Which New Health Technologies Do We Need to Achieve an End to HIV/AIDS?

In the last 15 years, antiretroviral therapy (ART) has been the most globally impactful life-saving development of medical research. Antiretrovirals (ARVs) are used with great success for both the treatment and prevention of HIV infection. Despite these remarkable advances, this epidemic grows relentlessly worldwide. Over 2.1 million new infections occur each year, two-thirds in women and 240,000 in children. The widespread elimination of HIV will require the development of new, more potent prevention tools. Such efforts are imperative on a global scale. However, it must also be recognised that true containment of the epidemic requires the development and widespread implementation of a scientific advancement that has eluded us to date—a highly effective vaccine. Striving for such medical advances is what is required to achieve the end of AIDS…

Even with all the biomedical and behavioural tools available today, HIV continues to be a formidable pathogen, altering the health economics and public health strategies of most countries worldwide. Of the 35 million HIV-infected individuals worldwide in 2014, more than half did not know their HIV status, and over a third were not receiving ARVs [1] despite the availability of affordable point-of-care diagnostics and treatments. Adoption of “universal test and treat” approaches, extension of medical male circumcision programs, universal access to basic harm reduction services for people who inject drugs, and more widespread use of PrEP in targeted populations can do much to “bend the curve” and initiate a process to slow the rate of new HIV infections (Table 4). Such efforts are imperative on a global scale. However, it must also be recognised that true containment of the epidemic requires the development and widespread implementation of a scientific advance that has eluded us to date—a highly effective vaccine. There are potential synergies that will accrue from an integrated approach involving treatment, microbicides, and HIV vaccines (Fig 2). Various mathematical models agree that treatment roll-out on its own will decrease HIV incidence over time. However, when a 30% preventative HIV vaccine was introduced to a model with expanding treatment access in southern Africa, incidence was predicted to be 67% lower over time compared to a scenario with no vaccine introduction [35].

Below: Medical interventions required to end the epidemic of HIV

Below:  The spectrum of biomedical innovation required to end AIDS

Full article at:   http://goo.gl/SmCmO6

By:  Glenda E. Gray,1,2,* Fatima Laher,2 Tanya Doherty,1,3,4 Salim Abdool Karim,5,6 Scott Hammer,7 John Mascola,8 Chris Beyrer,9,10 and Larry Corey11

¹South African Medical Research Council, Cape Town, South Africa

²Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

³School of Public Health, University of Western Cape, Bellville, South Africa

⁴School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

⁵Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa

⁶Mailman School of Public Health, Columbia University, New York City, New York, United States of America

⁷Columbia University Medical Center, New York City, New York, United States of America

⁸Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health. Bethesda, Maryland, United States of America

⁹Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America

¹⁰The International AIDS Society, Geneva, Switzerland

¹¹HIV Vaccine Trials Network, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington

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