THE COLD STATISTICS ON THE global catastrophe of AIDS long ago became mind-numbing: twenty-one mi... more THE COLD STATISTICS ON THE global catastrophe of AIDS long ago became mind-numbing: twenty-one million people dead; 26 million more living with HIV disease; one-half of South African 15-year-old boys destined to die of AIDS. It's obvious that an AIDS vaccine should be one of the world's top public health priorities (C&EN, Aug. 27, page 37). And judging from the recent flurry of enthusiastic industry press releases, you would think that the race for an AIDS vaccine is in full gallop. Just this year, we've read headlines like "Targeted Genetics Says HIV Vaccine Promising," "Vaxgen AIDS Vaccine Clears Phase III Safety Hurdle Again," and "Why Merck's Experimental AIDS Vaccine Has Scientists So Excited." That the search for an AIDS vaccine was not always so furious, and remains inadequate even today, seems unthinkable, given the magnitude of the AIDS pandemic. In "Shots in the Dark: The Wayward Search for an AIDS Vaccine," Jon Cohen provides a ...
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2010
HIV prevention services have succeeded in limiting HIV incidence in the United States but have no... more HIV prevention services have succeeded in limiting HIV incidence in the United States but have not prevented HIV from becoming a devastating epidemic in the communities most affected. The National HIV/AIDS Strategy represents an important opportunity to improve domestic HIV prevention efforts and to begin to reduce HIV incidence over time. Elements that are essential to improving HIV incidence outcomes include greater transparency and accountability in use of HIV prevention funds; scaling up programming for those most at risk; fostering and evaluating community-based HIV prevention efforts; and looking beyond individual behavior change programming by putting a greater emphasis on structural, network, and policy interventions. To overcome years of stagnation on HIV prevention outcomes, we need a response characterized by accountability, appropriate targeting, and sufficient scale.
The protection of human rights will be critical to the success of HIV vaccine trials throughout t... more The protection of human rights will be critical to the success of HIV vaccine trials throughout the world. A vaccine for HIV remains our best hope to control the global epidemic. In order to launch and sustain useful and successful human trials of HIV vaccines, a partnership between scientists, governments, pharmaceutical companies, and affected communities is essential. This article provides a review of some of the key issues relevant to human rights in the design, testing, and dissemination of HIV vaccines. The article gives specific examples from three countries -- Brazil, Thailand, and the United States -- which may initiate large-scale trials in the near future.
Canadian HIV/AIDS policy & law review / Canadian HIV/AIDS Legal Network, 2002
Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network... more Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network with a series of articles that describe past developments and future directions in several areas of policy and law related to HIV/AIDS. The following article is the first of these, discussing current challenges and future directions in the development of and access to HIV vaccines. It argues that governments are under public health, ethical, and legal obligations to develop and provide access to HIV vaccines. It further explains what is required for governments to fulfill their obligations: additional commitment and resources for HIV vaccine development in the context of increased global research and development regarding diseases of the poor; increased support and advocacy for partnerships to develop HIV vaccines; enhanced regulatory capacity in every country to review, approve, and monitor HIV vaccines; and assurance of global supply of, procurement of, delivery of, and access to vacc...
Journal of the International AIDS Society, May 16, 2017
HIV has been reported to be the leading cause of mortality amongst adolescents in Africa. This ha... more HIV has been reported to be the leading cause of mortality amongst adolescents in Africa. This has brought attention to the changes in service provision and health management that many adolescents living with HIV experience when transferring from specialized paediatric- or adolescent-focused services to adult care. When transition is enacted poorly, adherence may be affected and the continuum of care disrupted. As the population of HIV-infected adolescents grows, effective and supported transition increases in significance as an operational imperative. Considerable gaps remain in moving policy to practice at global, national, and local levels. Policies that give clear definition to transition and provide standard operating procedures or tools to support this process are lacking. National guidelines tend to neglect transition. Beyond transition itself, there has been slow progress on the inclusion of adolescents in national policies and strategies. Guidance often overlooks the specif...
Community action, including activism, advocacy and service delivery, has been crucially important... more Community action, including activism, advocacy and service delivery, has been crucially important in the global response to AIDS from the beginning of the epidemic and remains one of its defining features. This indispensable contribution has been increasingly acknowledged in strategic planning documents from UNAIDS, the Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank, the World Health Organization and other organizations. A growing body of literature demonstrates that community-based services can have measurable impact, serve populations that are not accessing public health services and reach people at scale. Recognition of the powerful potential role of community has not translated into full incorporation of community responses in programme planning or financing, and communities are still not fully understood as true assets within overall systems for health. The diverse community contributions remain seriously underappreciated and under-resourced in national res...
Jaids-journal of Acquired Immune Deficiency Syndromes, 2000
Programs for voluntary counseling and testing (VCT) for HIV play an increasingly important role i... more Programs for voluntary counseling and testing (VCT) for HIV play an increasingly important role in comprehensive prevention and care strategies. New technological advancements and behavioral interventions can improve the effectiveness of VCT as a tool for preventing new HIV infections and helping HIV-positive individuals access appropriate care. With growing consensus that early access to HIV therapy increases its effectiveness, and that individuals diagnosed with HIV reduce risk behavior, VCT has become integral to the continuum of HIV primary care. However, federal funding of VCT has declined, with concomitant decreases in numbers of people being tested. An estimated 200,000 people in the United States remain unaware that they are HIV positive, and many at-risk individuals do not seek out standard HIV counseling and testing services. To increase the acceptability and effectiveness of VCT, the authors recommend that VCT programs employ outreach programs offering anonymous testing to reach those at heightened risk of HIV infection, and to make rapid use of new technologies and counseling strategies to improve the reach and efficacy. Given the important role that VCT can play in both prevention and early treatment, the authors recommend significant increases in federal support.
THE COLD STATISTICS ON THE global catastrophe of AIDS long ago became mind-numbing: twenty-one mi... more THE COLD STATISTICS ON THE global catastrophe of AIDS long ago became mind-numbing: twenty-one million people dead; 26 million more living with HIV disease; one-half of South African 15-year-old boys destined to die of AIDS. It's obvious that an AIDS vaccine should be one of the world's top public health priorities (C&EN, Aug. 27, page 37). And judging from the recent flurry of enthusiastic industry press releases, you would think that the race for an AIDS vaccine is in full gallop. Just this year, we've read headlines like "Targeted Genetics Says HIV Vaccine Promising," "Vaxgen AIDS Vaccine Clears Phase III Safety Hurdle Again," and "Why Merck's Experimental AIDS Vaccine Has Scientists So Excited." That the search for an AIDS vaccine was not always so furious, and remains inadequate even today, seems unthinkable, given the magnitude of the AIDS pandemic. In "Shots in the Dark: The Wayward Search for an AIDS Vaccine," Jon Cohen provides a ...
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2010
HIV prevention services have succeeded in limiting HIV incidence in the United States but have no... more HIV prevention services have succeeded in limiting HIV incidence in the United States but have not prevented HIV from becoming a devastating epidemic in the communities most affected. The National HIV/AIDS Strategy represents an important opportunity to improve domestic HIV prevention efforts and to begin to reduce HIV incidence over time. Elements that are essential to improving HIV incidence outcomes include greater transparency and accountability in use of HIV prevention funds; scaling up programming for those most at risk; fostering and evaluating community-based HIV prevention efforts; and looking beyond individual behavior change programming by putting a greater emphasis on structural, network, and policy interventions. To overcome years of stagnation on HIV prevention outcomes, we need a response characterized by accountability, appropriate targeting, and sufficient scale.
The protection of human rights will be critical to the success of HIV vaccine trials throughout t... more The protection of human rights will be critical to the success of HIV vaccine trials throughout the world. A vaccine for HIV remains our best hope to control the global epidemic. In order to launch and sustain useful and successful human trials of HIV vaccines, a partnership between scientists, governments, pharmaceutical companies, and affected communities is essential. This article provides a review of some of the key issues relevant to human rights in the design, testing, and dissemination of HIV vaccines. The article gives specific examples from three countries -- Brazil, Thailand, and the United States -- which may initiate large-scale trials in the near future.
Canadian HIV/AIDS policy & law review / Canadian HIV/AIDS Legal Network, 2002
Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network... more Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network with a series of articles that describe past developments and future directions in several areas of policy and law related to HIV/AIDS. The following article is the first of these, discussing current challenges and future directions in the development of and access to HIV vaccines. It argues that governments are under public health, ethical, and legal obligations to develop and provide access to HIV vaccines. It further explains what is required for governments to fulfill their obligations: additional commitment and resources for HIV vaccine development in the context of increased global research and development regarding diseases of the poor; increased support and advocacy for partnerships to develop HIV vaccines; enhanced regulatory capacity in every country to review, approve, and monitor HIV vaccines; and assurance of global supply of, procurement of, delivery of, and access to vacc...
Journal of the International AIDS Society, May 16, 2017
HIV has been reported to be the leading cause of mortality amongst adolescents in Africa. This ha... more HIV has been reported to be the leading cause of mortality amongst adolescents in Africa. This has brought attention to the changes in service provision and health management that many adolescents living with HIV experience when transferring from specialized paediatric- or adolescent-focused services to adult care. When transition is enacted poorly, adherence may be affected and the continuum of care disrupted. As the population of HIV-infected adolescents grows, effective and supported transition increases in significance as an operational imperative. Considerable gaps remain in moving policy to practice at global, national, and local levels. Policies that give clear definition to transition and provide standard operating procedures or tools to support this process are lacking. National guidelines tend to neglect transition. Beyond transition itself, there has been slow progress on the inclusion of adolescents in national policies and strategies. Guidance often overlooks the specif...
Community action, including activism, advocacy and service delivery, has been crucially important... more Community action, including activism, advocacy and service delivery, has been crucially important in the global response to AIDS from the beginning of the epidemic and remains one of its defining features. This indispensable contribution has been increasingly acknowledged in strategic planning documents from UNAIDS, the Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank, the World Health Organization and other organizations. A growing body of literature demonstrates that community-based services can have measurable impact, serve populations that are not accessing public health services and reach people at scale. Recognition of the powerful potential role of community has not translated into full incorporation of community responses in programme planning or financing, and communities are still not fully understood as true assets within overall systems for health. The diverse community contributions remain seriously underappreciated and under-resourced in national res...
Jaids-journal of Acquired Immune Deficiency Syndromes, 2000
Programs for voluntary counseling and testing (VCT) for HIV play an increasingly important role i... more Programs for voluntary counseling and testing (VCT) for HIV play an increasingly important role in comprehensive prevention and care strategies. New technological advancements and behavioral interventions can improve the effectiveness of VCT as a tool for preventing new HIV infections and helping HIV-positive individuals access appropriate care. With growing consensus that early access to HIV therapy increases its effectiveness, and that individuals diagnosed with HIV reduce risk behavior, VCT has become integral to the continuum of HIV primary care. However, federal funding of VCT has declined, with concomitant decreases in numbers of people being tested. An estimated 200,000 people in the United States remain unaware that they are HIV positive, and many at-risk individuals do not seek out standard HIV counseling and testing services. To increase the acceptability and effectiveness of VCT, the authors recommend that VCT programs employ outreach programs offering anonymous testing to reach those at heightened risk of HIV infection, and to make rapid use of new technologies and counseling strategies to improve the reach and efficacy. Given the important role that VCT can play in both prevention and early treatment, the authors recommend significant increases in federal support.
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