It’s Friday, which often means postings are more frivolous. I don’t have anything like that today, but I thought it would be fun to offer some good news.
In my day job I have come across some very heartening information about treatment for HIV/AIDS. One of the top HIV researchers in the world (and someone who has been in the front lines of this research since the early 1980s) recently summarized some of the tremendous advances and breakthroughs that have been achieved after 25 years of research and treatment. That article isn’t available for linking, but many of the details are generally available in the published research, and I’d like to share some of these here.
My purpose isn’t just to share the good news about what is happening in this particular area, but also as an “antidote” to so much of what appears in the media today that focuses on “impossible” situations, worst case scenarios and “it’ll never happen” doom and gloom (whether for political gain or out of sheer ignorance).
Anyone who has paid attention to HIV treatment over the last 25 years is probably familiar with some of the treatment challenges that originally arose: most treatments were only marginally effective; many treatments had debilitating side-effects nearly as devastating as the disease; and treatment regimens were complex and depended on perfect timing. Additionally, the cost and complexity of the drug regimens raised the possibility that patients who began but couldn’t maintain the schedule would lead to further mutations of the virus resistant to the drugs. Here’s what is happening now:
- Effectiveness: An HIV patient that starts therapy today has a nearly 100% chance of suppressing the virus and restoring immune function (this does not mean eliminating the virus, however). HIV therapy today can almost always restore a patient’s T-cell count (the key measure of the strength of the immune system) to normal levels. This has dramatically reduced the occurence of common infections such as pneumonia, retinitis and cryptococcal meningitis, and Kaposi’s sarcoma (a once trademark affliction of HIV-infected) is now rare, as are the cancers that HIV patients were susceptible to. HIV infection today is now more predictably responsive to treatment than common diseases such as hypertension or diabetes.
- The cure doesn’t kill: Many of the early drug treatments and their applications were toxic and often disfiguring for the people who received them. Nausea, anemia, diarrhea, confusion, kidney stones and the loss of fatty tissue in the face and extremities were common. Today the drugs have been improved and the dosages refined so that side-effects, while still present, are less common and much less severe.
- Treatment is less complicated: Earlier treatment required handfuls of pills that had to be taken according to complex schedules. Some medications had to be taken on an empty stomach, others had to be taken on a full stomach. Today most treatment (antiretroviral) regimens are combined into just one or two pills, taken as little as once a day. It’s not only easier buy less expensive for patients because the combined pills reduce the amount of their co-pays. This also makes it easier to stick to the treatment plan, which in turn reduces the possibility of flare ups or the virus developing a resistance to the medication.
- Growing availability: Advances in treating HIV in the U.S. gives hope to other countries that have much higher infection rates. The developments already described here make treatment in other countries more practical and realistic. Additionally a miraculous combination of political will, philanthropy and social pressure are making treatment available in places where, until recently, it was thought to be impossible. HIV medicines are being provided mainly through two efforts: the U.S.-based President’s Emergency Plan for AIDS Relief and the Geneva-based Global Fund for HIV, TB and Malaria. These programs are supported by deeply discounted or generic antiretroviral drugs and are being used to treat hundreds of thousands of people in Africa, the Caribbean and Asia. That’s still just a small percentage of the global need, but it is significant progress.
With so much bad news reported (and celebrated) these days, I find it encouraging and inspiring that progress and breakthroughs can and do happen — even when a situation is said to be impossible and hopeless. Nothing happens overnight, but vision, integrity and focus — even by those “evil” pharmaceutical companies — are still making a better world. Happy Friday!
