Faculty Bibliography

China is negotiating to buy its own supply of Tamiflu, a senior Chinese health official said in an interview. Taiwan has already bought a large stockpile of Tamiflu, and is seeking to buy more and to set up its own production facilities. In Japan, the Health Ministry is also trying to arrange for domestic production of Tamiflu, which is now made at a single factory in Europe by the drug company Roche Holding. Tamiflu, an antiviral, is only effective if given in the first two days after the onset of infection. Since many people with little more than the sniffles would take Tamiflu before it became clear they did not actually have bird flu, the amount of Tamiflu needed in a health emergency could be enormous, said Roy Anderson, an epidemiologist at the University of London. Tamiflu is a fairly new drug, still under patent and very costly. Its typical retail cost in the United States is $68 for a 10- capsule treatment to be taken over five days. 'If Tamiflu is to be used in a pandemic situation, it will have to be stockpiled,' a Roche official said, warning that, 'it takes time to produce mass quantities.'

In its first progress report, issued a day before the 15th International AIDS Conference here on Sunday, the WHO estimated that 440,000 people were being treated. That is about twice as many as in 2002, said Dr. Jim Kim, director of the agency's AIDS program. But the agency's goal had been to treat 60,000 more people by now. [Lee Jong Wook] said that the U.N. agency could not let it fail because 'the collective response to the HIV/AIDS pandemic is the benchmark by which our generation will be judged.' Dr. Peter Piot, the director of the U.N. AIDS program, a partner in the 3 by 5 effort, said, 'We have to be frank and admit that we have a long way to go.'

The program, known as 3 by 5, has been a subject of debate since the agency's director general, Dr. Lee Jong Wook, announced it last fall. In its first progress report, issued a day before the 15th International AIDS Conference here on Sunday, the World Health Organization estimated that 440,000 people were being treated. That is about twice as many as in 2002, said Dr. Jim Kim, director of the agency's AIDS program. But the agency's goal had been to treat 60,000 more people by now. Only Botswana, Indonesia and Uganda have published such plans. Botswana is treating 18,000 people, with a goal of 30,000; Indonesia is treating 1,500, with a goal of 3,500; and Uganda is treating 20,000, with a goal of 55,000, said Melanie Zipperer, an agency spokeswoman

As the 15th International AIDS Conference starts today in Bangkok, few expect the 15,000 participants will learn about a cure or successful vaccine

Falling short: In its first progress report, issued a day before the 15th International AIDS Conference in Bangkok, Thailand, today, the World Health Organization estimated that 440,000 people were being treated. That is about twice as many as in 2002, said Dr. Jim Kim, director of the agency's AIDS program. But the agency's goal had been to treat 60,000 more people by now. Only Botswana, Indonesia and Uganda have published such plans. Botswana is treating 18,000 people, with a goal of 30,000; Indonesia is treating 1,500, with a goal of 3,500; and Uganda is treating 20,000, with a goal of 55,000, said Melanie Zipperer, an agency spokeswoman

In its first progress report, issued a day before the 15th International AIDS Conference here today, the WHO estimated that 440,000 people were being treated. That is about twice as many as in 2002, said Dr. Jim Kim, director of the agency's AIDS program. But the agency's goal had been to treat 60,000 more people by now. [Lee Jong Wook] said that the U.N. agency could not let it fail because 'the collective response to the HIV/AIDS pandemic is the benchmark by which our generation will be judged.' Only Botswana, Indonesia and Uganda have published such plans. Botswana is treating 18,000 people, with a goal of 30,000; Indonesia is treating 1,500, with a goal of 3,500; and Uganda is treating 20,000, with a goal of 55,000, said Melanie Zipperer, an agency spokeswoman. -->

Only one, President Yoweri Museveni of Uganda, accepted, said Dr. Peter Piot, the director of United Nations AIDS, an organizer of the conference. Dr. Piot's United Nations group has stressed the need to put AIDS on the agendas of political meetings like those of the Group of 8. At the same time, Dr. Piot and others have tried to get leaders to attend meetings like this one to combine politics and public policy with AIDS science. Prime Minister Manmohan Singh of India is not coming because his administration is just starting and is involved in budget debates this week, Dr. Piot said. Sonia Gandhi, the leader of the Congress Party, which leads the governing coalition in India, and Mr. [Nelson Mandela] are expected to speak at the close of the conference

Experience has taught scientists that there is no guarantee of an effective microbicide. At the AIDS Conference in Durban, South Africa, in 2000, health workers had fully expected that a large trial of a spermicide, nonoxynol-9, would prove that the drug was effective. But the trial showed that nonoxynol-9 may increase the risk of HIV infection rather than protect against it. So scientists have shifted their focus to drugs that specifically aim at separate parts of HIV's life cycle. An ideal microbicide would work in three ways. First, it would kill HIV in the vagina and cervix. Second, the microbicide would prevent any virus that escapes from attaching to a woman's cells, the way HIV starts to infect. Third, for any virus that does enter cells, the microbicide would block an enzyme, reverse transcriptase, that HIV needs to replicate

A microbicide is at the top of health workers' wish list to protect those women in poor countries whose husbands won't use condoms. A microbicide would also protect an infected woman's sex partners from infection. The need for a microbicide is even more urgent because there is no vaccine for HIV. 'Microbicides will not be magic bullets, and microbicides probably will never be as effective as condoms,' which are considered nearly 100 percent protective, Dr. Zeda F. Rosenberg, chief executive of the nonprofit International Partnership for Microbicides, said in an interview. For example, Rosenberg said, an ideal microbicide would not kill the bacteria that are normally present in healthy vaginas and that produce hydrogen peroxide, a natural disinfectant. Also, scientists do not want a microbicide to change the acidity of the vagina because it could allow unwanted bacteria to flourish

Of the 12,058 adults that Doctors Without Borders has treated with antiretroviral drugs in 21 countries in Africa, Central America and Asia since 2002, 6,861 received fixed-dose combinations. Since March, 80 percent of the group's new AIDS patients have received fixed-dose combinations. Among the 6,861 fixed-dose combination recipients, there was a significant increase in the number of immune cells, known as CD-4 cells, that are destroyed by H.I.V., the virus that causes AIDS. The CD-4 count rose by an average of 137 cells in a year, in about half the patients. In a separate part of the study conducted in Malawi, Dr. Arno Jeannin's Doctors Without Borders team randomly tested the amount of H.I.V. in the blood of 477 patients who had received fixed-dose combinations there for six months or longer. Of these, H.I.V. could not be detected in 85 percent, showing the overall effectiveness of the fixed-dose combinations