Faculty Bibliography

The patients, who were also infected with the virus that causes AIDS, were resistant to all first- and second-line drugs for tuberculosis, Dr. Neel R. Gandhi told the 16th International Conference on AIDS. Dr. [Gerald Friedland] estimated that half the patients had picked up their infections at hospitals or clinics. Most of those who died were in the advanced stages of AIDS, he said. Many were relatively young -- the median age was 35 -- and had never been treated for tuberculosis, so they presumably had not developed resistance slowly in themselves, but had caught the extremely resistant strains from someone else. Tuberculosis and infection with the AIDS virus have long been known to be closely intertwined. This year, the Centers for Disease Control and Prevention in Atlanta reported a total of 347 cases worldwide in which the agency found tuberculosis bacteria resistant to all first- and second-line drugs, including isoniazid, rifampin, ethambutol, streptomycin, kanamycin and ciprofloxacin

The official, Dr. Kevin M. De Cock, who directs the organization's AIDS program, said that an estimated 2.3 million children 15 and under around the world are infected with H.I.V., the virus that causes AIDS, and that 800,000 of them needed antiretroviral drugs to stay alive. Of the 800,000, only 60,000 to 100,000 are receiving therapy. While the children account for 14 percent of AIDS deaths, they make up only 6 percent of recipients of antiretroviral drug therapy. Many of the children are orphans. At the same time, Dr. De Cock said, fewer than 10 percent of pregnant women with H.I.V. in poor and middle-income countries are receiving the simple regimen of pills that can prevent the transmission of the AIDS virus to their newborns. By contrast, rich countries have virtually eliminated pediatric AIDS. Dr. De Cock also described an inequity in antiretroviral treatment for injecting drug users, particularly in Eastern Europe and Central Asia. There, these users account for more than 70 percent of people infected with H.I.V. but about a quarter of those receiving treatment

The studies are complex, the methods will not offer a magic bullet to prevent the disease and whatever preventive techniques are found to be effective will probably be combined with existing prevention strategies, the panel of 50 experts cautioned. The experts also urged the world to address the practical and ethical challenges that they said threaten to slow or derail critical research projects on many prevention measures. More donor financing will be needed to introduce and deliver the new methods, the panel, known as the Global HIV Prevention Working Group, concluded. The panel members made a number of recommendations, including finding ways to help poor countries train enough health workers to carry out male circumcision safely. Last year, a study conducted in South Africa found that circumcised men were 60 percent less likely than noncircumcised men to be infected with HIV by female sex partners. By 2007, the results should begin to come in from three studies under way in Kenya and Uganda. The studies are aimed at confirming the South African study and determining whether male circumcision also reduces the risk of HIV transmission from men to women

The official, Dr. Kevin De Cock, who directs the organization's AIDS program, said that an estimated 800,000 children worldwide under the age of 16 needed antiretroviral drugs to stay alive. Yet while they account for 14 percent of AIDS deaths, they make up only 6 percent of recipients of antiretroviral drug therapy. At the same time, less than 10 percent of pregnant women with HIV in poor- and middle-income countries are receiving the simple regimen of pills that can prevent the transmission of the AIDS virus to their newborns. This contrasts to the rich countries that have virtually eliminated pediatric AIDS, De Cock said

Large studies of an array of promising new ways to prevent HIV are nearing completion, but the world is unprepared to make them widely available to the hundreds of millions of people at risk of becoming infected, an international panel of experts reported here Tuesday. Findings from some studies, like those assessing the effectiveness of microbicides and male circumcision, are expected within the next five years, some possibly in about a year, the panel said at the 16th International Conference on AIDS. At the same time, a significant number of practical and ethical challenges threaten to slow or derail critical research on many prevention measures, the panel of international experts said

Last year, a study conducted in South Africa found that circumcised men were 60 percent less likely than non-circumcised men to be infected with HIV by female sex partners. In 2007, the findings should begin to come in from three under way in Kenya and Uganda. The studies are aimed at confirming the South African study and determining whether male circumcision also reduces the risk of HIV transmission from men to women

An array of promising new methods to prevent the spread of H.I.V. may become reality in the near future, but most countries are unprepared to provide them to the hundreds of millions of people at risk of becoming infected, an international panel of experts reported here on Tuesday. The studies are complex, the methods will not offer a magic bullet to prevent the disease, and whatever preventive techniques are found to be effective will probably be combined with existing prevention strategies, the panel of 50 experts cautioned. The experts also urged the world to address the practical and ethical challenges that they said threatened to slow or derail critical research projects on many prevention measures. Last year, a study conducted in South Africa found that circumcised men were 60 percent less likely than noncircumcised men to be infected with H.I.V. by women who are sex partners. In 2007, the findings should begin to come in from three studies under way in Kenya and Uganda. The studies are aimed at confirming the South African study and determining whether male circumcision also reduces the risk of H.I.V. transmission from men to women

Reflecting those efforts, Bill Gates, the chairman of Microsoft, told the conference on Sunday night that there was 'a new sense of optimism' in Africa because 'the world is doing far more than ever before to fight AIDS.' Gates and his wife, [Melinda Gates], who have made stopping AIDS the priority for their foundation, gave keynote addresses at the conference. They called for increased global access to HIV prevention and treatment programs and greater efforts to break the stigma of AIDS. Since the Zambian government opened 18 clinics in April 2004, death rates from AIDS have been reduced to compare favorably to those in the United States among patients who had taken standard anti-retroviral drugs for at least three months, said Dr. Jeffrey Stringer, who led the team that reported the Lusaka findings. Dr. Peter Piot, the executive director of the UN's AIDS program, said in an opening talk that the world must develop a sustainable plan to treat and prevent AIDS over the next several decades. 'We must ensure that no credible national AIDS plan goes unfunded, now or in the decades ahead,' Piot said

Both men praised the Bush administration's program, Pepfar, the President's Emergency Plan for AIDS Relief, a five-year, $15 billion program that serves 16 countries, 13 of them in Africa. One part of the program aims to help provide pregnant women with the pills to have healthy babies. For example, Mr. [Bill Gates] said, a simple drug therapy can help most infected mothers avoid passing the AIDS virus to newborns. But, in part because of stigma, poor countries are unable to provide that treatment for an overwhelming majority of pregnant women. As for stigma, Mr. [Bill Clinton] cited China's experience in reversing its position on AIDS. ''Initially, the Chinese were in denial about AIDS, and then they decided they wouldn't be, and they turned on a dime,'' he said

Mr. [Bill Clinton] and Mr. [Bill Gates], who each have charitable foundations that support the fight against AIDS, have become the newest popular face of the campaign as they have traveled the globe, often together, to learn more. Both Mr. Clinton and Mr. Gates praised the Bush administration's program, PEPFAR, the President's Emergency Plan for AIDS Relief, a five-year, $15 billion program that serves 16 countries, 13 of them in Africa. One part of the program aims to help provide pregnant women with the pills to have healthy babies. For example, Mr. Gates said, a simple drug therapy can help most infected mothers avoid passing the AIDS virus to newborns. But, in part because of stigma, poor countries are unable to provide that treatment for the overwhelming majority of pregnant women