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Peter Piot, director of the London School of Hygiene and Tropical Medicine, is the editor of this week's FT Health newsletter, which focuses on the challenges of the HIV / AIDS campaigns.
I was in Amsterdam this week at the 22nd International AIDS Conference, a unique gathering of more than 17,000 people bringing together a remarkable group of activists, people living with HIV, scientists, policymakers and many others. the world. Having attended many of these conferences, it was truly inspiring to see so many motivated young lawyers present this year. No other medical or health conference organizes such diverse constituencies.
The meeting could not have been held at a more critical time. Despite unprecedented progress in many countries, the harsh truth is that the end of the HIV pandemic is not in sight. We have heard promises of "the end of AIDS" but, as a new joint report by the International Aids Society and the Lancet Commission notes, this rhetoric has engendered a dangerous complacency that may have weakened our will global fight against the epidemic. It is now the critical moment to reinvigorate our efforts. According to a recent UNAIDS report, about 50 countries around the world have experienced an increase in new HIV infections in 2017, or about 40% among key population groups. The epidemic is uncontrolled in Eastern Europe and Central Asia, where new infections have increased by almost 30% between 2010 and 2017.
Despite HIV treatment that saves lives, There is still an increase in deaths in some areas. world, as in the Middle East and North Africa. With the largest generation of young people in sub-Saharan Africa and the fact that tens of millions of people will need access to therapy in the coming years, this is not the time to be complacent.
Still, I remain optimistic. This week, I have witnessed passionate and informed rallying calls to restart the HIV response and ensure that AIDS remains firmly on the agenda. Investing in health systems that put people at the center will be the key to getting the response to AIDS back on track.
The book I am currently reading is Pale Rider: The 1918 Spanish Flu and how it changed the world.
Peter questions Nduku Kilonzo, director of the National AIDS Council (NACC) in Kenya and long-time leader and advocate for the global response to HIV / AIDS
Do you think we are with the global response to AIDS?
We have made a lot of progress but we have to go back to basics. When I say that, I'm talking about primary HIV prevention. We still have about 2 million new infections each year. We will certainly not be able to meet global targets and targets with this level of new infections – so we need to get back to the basics.
Kenya has one of the most dynamic HIV programs. What is the key to this success?
It is true that Kenya has made a lot of progress. I believe our success lies in the existence of a strong coordinating framework, partnerships between the National AIDS Council and communities of people living with HIV and other non-state actors. and the government through the Ministry of Health. We are transcending traditional silos, for example, by working with the education sector to connect with young people who are experiencing the most new infections.
Kenya is hyper-decentralized. How do you manage this with local variations of the epidemic?
Acknowledging these differences, and the autonomy of county governments, the first thing we did was to develop the internal capacity of young Kenyan biostatisticians to generate and examine granular data. . These are the basis of engagement with the different counties. We work with them to develop targeted plans, but also to produce progress reports on county-level responses, which can be consulted and aggregated for national policy making.
Peter Piot selects the news
treatment of more than 50 years (Infectious Diseases Hub)
The fight against AIDS is threatened by complacency, according to a United Nations agency (FT)
The ophthalmologist unable to see the stars (BBC )
AIDS? These three places show that the epidemic is far from over (Science)
Fires of Greece: Dozens of deaths in the region of Attica (BBC)
No dosage Brexit recommended for medical research (FT)
after rapid response (Reuters)
Do not leave politics between me and my patients (NYT)
The security of the CRISPR gene editing -Cas9 is discussed (The Economist)
Publications / Reports
] Advancing global health and strengthening the response to HIV in the era of sustainable development goals. This important assessment shows that we are not on the right track to end the HIV pandemic and that we need to work together to restart the response, making sure people are at the center of our efforts. (International Aids Society / Lancet)
Miles to Go – Bridging gaps, breaking down barriers, correcting injustices. The 2018 global report presents the latest data on the state of HIV / AIDS and sends a strong warning: despite the progress made, many people are being left behind in the global AIDS response. (UNAids)
Statement of Experts on the Science of HIV in the Context of Criminal Law. (JIAS)
Persistence of the Ebola virus after the end of widespread transmission in Liberia: a report on the epidemic We drew important lessons from the 2014 Ebola outbreak in West Africa but there is still much to learn about the virus. (Lancet Infectious Diseases)
Evaluating Pioneers of the Social Impact in Health and Social Protection Governments around the world are seeking new funding mechanisms for health and care. Decision makers should try to learn from different models, but it seems that social impact obligations are not the silver bullet for better implementation of health and care services. (Policy Innovation Research Unit, LSHTM)
Rapid Screening for Tuberculosis in HIV-Positive Patients Hospitalized in Africa (STAMP): A Pragmatic, Multicenter, Concurrent, Double-Blind, Randomized, Controlled Trial .TB Kills More People as any other infectious disease, so that a new, effective diagnostic test is extremely important. (Lancet)
Association of retinal nerve fiber thinning with current and future cognitive decline: A study using optical coherence tomography Overcoming dementia is one of the greatest global health challenges of our time. We must find ways to detect it early. (JAMA Neurology)
Focus on population mobility to achieve HIV prevention goals. We must do better so that migrants and displaced populations can access HIV prevention and treatment services, as well as other broader social services. (JIAS)
Evaluation of an HIV-1 mosaic vaccine in a multicenter, randomized, double-blind, placebo-controlled, phase 1 / 2a (APPROACH) clinical trial and in rhesus monkeys. A vaccine will be essential if we are to end the HIV pandemic. (Lancet)
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