Still no magic bullets against HIV-AIDS, but…

World AIDS Day is the annual rallying cry for awareness of HIV-AIDS and to refocus efforts to combat the disease. Now, recent statistics and new treatments strategies have the potential to change the course of the disease.

UNAIDS reported last week that new HIV cases are down significantly worldwide. “We can say with confidence and conviction that we have broken the trajectory of the AIDS pandemic,” said Executive Director Michel Sidibe in Geneva.

Also, a surprise pronouncement from the pope, who writes in his new book that that condoms used to prevent disease transmission is better than having unprotected sex. A far cry from sensible advocacy of safe-sex, but a less rigid edict for Catholics nonetheless. The pope needs to get a clue and also recommend the vaginal microbicide gel containing tenofovir used before and after sex to be 39% effective in preventing new HIV infections in women. But hey, he has control issues to protect.

But, the biggest news concerning HIV-AIDS is a report about a study among gay men that shows that a new combination of two already available drugs protect against individuals from being infected. Short of a vaccine, this may be more effective in disease prevention than both safe-sex and abstinence programs combined. It is the most promising news since the development and refinement of antiretroviral drugs

President Obama said the new treatment study (dubbed PreP) “could mark the beginning of a new era in HIV prevention.”. Mitchell Warren, head of AIDS Vaccine Advocacy Coalition, told AP this week. “I don’t know of a day where so many pieces are beginning to align for HIV prevention and treatment, and frankly with a view to ending the epidemic,” adding “This is an incredibly opportune moment and we have to be sure we seize it.”

Dr. Anthony Fauci, at the forefront of strategies to combat the disease since the 80s and director of the National Institute of Allergy and Infectious Diseases calls the drug study “an exciting finding,” but cautions “it is only one study in one specific study population,” The three-year global study found that patients who took the pill cut the risk of infection by from 44, its efficacy increased when patients increased daily usage. It was also part of a study of healthy gay and bisexual men when given with condoms, counseling and other prevention services.

AIDS doctors are not calling the new drug protocol the chemical equivalent of a condom, but Dr. Margaret Chan, director-general of The World Health Organization said “The trial opens exciting new prospects. It shows that oral pre-exposure prophylaxis can reduce the risk of HIV infection in men who have sex with men. We look forward to further examining these data to consider how we can best use this tool to enhance HIV prevention.”

The down side in this is the cost- in the US, at $8,000 to $12,000 a year; the generic equivalent to be made available for export around $140. A price that will be manageable for many people with some level of insurance, enrolled in HIV-AIDS service organizations or both. The sad reality is that unless the global networking of AIDS drugs bypasses corporate profits and AIDS politics to deliver the medication at a much lower cost, people in poor countries will continue to suffer the ravages of HIV-AIDS. Another problem is that gay men are criminalized in some 80 countries and in many regions have little or no access to HIV prevention programs and treatment.

The CDC already has recommendations on the drug for gay and bisexual men as a strategy of testing and treatment for HIV, counseling and condom use. The success of this should immediately be a launch pad for a wider outreach to all at-risk groups, primary among them oppressed sexual minority around the world.

The CDC, UNAIDS and all AIDS service organizations should mobilize to ensure that these new advances in treatment are known and available to all who seek them, not only in the US, but as part of the global initiative to eradicate HIV-AIDS. With leadership, this December 1 could be the beginning of the end for the need for World AIDS Day.