SOUTH AFRICA: Military's HIV ban unlawful

"South Africa's High Court in Pretoria has ruled that the military's exclusion of HIV-positive people from recruitment, promotion and foreign deployment is unconstitutional.

"'This case is not about the relevance of HIV in a military context,' argued senior advocate Gilbert Marcus. 'The case is about the exclusion from recruitment, deployment and promotion of HIV-positive people, without any individual assessment of the state of their health.'

"The case against the South African National Defence Force (SANDF), which could set a precedent for armed forces internationally, was brought by the South African Security Forces Union (SASFU), the organisation representing SANDF employees, and by two men who were denied deployment and employment opportunities because of their positive HIV status."

"Marcus, who represented both the men and the union, said that almost 25 percent of SANDF employees were HIV positive."

Read more in IRIN, May 17, 2008.

Africa: World Bank Shifting Gears On Aids

"At the global level, the lender will advise countries on how best to manage their international financing, which the bank said is characterised by "complexity", a euphemism for the grab-bag of disparate political and practical terms, conditions, and reporting and other administrative requirements that come with the mess of multilateral, bilateral, and private money that is being thrown at the epidemic.

"In part, this new global tack is designed to help African countries to tap tens of billions of dollars in new funding from sources including the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the Swiss-based Global Fund to Fight AIDS, Tuberculosis, and Malaria."

Read more in Inter Press Service (Johannesburg), May 15, 2008.

HIV infection stems from few viruses

"'We can now identify unambiguously those viruses that are responsible for sexual transmission of HIV-1. For the first time we can see clearly the face of the enemy,' said (Professor George M.) Shaw, a project leader with the Center for HIV/AIDS Vaccine Immunology. ...

"...In 80 percent of the newly infected patients, a single virus caused transmission, though each virus was different in each patient. In the other 20 percent of patients, two to five unique viruses caused transmission."

Read more in EurekAlert!, May 15, 2008.

PNAS and Open Access

Comment: Clear, sensible discussion on open access, the movement to allow anyone to read medical and scientific research publications online without a subscription. The author has worked with both PNAS (not open access but moving in that direction) and PLoS (always open access). Here are the first four in a list of nine statements on the issue:

"1. There is no debate among scientists about the desirability of OA. Why would any scientist want their published paper to be restricted or delayed in dissemination?

"2. The current system for journal subscriptions can be illogical, inefficient and unfair. Like life, the current system evolved and it works, but it can be improved. The fulfilment and maintenance of on-line subscriptions costs money, as do subscription agents. With OA, these costs are eliminated. The situation reminds me of the inefficiency of charitable giving. On average, only two-thirds of the money donated to a charity actually goes to the people or cause served by the charity. Moreover, some publishers bundle subscriptions to journals so that libraries must purchase the entire collection to get the ones they really want or pay a hefty price for cancellation.

"3. The author-pays-only model for OA is unworkable, at least for the foreseeable future for any selective publication. It is disingenuous, though, to see author charges as the only way to support OA. Publication costs are a community responsibility.

"4. Hybrid funding models will work. Most of the money for scientific journal publishing comes from the government or private granting agencies. OA just changes the way in which the money flows and limits waste."

Read more in Nature, May 18, 2008.

New drug 'can kill MRSA superbug'

"Pharmaceutical company Destiny Pharma believes its compound - codenamed XF-73 - could be a "breakthrough" in the battle against the hospital superbug.

A study of the new drug, which is applied as a gel into patients' noses, showed methicillin-resistant Staphylococcus aureus bacteria (MRSA) did not develop resistance to the compound despite being exposed to it 55 times. "

Read more in BBC, May 18, 2008.

Vitamin D May Help Curb Breast Cancer, Study Finds

"Breast cancer patients with low levels of vitamin D were much more likely to die of the disease or have it spread than patients getting enough of the nutrient, a study found -- adding to evidence the ''sunshine vitamin'' has anti-cancer benefits. The results are sure to renew arguments about whether a little more sunshine is a good thing.

The skin makes vitamin D from ultraviolet light. Too much sunlight can raise the risk of skin cancer, but small amounts -- 15 minutes or so a few times a week without sunscreen -- may be beneficial, many doctors believe.

While the vitamin is found in certain foods and supplements, most don't contain the best form, D-3, and have only a modest effect on blood levels of the nutrient. That's what matters, the Canadian study found.

Only 24 percent of women in the study had sufficient blood levels of D at the time they were first diagnosed with breast cancer. Those who were deficient were nearly twice as likely to have their cancer recur or spread over the next 10 years, and 73 percent more likely to die of the disease. ...

One red flag: The few women with the very highest levels of vitamin D seemed to have worse survival.

Though the study was too small and those results were not conclusive, ''there may be an optimal level of vitamin D in women with breast cancer and it may be possible to take too much,'' Goodwin said.

The federal government says up to 2,000 international units of vitamin D a day seems OK. Taking 800 units per day will, on average, raise blood levels to the middle of the range that seems best for bone and general health, Goodwin said. ...

Doctors do suggest breast cancer patients get their vitamin D levels checked to see whether they are deficient. The simple blood test is available in many hospitals and labs for about $25, Goodwin said."

Read more in Associated Press, New York Times, May 16, 2008.

Health Ministers To Discuss Issues Surrounding Drug Patents, Access at World Health Assembly

"Health ministers from countries worldwide next week at the World Health Assembly will discuss issues surrounding patents and access to drugs for diseases such as HIV/AIDS in developing countries, Reuters UK reports. The World Health Organization has "struggled to find a way" to encourage the development of effective and low-cost drugs for diseases that affect developing countries, according to Reuters UK. A WHO draft plan to address the issue was rejected two years ago by the pharmaceutical industry and low-income nations, and an intergovernmental group earlier this month could not agree on alternatives to the current patent system. ...

"'It's now up to the World Health Assembly in May to translate bold ideas into concrete action,' Medecins Sans Frontieres said in a statement, adding, 'What we need to see is a wider, more ambitious framewo' for research and development, and 'political leadership, in particular from WHO.'"

Read more in Kaiser Daily HIV/AIDS Report, May 16, 2008.

AIDS is on the rise again

"HIV practitioners must now confront the reality that success in ARV development has led to complacency in regard to high risk sexual behaviour, that, in turn, has resulted in steep rises in numbers of new cases. As an example, a recent report in the Washington Blade, a magazine that caters to gays and lesbians, highlighted that HIV infection rates among gay men have shot up by 30% or more during the last five years in the United States, a stark contrast to the significant drops in numbers of HIV infections that were seen in gay male populations between the mid-1980s and mid-1990s. ...

"One answer may be to make sure that vulnerable individuals understand that the ARVs may not, in fact, work as well as we would like them to. Although the drugs are certainly effective at blocking HIV replication, there is growing evidence that HIV-infected individuals are prone to develop a variety of cancers and some other conditions that are rare in the general population. The most likely explanation is that HIV infection causes irreparable damage to the immune system, weakening natural surveillance systems that defend against cancer. Perhaps, it is fear of cancer and not HIV itself that will encourage people at risk to desist from high risk sexual behaviour and lead over time to reductions in numbers of new cases of HIV transmission. - Mark A. Wainberg is the director of the McGill University AIDS Centre, Jewish General Hospital, Montreal. Julio Montaner is the director of the BC Centre for Excellence in HIV/AIDS, University of British Columbia."

Read more in National Post (Canada), May 15, 2008.

Essay Examines Progress, Challenges in HIV/AIDS Research

"'25 Years of HIV,' Nature: In the essay, Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, examines progress and challenges associated with HIV/AIDS research since the virus was isolated in 1983. According to Fauci, the "biomedical research effort directed at HIV/AIDS has resulted in some breathtaking successes"; however, much "remains to be accomplished in the global fight against HIV." To address such challenges, researchers have "two main options," Fauci writes. The first is to "purge every vestige of virus from" HIV-positive people's "bodies so that a course of treatment could be measured in weeks or months rather than a lifetime." He adds that because of HIV's ability to "hide within cells from both drugs and the immune system, such a treatment regime has proved elusive, although important work in this area is being pursued." This leaves researchers "with the second option" of preventing HIV "in the first place," according to Fauci."

Read more in Kaiser Daily HIV/AIDS Report, May 15, 2008.

Full text free in Nature.

Leaders come together to pursue a National AIDS Strategy pursue a National AIDS Strategy

"On April 9, 2008, 42 leaders in the domestic response to HIV/AIDS met at the Ford Foundation in New York City to discuss development of a National AIDS Strategy (NAS) for the United States. ... The NAS effort was initiated by the AIDS Action Council, AIDS Foundation of Chicago, Balm in Gilead, Black AIDS Institute, Community HIV/AIDS Mobilization Project, Gay Men’s Health Crisis, and the San Francisco AIDS Foundation.

In the months leading up to the meeting, a Call to Action for a NAS had received the support of over 200 organizations and hundreds of individuals (www.nationalaidsstrategy.org). Two of the three leading Presidential candidates had pledged to develop an NAS if elected.

The Call to Action identifies the need for an outcomes-oriented NAS that is designed to bring national HIV incidence rates down, increase access to HIV-related care, and reduce HIV-related racial disparities. It urges development of a NAS that is coordinated across federal agencies and includes measurable goals and accountability mechanisms.

The meeting at the Ford Foundation was organized in order to broaden engagement in the NAS concept and to discuss how to move forward with the proposal. Attendees did not attempt to develop the NAS, but discussed potential goals for a NAS, elements needed to make a NAS successful, and next steps for advancing the concept. ...

There was general agreement that the NAS should be owned by the federal government (which would be responsible for reporting on progress towards NAS goals and coordinating the work of federal agencies), but that the AIDS community should help outline the framework for the Strategy and that multiple stakeholders should be engaged in NAS planning and implementation.

Next steps include:

* Broadening engagement in the NAS effort among the AIDS community, policy makers, private industry, media, and the public.

* Working towards development of a guidance document for the next Presidential Administration that makes recommendations for the structure and process of developing an NAS."

Read more in Project Inform's eNews, May 8, 2008.

For more information: A Google search for

"national aids strategy" 2008

returns about 800 pages.