AFTER 25 years battling the mother of all viruses, have we finally got the measure of HIV? Three developments featured in this issue collectively give grounds for optimism that would have been scarcely believable a year ago in the wake of another failed vaccine and continuing problems supplying drugs to all who need them.
Perhaps the most compelling hope lies in the apparent 鈥渃ure鈥� of a man with HIV who had also developed leukaemia. Doctors treated his leukaemia with a bone marrow transplant that also vanquished the virus (see 鈥淥ne shot to rid body of HIV鈥�). Now US company Sangamo Biosciences is hoping to emulate the effect using gene therapy. If it works, and that is still a big if, it would open up the possibility of patients being cured with a single shot of gene therapy, instead of taking antiretroviral drugs for life.
Antiretroviral therapy (ART) is itself another reason for optimism. Researchers at the World 91色情片 Organization have calculated that HIV could be effectively eliminated in Africa and other hard-hit places using existing drugs. The trick is to test everyone often, and give those who test positive ART as soon as possible (see 鈥淗ow to eliminate AIDS鈥�). Because the drugs rapidly reduce circulating levels of the virus to almost zero, it would stop people passing it on through sex. By blocking the cycle of infection in this way, the virus could be virtually eliminated by 2050.
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Bankrolling such a long-term programme would cost serious money 鈥� initially around $3.5 billion a year in South Africa alone, rising to $85 billion in total. Huge as it sounds, however, it is peanuts compared with the estimated $1.9 trillion cost of the Iraq war, or the $700 billion spent in one go propping up the US banking sector. It also looks small beer compared with the costs of carrying on as usual, which the WHO says can only lead to spiralling cases and costs.
鈥淭he cost of a mass HIV testing and treatment programme is peanuts compared with the Iraq war鈥�
The final bit of good news is that the cost of ART could keep on falling. Last Friday, that his company would offer all its medicines to the poorest countries for at least 25 per cent less than the typical price in rich countries (see 鈥淏ig Pharma has a heart after all鈥�). GSK has already been doing this for ART, but the hope is that the company may now offer it cheaper still and that other firms will follow their lead.
No one doubts the devastation caused by AIDS. In 2007, 2 million people died and 2.7 million more contracted the virus. Those dismal numbers are not going to turn around soon 鈥� and they won鈥檛 turn around at all without huge effort and investment. But at least there is renewed belief that, given the time and money, we can finally start ridding the world of this most fearsome of viruses.
