Category Archives: HIV/AIDS

They Go to Die: A TB/HIV and Human Rights Film

“If we turn an epi­demic into an emo­tion, we moti­vate change.” – Jonathan Smith

In his film, Jonathan Smith – an epidemiologist and Director of the Visual Ethnography Project at Yale University – aims to put humanity back into research. He’s invited into the homes of four mine workers living with HIV/TB co-infection and, in the broader context of human life, he takes viewers beyond cold epidemiological data and into the lives of the men. They are not unlike many others seeking work in the South African mining industry. But not all work is created equal: poorly ventilated mines are perfect terrain for TB transmission, and mines, combined with HIV, are currently the two largest driving factors of the TB epidemic in South Africa.

The message is simple: mine workers become sick and they go home to die because they’re not provided with the essential health care or medicine required to keep them alive. But death is not inevitable: HIV/TB co-infection is largely preventable and treatable – so long as there’s the will to do it.

Jonathan is on a mission to do just that: he’s seeking to raise enough funds to complete post-production of the film with the hope that viewers, like you, will create the pressure and impetus necessary to improve the working conditions in mines and impact the lives of hundreds of thousands of workers looking to make an honest living.

Interested in meeting Jonathan in person? Join him in Vancouver at UBC for a viewing of the film!

Date: 4:00PM, Friday, October 21st
Location:  Norm Theatre, Student Union Building, UBC, 6138 Student Union Blvd.
Admission: Free

A portrait of HIV/AIDS in sub-Saharan Africa

I came across this photo-essay in the Walrus archives. It’s easy to get lost in the enormity of the pandemic but I think these photos help humanize the data.

HIV positive babies?

Sounds like an oxymoron, right? Well, sadly, it’s not. HIV transmission from mom to baby (affectionately referred to as Prevention of Mother-to-Child Transmission of HIV) has almost been eliminated in wealthy countries due to effective prevention strategies but the same can’t be said for many poor regions. While the reasons for this are complex, one factor remains: there is very little market incentive for pharmaceutical companies to develop paediatric HIV drugs that are appropriate and safe.

Thankfully, the Drugs for Neglected Diseases initiative (DNDi)a not-for-profit organization that uses an alternative model to develop medicine for neglected diseases–is doing something about it. On July 18th at the 6th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention, DNDannounced the launch of a new program that aims to address this unmet need. More details can be found here. According to Dr. Bernard Pécoul, the Executive Director of  DNDi:

There are millions of children with HIV/AIDS in low- and middle-income countries, but their needs are absent from the HIV research and development agenda, and this is largely because they are poor and voiceless and do not represent a lucrative marketWorking with partners, we hope to help fill this terrible gap and offer improved treatment options for children with HIV/AIDS.

I can imagine a world where more people are able to live a healthy and fruitful life. Ideally, this begins with a healthy childhood. Props to DNDi for refusing to accept such a grim global reality.

Passing drug bill imperative: AIDS in Africa could be stopped in its tracks if medications were available

Here is a recent op-ed written by Craig and Marc Kielburger of the non-profit Free the Children. Reprinted from the Edmonton Journal. Definitely worth a read…

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We build schools in Kenyan villages where teachers die, but their students refuse to name the cause because of its potent stigma, even as coffins are lowered into graves.

We’ve seen husbands, mothers, and then their children, wither away from a mysterious illness rather than be ostracized with a diagnosis.

In North America, access to treatment makes it possible for people with HIV/AIDS to lead relatively comfortable lives. In developing countries, where antiretroviral drugs (ARVs) are prohibitively expensive, AIDS is a curse.

There’s still no cure, but Canada has a chance to save potentially millions of lives with a single legislation. Bill C-393 would reform Canada’s Access to Medicines Regime, a system so flawed it’s only been used to ship a single drug to Rwanda since it was first introduced six years ago.

Bill C-393 allows Canadian companies to manufacture generic versions of patented drugs, like ARVs, making it easier to deliver affordable medicine to developing countries. It passed the House of Commons on March 9, but stalled in the Senate, and then died on the order paper when the government fell.

When Parliament resumes June 2 there will be numerous pleas for the attention of Stephen Harper’s majority government. But this is more than a plea. Finally passing this bill is a moral imperative, and research released since its initial passing has made it an urgent one.

A few weeks ago, a major clinical trial found that treating HIV-positive people with ARVs led to 96 per cent reduction of transmission for the 1,763 participating couples in 13 sites all over the world, including Kenya.

The breakthrough was so great that results were released four years earlier than scheduled.

“We have a new vaccine and it’s called treatment,” Dr. Jennifer Cohn from Medecins sans frontieres, a medical relief organization with offices in Kenya, recently told the Nairobi Star. Advocacy organizations also predicted the virus could be eradicated in Kenya in just a few years.

Kenya is our second home -we’ve spent the past 15 summers there. We love the untouched beauty of its landscapes and the warmth of its people, but we’re sick with the knowledge that AIDS devastates the country.

Mary was a nurse in Kenya’s Rift Valley. She knew her husband had been unfaithful, and that she was in danger. But he refused to wear condoms -he’d paid her dowry, she was his property. When Mary was diagnosed with HIV, her husband abandoned her while she was pregnant with their second child. Women are more likely to be identified as carriers because of prenatal testing. Her child, who we will call Abby, was born HIV-positive.

Mary couldn’t afford proper treatment. When she died, none of her close relatives would adopt Abby for fear of “catching” the virus. The now two-year-old has little hope of receiving the medicine she desperately needs to survive.

Canadian pharmaceutical company Apotex Inc. has promised to make a generic duplicate of a pediatric ARV should bill C-393 pass. Dr. James Orbinski, founder of the medical humanitarian organization Dignitas International and staunch supporter of C-393, has said this alone would save millions of lives, since generic drugs reduce treatment costs from $10,000 to $100 a year -even less for children, like Abby.

We wonder how many people were infected while Canada’s unelected Senate stalled a bill that passed in the House of Commons with a vote 172 to 111 -including support from the Bloc and NDP, all but two Liberals and a handful of Conservatives.

But not a single Conservative cabinet minister supported the bill, and brand-name drug companies, threatened by the prospect of lost business, lobbied against it.

Ideally, competition on the global market would increase with added competition from generic companies better able to compete on price, driving costs down for poor people dying preventable deaths. This is a humanitarian aid bill meant to save lives, not money.
After years battling opposition and regulatory quirks in the House, only to be stalled to death in the Senate, Bill C-393 isn’t guaranteed a swift pass through this Parliament.

Canada’s political landscape has changed. The NDP say they will reintroduce the private member’s bill that was first passed in the minority Parliament.

Canada has two choices.

The Conservative government could bolster the country’s reputation on the world stage at no cost to taxpayers. In fact, passing the bill would make Canada’s foreign aid dollars go further because we, and developing countries, could purchase more medicine for less.

Or, our government could fail to act, leaving countless people to die needless deaths.

MacGyver would be proud: Possible 3 cent HIV test.

Literally, an HIV diagnostic kit made from tape and paper.  Seriously, if there was also a mention of a paper clip in there, I’d haf expect MacGyver to be a co-author.

Anyway, here’s a quote from the blog post over at Discover Magazine:

A new device smaller and cheaper than a postage stamp could be used to diagnose diseases in developing countries, Harvard researchers report. The sophisticated microfluidic diagnostic devices, called microPADS, are made out of little more than paper and sticky tape and cost about three cents each. “The starting point with us was asking, ‘What’s the simplest, cheapest [material] we could think of?’ … And that was paper,” [The Scientist] said co-author George Whitesides. (read more)

For those who prefer the technical jargon, this was recently published at PNAS, but I’ve copied the abstract below:

“This article describes a method for fabricating 3D microfluidic devices by stacking layers of patterned paper and double-sided adhesive tape. Paper-based 3D microfluidic devices have capabilities in microfluidics that are difficult to achieve using conventional open-channel microsystems made from glass or polymers. In particular, 3D paper-based devices wick fluids and distribute microliter volumes of samples from single inlet points into arrays of detection zones (with numbers up to thousands). This capability makes it possible to carry out a range of new analytical protocols simply and inexpensively (all on a piece of paper) without external pumps. We demonstrate a prototype 3D device that tests 4 different samples for up to 4 different analytes and displays the results of the assays in a side-by-side configuration for easy comparison. Three-dimensional paper-based microfluidic devices are especially appropriate for use in distributed healthcare in the developing world and in environmental monitoring and water analysis.”

A Primer on the Subject of Access to Medicines

Here’s a piece I wrote for online reading at Scientific American. It basically tries to cover the main ideas and main challenges in Access to Medicines issues. Not a bad place to start to get into the swing of things. Also, If you’re a reader from Canada, don’t forget to check out aidsaction.ca. Here, you can look up your candidates and send off an email to support the Call to Action to reform Canada’s Access to Medicines Regime and help save lives!

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30 minutes, 70 fates.

You don’t know it, but as I write this piece, there is some serious procrastination going on. My attention span is weak and sidetracked constantly by a variety of diversions, and if you must know, it’s taken me close to half an hour to write these first two sentences. Still, one could argue that none of us are strangers to procrastination, and 30 minutes is relatively short – only a minor instance of time in the grand scheme of things.

But a lot can happen in thirty minutes. Earlier, I had been looking over some 2009 UNAIDS statistics, and noting the numbers issued in the report. They are all very big, big enough certainly to require the pressing of buttons on calculators. More to the point, I learn that during my thirty minutes, approximately 70 people died from HIV/AIDS in Sub-Sahara Africa. That’s 1.3 million victims each year – in Sub-Sahara Africa alone. Many of these were parents leaving orphans, and many were young children just leaving. Most troubling, however, is the fact that all of them suffered their fate with a loss of dignity.

Why do I say this? I say this because people shouldn’t have to die from HIV/AIDS. There are good medicines out there, and they can control the disease. In fact, for those in the developed world, HIV/AIDS is now considered a chronic disorder, not a death sentence. If you are diagnosed, you are no longer forced to take a shortcut to demise. You can still have a long life, you can still be productive, and you can still live with dignity.

Unfortunately, this wasn’t an option for those who passed away. For them, the medicines were out of reach. They were simply too expensive. And from this, you come to realize a cold hard fact in this narrative: that the fate of a person living or dying from HIV/AIDS is determined by their income. This statement is fairly straightforward, with no mincing of words, or confused rhetoric. But for most, it feels fundamentally wrong, and yet, it is a simple reality of how the world works today. Why it works in this way, however, is complicated.
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Whoa… This is what HIV looks like. Amazing how devastating this tiny thing can be.

This amazing model (which was also included in the 2010 best Science Visualization Images) can be found here with many others. In particular, when you go to the site, click the “label” button for a quick primer on the different structures on the virion.

LINK: Visual Science HIV Image