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It is true
Sep 21, 2003

Hi Drs,

It is true that the 20 or so medications available for the virus have shown great efficacy. I am amazed that many of the side effects diminish after soem time and provide people with many years of life and one that is lived realtively comfortably. I expect revolutions in treatments within the next five years. Permanent supression of at least one strain within ten years, this is not hubris.

One question brought up by a dr. is why the life saving treatments are unavailable to those who need it most (high risk populations in poor countries, where insufficient nutrition and crowded conditions invite more diseases). There are two answers to this in my opinion: 1. Current treatments utilize such breakthroughs as NNRTIs, and in the future, fusion inhibitors. Millions of dollars are invested in R&D so that ill people can benefit from these treatments. As a matter of fact, ARVs are targeted at an esoteric population, not like antibiotics. If they are given for free to millions*(the only way many of those in Bangladesh or Kazakastan could acquire them) than there would be no profit to drive the engine of R&D. My professor, whom is also employed at Trimeris, confirms this somber view. 2. Even if there are discounts and drugs are made available, there is the crucial need for education in all those infected. Teach people that there is a strict treatment protocol and it must be followed or else their health will suffer. Even in US where the issue of adherence should be one that is not a problem, studies show many still miss doses and do not take them as they should. Even Majoc Johnsons wife said that her husband was cured and that he gets sick with colds less than she does and how he is fit as a fiddle. Little does she know the virus is still replicating, though at a minute rate.So in Africa the populations may think they are cured after they begin treatment and feel better and stop taking them. Also with treatment comes the all-important lab analysis of bloodwork and there are not facilities with the sophisticated equipment in these third world countries.

I want to say it is a travesty that people are dying when the medication is able to save them. But to say it should be available and WILL be are two different issues. Instead of investing money in distribution of ARVs, all time and efforts should be parlayed into vaccine development, one area that seems to be moving foward, so long as the scientific community, the industrial corporations, and the non-profit centers can work in tandem towards a realistic goal that will save millions and end this epidemic.

Response from Dr. Pierone

You bring up many valid points about the worldwide situation with HIV. The tasks ahead are monumental and the future is uncertain. The scientific issues are challenging and we also need the political will to provide HIV medications to those that need them worldwide. More work on vaccine development should occur in conjunction with efforts to expand treatment to those that are dying now.



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