinating authority on international health work, the World Health Organization (WHO) takes the lead within the UN system in the global health sector response to HIV/AIDS. WHO provides technical, evidence-based support to Member States to help strengthen health systems to provide a comprehensive and sustainable response to HIV/AIDS including treatment, care, support and prevention services through the health sector.

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http://www.iusy.org/pictures/campaigns/2005/aids/aids_front_big.gifWHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children

With a view to facilitating the scaling up of access to antiretroviral therapy, and in line with a public health approach , this publication outlines recent revisions WHO has made to case definitions for surveillance of HIV and the clinical and the immunological classification for HIV-related disease. HIV case definitions are defined and harmonized with the clinical staging and immunological classifications to facilitate improved HIV-related surveillance, to better track the incidence, prevalence and treatment burden of HIV infection and to plan appropriate public health responses. The revised clinical staging and immunological classification of HIV are designed to assist in clinically managing HIV, especially where there is limited laboratory capacity. The final revisions outlined here are derived from a series of regional consultations with Member States in all WHO regions held throughout 2004 and 2005, comments from public consultation and the deliberations of a global consensus meeting held in April 2006.

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WHAT DOES "AIDS" MEAN?
AIDS stands for Acquired Immune Deficiency Syndrome:


Acquired means you can get infected with it;
Immune Deficiency means a weakness in the body's system that fights diseases.
Syndrome means a group of health problems that make up a disease.
AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you get infected with HIV, your body will try to fight the infection. It will make "antibodies," special molecules to fight HIV.

A blood test for HIV looks for these antibodies. If you have them in your blood, it means that you have HIV infection. People who have the HIV antibodies are called "HIV-Positive." Fact Sheet 102 has more information on HIV testing.

Being HIV-positive, or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don't get sick for many years. As HIV disease continues, it slowly wears down the immune system. Viruses, parasites, fungi and bacteria that usually don't cause any problems can make you very sick if your immune system is damaged. These are called "opportunistic infections." See Fact Sheet 500 for an overview of opportunistic infections.
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HOW DO YOU GET AIDS?
You don't actually "get" AIDS. You might get infected with HIV, and later you might develop AIDS. You can get infected with HIV from anyone who's infected, even if they don't look sick and even if they haven't tested HIV-positive yet. The blood, vaginal fluid, semen, and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:



having sex with an infected person
sharing a needle (shooting drugs) with someone who's infected
being born when their mother is infected, or drinking the breast milk of an infected woman
Getting a transfusion of infected blood used to be a way people got AIDS, but now the blood supply is screened very carefully and the risk is extremely low.

There are no documented cases of HIV being transmitted by tears or saliva, but it is possible to be infected with HIV through oral sex or in rare cases through deep kissing, especially if you have open sores in your mouth or bleeding gums. For more information, see the following Fact Sheets:


150: Stopping the Spread of HIV
151: Safer Sex Guidelines
152: How Risky Is It?
The Centers for Disease Control and Prevention (CDC) estimates that 1 million to 1.2 million U.S. residents are living with HIV infection, about one-quarter of whom are unaware of their infection. Each year, there are about 40,000 new infections. Of these, about 70 percent are among men and 30 percent among women.

In the mid-1990s, AIDS was a leading cause of death. However, newer treatments have cut the AIDS death rate significantly. For more information,

WHAT HAPPENS IF I'M HIV POSITIVE?
You might not know if you get infected by HIV. Some people get fever, headache, sore muscles and joints, stomach ache, swollen lymph glands, or a skin rash for one or two weeks. Most people think it's the flu. Some people have no symptoms. Fact Sheet 103 has more information on the early stage of HIV infection.

The virus will multiply in your body for a few weeks or even months before your immune system responds. During this time, you won't test positive for HIV, but you can infect other people.

When your immune system responds, it starts to make antibodies. When this happens, you will test positive for HIV.

After the first flu-like symptoms, some people with HIV stay healthy for ten years or longer. But during this time, HIV is damaging your immune system.

One way to measure the damage to your immune system is to count your CD4 cells you have. These cells, also called "T-helper" cells, are an important part of the immune system. Healthy people have between 500 and 1,500 CD4 cells in a milliliter of blood. Fact Sheet 124 has has more information on CD4 cells.

Without treatment, your CD4 cell count will most likely go down. You might start having signs of HIV disease like fevers, night sweats, diarrhea, or swollen lymph nodes. If you have HIV disease, these problems will last more than a few days, and probably continue for several weeks.

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HOW DO I KNOW IF I HAVE AIDS?
HIV disease becomes AIDS when your immune system is seriously damaged. If you have less than 200 CD4 cells or if your CD4 percentage is less than 14%, you have AIDS. See Fact Sheet 124 for more information on CD4 cells. If you get an opportunistic infection, you have AIDS. There is an "official" list of these opportunistic infections put out by the Centers for Disease Control (CDC). The most common ones are:

PCP (Pneumocystis pneumonia), a lung infection;
KS (Kaposi's sarcoma), a skin cancer;
CMV (Cytomegalovirus), an infection that usually affects the eyes; and
Candida, a fungal infection that can cause thrush (a white film in your mouth) or infections in your throat or vagina.
AIDS-related diseases also includes serious weight loss, brain tumors, and other health problems. Without treatment, these opportunistic infections can kill you.

AIDS is different in every infected person. Some people die a few months after getting infected, while others live fairly normal lives for many years, even after they "officially" have AIDS. A few HIV-positive people stay healthy for many years even without taking antiretroviral medications (ARVs).
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IS THERE A CURE FOR AIDS?
There is no cure for AIDS. There are drugs that can slow down the HIV virus, and slow down the damage to your immune system. There is no way to "clear" the HIV out of your body.
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Other drugs can prevent or treat opportunistic infections (OIs). In most cases, these drugs work very well. The newer, stronger ARVs have also helped reduce the rates of most OIs. A few OIs, however, are still very difficult to treat. See Fact Sheet 500 for more information on opportunistic infections.

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Meeting on HIV and infant feeding counselling: From research to practice

The Department of Child and Adolescent Health and Development, in collaboration with the Department of Nutrition for Health and Development, convened an informal meeting, "HIV and infant feeding counselling: From research to practice" in Geneva from 15-16 November. The principal objectives of the meeting were to share the latest findings from operations research related to HIV and infant feeding counselling, including from CAH-supported projects, and to discuss the implications of research findings for the existing HIV and infant feeding counselling course and the integrated breastfeeding/HIV and infant feeding/complementary feeding counselling course. Participants included researchers and implementers from several countries, representatives from UNICEF and from WHO's HIV and Reproductive Health Departments.

On the basis of the information and discussions, the meeting participants made several recommendations related to improving support on infant feeding for HIV-positive women, as specified in the operational targets of the Global Strategy for Infant and Young Child Feeding. Issues and challenges related to the available tools and processes for skills development, health system support, and community engagement were discussed. Specific recommendations included providing clear information to countries about the different training materials available, their purpose and target audience, framing the integrated counselling course around building participants' competencies, advocating in countries to create an appropriate environment for infant feeding counselling and to overcome specific obstacles to its adequate implementation, paying more attention to the quality and selection of trainers and supervisors, and emphasizing follow-up (for trainees after training and for mothers after counselling).

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HIV / AIDS is an important health issue in children and adolescents. Since the first clinical evidence of AIDS was reported two decades ago, HIV / AIDS has spread to every corner of the world.

Children and young people are at the center of the epidemic.

According to estimates by UNAIDS and WHO, more than four million children under the age of 15 have been infected with HIV since the epidemic began. More than 90% of them were infants born to HIV-positive mothers who acquired the virus before or during birth or through breastfeeding. Because HIV infection often progresses quickly to AIDS in children, most of the children under 15 who have been infected have developed AIDS, and most of these children have died. Another 13 million children have lost their mother or both parents to the disease.
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An estimated 10.3 million young people aged 15-24 are living with HIV/AIDS, and half of all new infections – over 7000 daily – are occurring among young people. Young people are vulnerable to HIV because of risky sexual behaviour, substance use and their lack of access to HIV information and prevention services. Many young people do not believe that HIV is a threat to them, and many others do not know how to protect themselves from HIV.

Today, HIV / AIDS is still spreading rapidly. The epidemic is reversing development gains, robbing millions of people of their lives, widening the gap between rich and poor, and shattering young people’s opportunities for healthy adult lives.

Within the WHO Department of Child and Adolescent Health and Development (CAH), HIV / AIDS work is taking place in the following areas:

Preventing the transmission of HIV infection in neonates

Improving care and management of children with symptomatic HIV infection

Preventing and treating adolescents with HIV/AIDS

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Prevention of Transmission of HIV Infection in Neonates

For neonates and children under the age of 10, the most significant source of HIV infection is mother-to-child transmission (MTCT) of HIV.

In October, 2000, the UNFPA/UNICEF/WHO/UNAIDS Inter-Agency Task Team (Task Team) held a technical consultation on Mother-to-Child Transmission of HIV. The conclusions and recommendations of this consultation are available from the WHO Department of Child and Adolescent Health and Development (CAH).

The strategy recommended by the Task Team to prevent mother-to-child transmission of HIV includes 3 main components:

The primary prevention of HIV infection among parents-to-be

The prevention of unwanted pregnancies in HIV infected women

The prevention of HIV transmission from HIV-infected women to their infants

The provision of care and support to HIV-infected women, their infants and family.

While the best ways to prevent HIV infection in infants remain primary prevention of HIV infection and reduction of unwanted pregnancies among women who are infected with HIV, many HIV-infected women become pregnant. For these women the primary methods for preventing mother-to-child transmission of HIV include antiretroviral regimens, elective caesarean section and the avoidance of breastfeeding.

Antiretroviral (ARV) regimens vary in length and in what specific drugs are used, but can include the use of Zidovudine (ZDF), Lamivudine (3TC), and Nevirapine. While the efficacy of ARV regimens in reducing HIV transmission is important, it is necessary to also consider other factors such as practicality, safety, and drug resistance. Overall, the Task Team concluded that the benefit of these drugs in reducing mother-to-child transmission HIV transmission greatly outweighs any potential adverse effects of drug exposure or drug resistance.
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The Task Team also recommended the avoidance of all breastfeeding by HIV-infected mothers when replacement feeding is acceptable, feasible, affordable, sustainable, and safe.

MTCT-prevention interventions should not stand in isolation. To be most effective, they must be integrated where possible into existing health care infrastructures and reproductive health services.

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Improving Care and Management of Children with Symptomatic HIV Infection

Progress has been made to develop improved case management guidelines for children in high HIV prevalence countries. In collaboration with the WHO African Regional Office (AFRO), a regional consultation was held in Durban, S. Africa in August 2000. Public health professionals from Botswana, Ethiopia, Mozambique, Namibia, Kenya, South Africa, Zambia and Zimbabwe, international experts and WHO staff participated.

The consultation addressed four issues:

Reviewed the problem/burden of diseases due to HIV/AIDS and the implications for implementation of IMCI

Reviewed the experience with the HIV/AIDS clinical guidelines in countries

Developed interim guidelines for countries for HIV/AIDS adaptations of IMCI.

Made recommendations on research and development required on HIV in relation to IMCI.

The final report of this meeting prepared by the AFRO regional office is now available.
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Following the Regional Consultation, the WHO Department of Child and Adolescent Health and Development (CAH), in collaboration with AFRO, supported a research project to evaluate the HIV Component of the IMCI clinical guidelines in KwaZulu-Natal, South Africa. The project started in December 2000 and the data collection was completed in April 2001. Results from this study were used to develop draft generic IMCI guidelines to manage children with symptomatic HIV.

A second regional consultation was held in collaboration with AFRO in Harare in June 2001. Experts from Ethiopia, Ghana, Kenya, Malawi, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia and Zimbabwe, as well as WHO AFRO and HQ staff participated. The data from the evaluation study were presented and the generic IMCI guidelines to manage symptomatic HIV children were discussed in detail. In light of these discussions the generic guidelines and related materials have been refined and are available from CAH and AFRO. Most of the above mentioned countries have already initiated the adaptation process of their national IMCI guidelines to include management of children with symptomatic HIV.

CAH is working closely with the WHO HIV/AIDS programme and UNAIDS. Plans are under way to conduct validation studies in different epidemiological settings and to test the feasibility of using the adapted guidelines at first level health facilities.

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HIV/AIDS
HIV/AIDS and Adolescents



Young People* - a window of hope in the HIV/AIDS pandermic
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The HIV/AIDS pandemic is one of the most important and urgent public health challenges facing governments and civil societies around the world. Adolescents are at the centre of the pandemic in terms of transmission, impact, and potential for changing the attitudes and behaviours that underlie this disease.

It is estimated that 50% of all new HIV infections are among young people (about 7,000 young people become infected every day), and that 30% of the 40 million people living with HIV/AIDS are in the 15-24 year age group. The vast majority of young people who are HIV positive do not know that they are infected, and few young people who are engaging in sex know the HIV status of their partners.

The importance of focusing on young people has been recognised at a global level by the 2001 UN General Assembly Special Session on HIV/AIDS, which endorsed a number of goals for young people, including:

"By 2003, establish time-bound national targets to achieve the internationally agreed global prevention goal [adopted during the ICPD+5 Conference] to reduce by 2005 HIV prevalence among young men and women aged 15-24 in the most affected countries by 25% and by 25% globally by 2010"

"By 2005, ensure that at least 90%, and by 2010 at least 95% of young men and women have access to the information, education, including peer education and youth-specific education, and services necessary to develop the life skills required to reduce their vulnerability to HIV infection; in full partnership with youth, parents, families, educators and health care providers."

Fortunately, most young people are not infected. In fact, during early adolescence HIV rates are the lowest of any period during the life cycle. The challenge is to keep them this way. Focusing on young people is likely to be the most effective approach to confronting the epidemic, particularly in high prevalence countries.

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.1 If someone suspects that he has AIDS, what should he do?

He should see a doctor immediately

He should have a blood test to find out if there is HIV in his blood. If he has it in his blood, he will be told that he is HIV-positive. If it is not there, he will be told he is HIV-negative.

Sometimes, HIV does not appear for many months after it has got into a new person's blood. So, anyone who has reason to suspect that he might have it but tests negative, should go for another test after six months.

5.2 Under what circumstances should a person. go for the HIV test?

It is in the interest of any person to have the HIV test:

if worried that he or she might have HIV;

if the person's wife, husband, boyfriend or girlfriend has it;

when thinking of getting married;

and before deciding to have a baby.

5.3 Won't this test expose the person to embarrassment?

This is the most difficult part of the situation. Out of fear and shame, a person who has HIV may not want to let anyone know he has the virus. Yet, not having the test is very dangerous. If he fails to go for this test, he will never be sure whether or not
he has HIV and will not receive the kind of attention which he needs. Also, he will be endangering the lives of his friends and family members.

So, any one who fears he has HIV must go and see the doctor. He needs to know what to do urgently.

5.4 If it is confirmed that the person has HIV, what should he do or not do?

He must:

use a condom if he must have sexual intercourse;

get immediate treatment for any infections;

avoid doing any hard work or anything that can make him tired;

have a lot of rest;

eat well;

avoid tobacco and alcohol.

5.5 Won't knowing that he has AIDS make a person become worried and depressed?

Worrying won't help. Rather, he must:

try not to get depressed or worry too much about it;

try not to get angry or feel guilty;

avoid becoming self-conscious or feeling ashamed and hiding himself from others; he needs other people's company and support;

speak to a trusted and sympathetic friend, elder or relation, or to a counsellor or doctor about the problem. Such people may give him the advice and support he needs to cope with the situation;

develop a positive attitude to life;

plan how to make the best use of the rest of his life.

6. If someone has AIDS, what should the family members, friends or those who take care of him do?

Family members and friends should:

not isolate or reject any one suffering from AIDS;

give the person all possible moral support and care and make sure he sees a doctor when suffering from any infection.

6.1 What should those who take care of him do?

Those who take care of him should:

wear rubber gloves.

after attending to him, wash any part of their body which touches his blood, vomit, wounds, sores or stool with soap and water in which they have put germ killers, such as chlorine bleach.

7. What are the effects of AIDS on a person who has it?

Once HIV has weakened or destroyed his body's ability to fight off other diseases, the person begins to have different kinds of serious illnesses. These may include:

chest infections, resulting in pneumonia, shortness of breath and, sometimes, tuberculosis;

brain infections, causing mental confusion, severe headache and fits;

stomach infections, causing frequent watery stooling, lasting many weeks;

cancers, especially skin and brain cancer.

People with AIDS die from these diseases which their bodies can no longer fight. AIDS kills the most valuable members of the community, especially people between 15 and 49 years of age who work to support the rest of the family.

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1. What is AIDS?

AIDS is the shortened form for Acquired Immuno-Deficiency Syndrome. This is a killer disease a person gets when his body cannot fight any disease that attacks him. It is caused by a germ, called Human Immuno-Deficiency Virus (HIV). When this germ enters the blood, it weakens or destroys the body's ability to fight other diseases. The person falls sick, becomes very thin and dies after some time.

2. How does someone get HIV infection?

Any one will get HIV if he has contact with the blood, sperm or vaginal juice of someone who already has HIV, and, as a result, the germs get into his blood.

This can happen if:

he/she has a wound or cut at the point where his/her body comes into contact with the blood, sperm or vaginal juice of someone who already has HIV;

he/she has sex with someone who has HIV;

he/she uses, without sterilizing it, the same needle or syringe, razor or any instrument that cuts the skin after someone with HIV has used it;

a pregnant woman who has HIV passes it to her baby

before birth

during birth or

immediately after birth.
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2.1 What does HIV do when it enters the body?

The HIV, on getting into the blood of the newly infected person, destroys the substance in the blood that helps the body to fight and kill the germs which cause other diseases. Different diseases later attack the person at the same time and he/she starts getting thinner and thinner.. Then, he/she has got AIDS.

2.2 Can a person get HIV by sharing the same room, toilet, spoon or plates with someone who has it?

No!

2.3 Can a person get HIV by touching or shaking hands with someone who has it?

No!

2.4 Can a person get HIV through a mosquito bite ?

No!

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Globally, between 35 and 42 million people are estimated to be infected with HIV/AIDS. Every single day AIDS kills 8,000 people and orphans thousands of children. Heavily affected countries face total social and economic collapse within just a few generations if decisive steps are not taken.

"3 BY 5": Closing the Treatment Gap (downloadable pdf.155 Kb)


• Six million people need treatment now.
• Three million people die every year because they cannot get it.
• Worldwide only 440,000 people have access to treatment.
• In Africa, where 70% of people with HIV/AIDS live, ART is available to less than 4%of those in need.

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At the United Nations General Assembly Special Session on HIV/AIDS in September 2003, the failure to deliver life prolonging drugs to millions of people in need was declared a global health emergency. On World AIDS Day 2003 (December 1), the World Health Organization (WHO) and UNAIDS launched “3 by 5” - a global target to get three million people living with AIDS on antiretroviral treatment by the end of 2005. This target is a vital step towards the ultimate goal of providing universal access to AIDS treatment for all those who need it.

WHAT WILL WHO DO TO CONTRIBUTE TO “3 BY 5”?


“WHO provides support to developing countries in the form of simplified tools and guidelines and other forms of direct technical assistance for scaling up ART. Procurement and management of pharmaceuticals and diagnostics pose a problem for most resource-limited countries. Therefore, WHO has established the AIDS Medicines and Diagnostics Service (AMDS) to assist countries with all aspects of selecting, procuring and delivering AIDS medicines and diagnostic tools to the point of service delivery.


Children at the Launch of "3 by 5", 1 December 2003, Nairobi, Kenya (WHO/Sven Torfinn)

To assist in reaching the “3 by 5” target, WHO and UNAIDS are focusing on key areas including:
• Providing simplified, standardized tools and treatment guidelines for ART in poor countries.
• Creating the new service (AMDS) to help countries to ensure an effective, reliable supply of medicines and diagnostics.
• Rapid identification, dissemination and application of new knowledge and successful strategies.
• Providing urgent, sustained support for countries to help with scale up of treatment.
• Providing assistance to countries and developing guidelines for capacity building and training.

WORLD MUST UNITE TO MEET THE TARGET


“3 by 5” is a global target that has been endorsed by 192 countries at the World Health Assembly held in May 2004. Partnerships and collaboration at country and international level between national authorities, UN agencies, multilateral agencies, foundations, non-governmental, faith-based and community organizations, the private sector, labour unions and representatives of the community of people living with HIV/AIDS are absolutely essential if “3 by 5” is to be accomplished. Everybody has to play their part.


“ART prolongs lives, making HIV/AIDS a chronic disease, not a death sentence. Affluent countries have seen a 50 - 70% decline in HIV/AIDS deaths since the introduction of ART.
ART will help reduce stigma and change attitudes towards HIV/AIDS.
ART can significantly reduce HIV transmission.
ART - once very costly - is now much more affordable in developing countries.
ART can reduce overall health care costs and restore quality of life.

TREATMENT AND PREVENTION GO TOGETHER


“To ensure a comprehensive response to HIV/AIDS, treatment and prevention programmes must enhance and accelerate each other. When people have hope that they can be treated and lead productive lives, the incentive to know their status and to protect themselves and their partners is much greater. Evidence and experience show that rapidly increasing the availability of ART leads to greater uptake of HIV testing. Availability of treatment, as well as enhanced community outreach, can lead to more openness about AIDS - which helps break down stigma and discrimination. People on effective treatment are also likely to be less infectious and less able to spread the virus.

CAN IT BE DONE?

A growing number of countries have shown that increasing access to treatment is both possible and effective. Brazil has the most advanced national HIV/AIDS treatment programme in the developing world. It is estimated that between 1994 and 2002, almost 100,000 deaths have been averted in Brazil (a 50% drop in mortality) through the introduction of ART.

The programme in Brazil clearly demonstrates how scaling up can also help to strengthen health systems and dramatically reduce public health costs. As a result of the programme, there has been a significant decline in the number of hospital admissions. Cost savings in reduced hospital admissions and opportunistic infections are estimated at more than US $ 1 billion. The programme has also been effective in reducing the rates of TB and other opportunistic infections.

MAKING IT EASIER


WHO has published guidelines to increase the availability of treatment in poor countries by recommending standardized treatment regimens and simplified approaches to clinical monitoring. These simplified guidelines also make it easier to train the thousands of health care workers needed to make scale up happen.

FIXED DOSE COMBINATIONS

Fixed dose combinations (FDCs) of antiretroviral drugs are pills containing two or three AIDS drugs in one tablet. FDCs are a major breakthrough for AIDS treatment in poor countries as they offer significant operational advantages, including ease of distribution and storage, the likelihood of greater adherence, reduced incidence of treatment failure and drug resistance. Wherever possible, WHO recommends that FDCs be used in ART.

PREQUALIFICATION

Countries most in need of life-saving antiretroviral and other drugs often do not have the regulatory capacity to ensure the safety and quality of medicines from different suppliers around the world. They often rely on procurement agencies, such as UNICEF and some non-governmental organizations to puchase these medicines in bulk and distribute them. The Prequalification project, set up in 2001, is a service provided by WHO to facilitate the procurement of medicines that meet international standards of quality, safety and efficacy for HIV/AIDS, malaria and tuberculosis.

Prequalification was originally intended to give United Nations procurement agencies such as UNICEF the choice of a range of quality medicines. With time, the growing list of medicines that have been found to meet the set requirements has come to be seen as a useful tool for anyone purchasing medicines in bulk, including national governments and other organizations. For instance, the Global Fund to Fight AIDS, Tuberculosis and Malaria grants money for medicines that have been prequalified by the WHO process.

Lack of access to antiretroviral therapy (ART) is a global health emergency. To deliver ART to the millions who need it, we must change the way we think and change the way we act.” Dr. LEE Jong-Wook, Director-General, World Health Organization

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Latest Global HIV/AIDS Figures Released
New York, 21 November 2006 – In the last year, 4.3 million people were newly-infected with HIV, bringing the total of number of HIV-infected individuals worldwide to 39.5 million, according to new statistics released today by the Joint United Nations Program on AIDS (UNAIDS) and the World Health Organization (WHO) in advance of World AIDS Day. Twenty-five years after the discovery of a novel immunodeficiency disease, later to become known as AIDS, new numbers confirm that despite promising developments, including increased access to effective treatment and current prevention programs, AIDS continues to outpace the international community’s response.
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New statistics reveal that prevention programs in many countries are not reaching those who are most at risk for infection, including women, young people, racial and ethnic minorities, as well as certain high-risk groups. Forty percent of new adult HIV infections worldwide in 2006 occurred among young people 15 - 24 years old. More adult women now are living with HIV than ever before; 59% of HIV-infected people in sub-Saharan Africa are women, and the proportions of HIV-infected women continues to grow in many countries of Asia, Eastern Europe and Latin America.

"Despite enormous global international strides to expand AIDS treatment and care programs worldwide, the number of HIV infections continues to rise, especially among women, youth and marginalized groups around the world," said Seth Berkley, president and CEO of IAVI. "For both women and men, new AIDS prevention technologies, including effective microbicides and most especially vaccines, offer the world’s best hope of reversing and ultimately halting the epidemic. We cannot afford to wait another quarter of a century to reverse these devastating trends."

According to IAVI's newly-published annual vaccine impact modeling report, Estimating the Impact of an AIDS Vaccine in Developing Countries, a 50% effective vaccine given to just one-third of the population could cut the number of new HIV infections in the developing world by more than half in 15 years. A more powerful first-generation vaccine would be even more effective in stopping the spread of AIDS.

An AIDS vaccine would also have a tremendous positive effect on improving social and economic progress for millions of poor people living in Africa, Asia and Latin America. HIV/AIDS, as the leading cause of mortality among adults worldwide, poses a major threat to achieving the Millennium Development Goals (MDGs) set forth by nearly all world leaders in 2000 to improve living standards worldwide. HIV/AIDS undermines efforts to end poverty, hunger and illiteracy, combat major infectious diseases and improve the health of children and mothers everywhere.

Although increased access to treatment and prevention programs has saved an estimated 2 million life years in low- and middle-income countries since 2002 and led to positive trends in young people’s sexual behaviors, the number of people living with HIV increased in every region of the world over the past two years. UNAIDS/WHO reports that the most striking increases occurred in East and Central Asia, as well as Eastern Europe where the number of people living in HIV increased by more than 20% since 2004. There were 2.9 million AIDS-related deaths in 2006.

IAVI Mission Statement
IAVI's mission is to ensure the development of safe, effective, accessible, preventive HIV vaccines for use throughout the world.

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Prequalified HIV/AIDS medicines updated

On 4 April 2005, the WHO prequalification project, created to assess the quality of a selected number of HIV/AIDS medicines (mainly antiretrovirals) procured by UN agencies, updated the prequalified HIV/AIDS drugs list.

The direct link to the current version of the list of prequalified HIV/AIDS medicines is: , it is advisable to always check for the latest version on the

Other procurement agencies and national regulatory agencies may also refer to the list of WHO pre-qualified products, for example in case they consider importing these products and face difficulties in conducting their own quality assessment.

However, the list does not override or replace registration by the national regulatory authority. Moreover, while the list provides an independent assessment of quality, in line with standard regulatory practice, the ultimate responsibility for the quality of the products lies with the manufacturers.

The web link for general information on the prequalification project is
This site contains, among others, information for manufacturers interested in applying for prequalification, and includes for example details about the application procedure and the dossiers to be submitted, as well as background and reference materials.




Indian Patent Act Revised



On 23 March 2005, the Indian Parliament passed the 3rd Amendment to the Patents Act. This Amendment was necessary to make India compliant with the TRIPS Agreement. The amendment introduces product patents for pharmaceuticals. Before 2005, India did not grant such protection; therefore generic versions of medicines that were patented elsewhere in the world could be produced in India. The Amendment to the Patent Act will change this.

Moreover, under TRIPS transitional provisions, India had to set up a ‘mailbox’ system to receive applications for medicines patented elsewhere, between 1995 and 2004. Applications in the mailbox, which may include some of antiretroviral medicines as well as other relatively new medicines, will now have to be assessed, and patents maybe granted.

From a public health perspective, the most immediate concern relates to whether the production of generic versions of medicines with “mailbox-patents” would have to stop. Fortunately, the 3rd Amendment provides that the production of generic medicines which are already on the market in India can continue, subject to the payment of royalties to the patent holder. This is an important positive feature of the amendment; it will help to ensure that there is no backsliding in access to affordable medicines in the short term.



First ever AIDS vaccine clinical trial begins in India



On 7 February 2005 began India’s first-ever human clinical trial of an investigational vaccine candidate designed to prevent HIV/AIDS at the Indian Council of Medical Research (ICMR) National AIDS Research Institute (NARI) in Pune, outside of Mumbai. A vaccine candidate named tgAAC09 (recombinant adeno–associated viral vector, rAAV) is being tested. The trial is being conducted by a partnership between the Government of India and the not-for-profit International AIDS Vaccine Initiative (IAVI).

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Today began India’s first-ever human clinical trial of an investigational vaccine candidate designed to prevent HIV/AIDS. The trial is being conducted by a partnership between the Government of India—through the Indian Council of Medical Research (ICMR) and the National AIDS Control Organization (NACO)—and the not-for-profit International AIDS Vaccine Initiative (IAVI).


Announcing the trial, The Union Minister of Health and Family Welfare, Dr. Anbumani Ramadoss, said: “Developing a vaccine to prevent AIDS is one of the most difficult scientific challenges of our time. It is also one of the most urgent health needs. Perseverance is the way forward, and India has a long-term commitment.”


IAVI Board Member and Minister of State, Science and Technology Mr. Kapil Sibal said: “Vaccine research is so critical that the Health Ministry and the Science and Technology Ministry have joined hands to provide the effort the support it needs.”


Dr. N. K. Ganguly, Director General of ICMR, heralded the trial as part of the Indian government’s commitment to combat the AIDS epidemic: “Our country is an emerging global leader in biomedical research. With this first trial, Indian scientists are making an important contribution that will bring the world a step closer to an AIDS vaccine.”


Dr. S.Y Quraishi, Director General of NACO said: “The trial initiation is a great culmination of the tripartite partnership among ICMR, NACO and IAVI. We expect to test other vaccine candidates in the coming years under this partnership.”


More than 20 years after HIV/AIDS was identified, new infections are occurring worldwide at the rate of 14,000 every day. Public health experts agree that it is essential to develop a safe and effective vaccine.


Researchers are pursuing multiple vaccine candidates simultaneously because it is not certain which of many possible designs may prove effective.


Dr. Seth Berkley, President and CEO of IAVI, highlighted the need for global partnership: “The partnership in India is an example of the kind of international collaboration that is critical to the quest for a vaccine. We must work together to mobilize the best science in the fight against the epidemic.”


The trial in Pune
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The Phase I trial that began today is being conducted at ICMR’s National AIDS Research Institute (NARI) in Pune, outside of Mumbai, and is testing a vaccine candidate named tgAAC09 (recombinant adeno–associated viral vector, rAAV). Targeted Genetics Corp. (NASDAQ:TGEN), a Seattle-based biotechnology company, and Columbus Children’s Research Institute (CCRI) in Ohio designed the vaccine candidate in partnership with IAVI.


The vaccine candidate tgAAC09 is modeled after subtype C of HIV, the subtype that accounts for the most infections worldwide and is prevalent in many developing countries, including India and South Africa.


tgAAC09 is designed so that it cannot cause HIV infection or AIDS; it consists of an artificially made copy of a portion of HIV’s genetic material.


Phase I accine trial is the first stage of human testing, and the primary purpose is to evaluate safety. The trial will take roughly 15 months to complete and will enroll 30 volunteers, men and women, who are in good health and not infected with HIV.


The trial in India is part of a multi-country Phase I trial of tgAAC09 that is also underway in Europe; researchers in Germany and Belgium are testing the vaccine candidate in partnership with IAVI.


Regulatory approval to test tgAAC09 in India was granted by the Drugs Controller General, the Health Ministry Steering Committee, the Genetic Engineering Approval Committee, the NARI Scientific Committee, the NARI Ethics Committee and the National Ethics Committee. For the trial in Germany and Belgium, approval was obtained from authorities in the countries.


tgAAC09 utilizes a vaccine-making technology called recombinant adeno-associated viral vector (rAAV). This showed encouraging results in animals, protecting some of them from developing AIDS after they became infected with a HIV-like virus. Because what works in animals only provides a guide for what might work in humans, researchers now need to study tgAAC09 in clinical trials.

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this r a few quotes by the help of which we can create a better AIDS AWARENESS...
World AIDS Day-

Information is Ammunition

If you Test, You'll get Rest

It Could Happen To You

Let's Kill It With Kindness

It's Everyone's Problem

Prevention & Intervention

Avoid the Scare...Be Aware

Help Us Find A Way to End the Decay

Don't Delay...Get Tested Today

End the Pandemic...Help Us Find a Cure

End the Dread...Stop the Spread

Help Us Find A Way to Take AIDS Away



“AIDS brings pain! Girls, please abstain! Ladies, be wise! Make them guys condomize!”



“Be Aware! Be Prepared! HIV is passing, but don’t be scared!”