Special Report: Fighting the U.S. AIDS Epidemic

aidsribbons-smallIt’s a strange irony: Countries receiving U.S. funding for AIDS relief are required to have a strategic plan to fight the disease, but the U.S. doesn’t have a plan of its own. The U.S. Centers for Disease Control and Prevention (CDC) estimates that 1.2 million people in America have HIV, the virus that causes AIDS. Of this number, 250,000 people don’t realize they are HIV-positive, while another 250,000 know it but aren’t in treatment. That’s half the infected population walking around untreated.

Last month, the American Medical Association adopted a resolution stating that the U.S. should have a national AIDS strategy. AIDS advocate Michael Manganiello agrees. Manganiello is a partner at HCM Strategists, where he leads the firm’s work with the National Institutes of Health (NIH). He was diagnosed with the HIV virus in 1987. At the time, he lived in the Manhattan Towers, a public housing complex that was hit particularly hard by the AIDS epidemic. Those infected with HIV had few options. Little was known about the disease, and government support was lacking. Manganiello became an activist out of necessity. He struggled to get into clinical trials at the NIH, where he finally found a combination of HIV drugs that returned him to health. Within one week, Manganiello’s T-cell count increased and the virus became almost undetectable in his body. More recently, he found success with the drug Prezista, a protease inhibitor developed by the Tibotec Corporation.

Manganiello joined a number of pharmaceutical executives and patient representatives at this year’s BIO International Convention in Atlanta to speak about the HIV/AIDS epidemic and the importance of finding new treatments. AIDS patients today have more options than they did when Manganiello was diagnosed. Back then, the only option was AZT, an antiretroviral drug that had limited effects on HIV. Today, patients have access to drugs such as GlaxoSmithKline’s Ziagen and Combivir; Bristol-Myers Squibb’s Reyataz, Sustiva, and Atripla; Tibotec’s Prezista, and Tenvir by Cipla. But while the drugs exist, getting them into patients’ hands has proven difficult. An estimated 33 million people worldwide are HIV-positive. Many patients, particularly those in developing countries, simply can’t afford the cost of treatment. The lifetime cost of taking care of someone with HIV is approximately $600,000.

The ultimate goal of an AIDS vaccine has continually eluded scientists. “This virus is insidious; it’s incredibly adaptive. It has a tremendous ability to mutate,” says Manganiello. Pharma giant Merck experienced a high-profile setback in 2007 when its HIV vaccine failed in clinical trials. Still, a handful of pharmaceutical companies are pressing forward. PhotoImmune Biotechnology of Texas is developing a vaccine that uses photo-labeling to render the HIV virus inactive. Swiss company Mymetics Corporation is working on a vaccine that prevents the virus from infecting host cells. An HIV/AIDS vaccine from Atlanta-based GeoVax is undergoing Phase 2a clinical trials in North and South America. GeoVax was among the presenters at BIO.

The number of new HIV cases in the U.S. has dropped over the years due to greater AIDS awareness and the promotion of safe sex practices. However, recent spikes in two large demographic groups are causing alarm among AIDS activists: Black women and young gay men are contracting the HIV virus in increasing numbers. AIDS is one of the top three causes of death for black women ages 25 to 34. According to the District of Columbia Department of Health, 90 percent of new HIV infections in the D.C. area occur in black women. A 2008 study by the CDC found that new cases of HIV have increased 12 percent annually among gay men ages 13 to 24.

Manganiello believes that the scare tactics of the 1980s aren’t working anymore. With innovations in medicine prolonging the lives of AIDS patients, many young people have come to think of the disease as a manageable chronic illness. According to Manganiello, new HIV/AIDS awareness campaigns need to be customized to at-risk populations. The CDC website, he says, is not going to appeal to an 18-year-old kid. He views creative input from a variety of sources, including Madison Avenue, bloggers, and new media innovators, as crucial to success. “We need new ideas and new blood.”

It’s this unified front that Manganiello hopes will finally give HIV/AIDS the attention it needs in the U.S. President Barack Obama has expressed interest in formulating a national plan to fight HIV/AIDS, but his words have yet to translate into action. Manganiello wants to bring in representatives from countries that reduced their number of HIV infections, and find out how they did it. He wants coordination among federal agencies, HIV organizations, and business leaders. He wants a focus on prevention and testing. Even the average American can call his or her Congressman and ask what the government is doing about the HIV crisis. “This is a terminal, deadly, infectious disease, and that’s the reality of it,” Manganiello says. “It shouldn’t be happening.”
 
Some of the international companies developing therapeutics for HIV/AIDS are: Monogram Biosciences, CREABILIS Therapeutics, Evolutionary Genomics, VIRxSYS Corporation, Heidelberg Pharma GmbH, A-viral, Tripep, SRD Pharmaceuticals, BioInvent International, Tobira Therapeutics, LAURAS, Samaritan Pharmaceuticals, and Targeted Genetics Corporation.

Related link: Framework for Developing a National AIDS Strategy for the United States

Related post: GlaxoSmithKline, Pfizer Team Up Against HIV

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