Africa: Daily HIV/Aids Report

The trade representative's report, which was released on Monday, placed Thailand on its Priority Watch List and cited an "overall deterioration" in the protection and enforcement of intellectual property rights in the country. According to the report, which reviews 87 countries, the U.S. is "concerned about the weak protection against unfair commercial use of undisclosed test and other data" submitted by drug companies seeking marketing approval for their products, as well as "pharmaceutical patent approvals" by the Thai Department of Intellectual Property. The report said that in late 2006 and 2007, "there were further indications of a weakening of respect for patents, as the Thai Government announced decisions to issue compulsory licenses for several patented pharmaceutical products." The report also said that although the U.S. "acknowledged a country's ability to issue such licenses in accordance with" World Trade Organization regulations, the "lack of transparency exhibited in Thailand represents a serious concern." The report did not mention any drugs by name but "appeared to be referring" to the compulsory licenses for Efavirenz and Kaletra. Thailand, which was the only country to be added to the Priority Watch List this year, will be monitored to "encourage and maintain" effective intellectual property protections, according to the report (Kaiser Daily HIV/AIDS Report, 5/1).

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Issuing compulsory licenses is "meant to allow those in need who can't afford the expensive drugs to have access to them," Mongkol said, adding, "I insist that Thailand will continue with it for the benefits of the public" (Associated Press, 5/2). According to Mongkol, pharmaceutical companies likely called on USTR to place the country on the watch list "in a bid to damage Thailand's credibility." Nimit Tienudom, director of the AIDS Access Foundation, also criticized the report. He said, "These drug companies want the Thai government to stop using" compulsory licenses that allow a country to produce generic drugs (Agence France-Presse, 5/2).

Some experts said Thailand's move could set off similar actions in other emerging markets. "If one country makes a decision, it can embolden others," Lawrence Kogan -- CEO of the Institute for Trade, Standard and Sustainable Development -- said. Gustav Ando, an analyst for Global Insight, said, "If Thailand sets a precedent and says we don't have to uphold patents, it will probably start in Asia in the Philippines and Malaysia, and then spread to Latin America." American University's Washington College of Law last week issued a report that concluded Thailand's actions comply with patent law, Reuters reports. Sean Flynn of the law school's justice and intellectual property program said, "Arguments to the contrary" of Thailand's actions "should be dismissed as political posturing" (Dixon, Reuters, 5/1). Thai Deputy Prime Minister Kosit Punpiemrat on Tuesday said that Mongkol will visit Washington, D.C., in the coming weeks to explain the country's decision to issue compulsory licenses (Pinyorat, AP/Forbes, 5/1).

Public Health & Education

More Than One-Third of HIV-Positive MSM in U.K. Having Unprotected Sex, Study Says

[May 02, 2007]

More than one-third of HIV-positive men who have sex with men in the United Kingdom continue to have unprotected sex, according to a study published on Tuesday in the journal Sexually Transmitted Infections, AFP/Yahoo! News reports. For the study, Julie Dodds of the Centre for Sexual Health and HIV Research at the University College London and colleagues conducted surveys between 2003 and 2004 among 2,640 men in Manchester, Brighton and London (AFP/Yahoo! News, 4/30). The surveys were filled out by study participants at gay clubs, bars and saunas, BBC News reports. Thirty-seven percent of HIV-positive men and 18% of the HIV-negative men surveyed said they had unprotected sex with more than one partner during the past year. During the same time period, one in five HIV-negative men and four in 10 HIV-positive men said that they had contracted a sexually transmitted infection, the study found. One-third of the HIV-positive men did not know their status, but more than two-thirds of these men said they had been to a sexual health clinic during the past year, according to the study. HIV prevalence among the study participants was highest in Brighton, at almost 14%, and prevalence was lowest in Manchester, at 8.6%, the study found. About one-third of new HIV cases in the United Kingdom are among MSM with more than 7,450 new cases identified in 2005, BBC News reports.

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Study co-author Danielle Mercey said, "We have to renew our efforts to ensure people with HIV get early diagnosis and also look to curb risky behavior," adding, "It is only by early diagnosis and safe sex that we will reduce the rate of HIV." Michael Carter of Aidsmap said the study's findings "are entirely realistic, but before we condemn the figures, we have to see it in context." He added, "Many of these men with HIV will be having sex with other men with HIV." Will Nutland, head of health promotion at the Terrence Higgins Trust, said the study's findings support other evidence that "demonstrates the need for ongoing, targeted HIV prevention work with gay and bisexual men" in the United Kingdom, adding, "The number of gay men with undiagnosed HIV infection is not reducing" (BBC News, 4/30).

The study is available online.

Science & Medicine

Results from Thai HIV/AIDS Vaccine Trial Scheduled To Be Released in July

[May 02, 2007]

The Thai Ministry of Public Health on Tuesday announced that results from the latest phase of an HIV/AIDS vaccine clinical trial are scheduled to be released in July, Thai News Agency/MCOT reports (Thai News Agency/MCOT, 5/1). The NIH-funded trial is testing Brisbane, Calif.-based biotechnology company VaxGen's AIDS vaccine AIDSVAX in conjunction with Sanofi Pasteur's ALVAC among 16,000 HIV-negative volunteers from Thailand's Rayong and Chon Buri provinces. In the trial, AIDSVAX is used as a booster for the ALVAC vaccine. Each volunteer for the trial, which is scheduled to end in 2009, will be followed up for at least three-and-a-half years. Some researchers have questioned the validity, science, ethics and potential efficacy of the trial. A group of 22 prominent AIDS researchers in the Jan. 16, 2004, issue of the journal Science wrote that the study should be halted because of its high cost and because the two vaccines used by themselves in Phase I and Phase II clinical trials were ineffective in preventing HIV transmission (Kaiser Daily HIV/AIDS Report, 5/22/06).

According to Thawat Suntrajarn, director-general of Thailand's Department of Disease Control, the health ministry last week discussed the results with several U.S. government agencies and companies to prepare a response plan to handle any emergencies that arise after the results are released. NIH and the vaccine makers will meet in Thailand in June to determine the next steps in the process, Thawat said. If the test results find the vaccine has an efficacy of 80% or higher, the vaccine will enter commercial production. The vaccine will be tested for another two years if it is found to have an efficacy of between 50% and 79%, and the trial will be discontinued if the efficacy is below 50%, according to Thai News Agency/MCOT (Thai News Agency/MCOT, 5/1).

Drug-Resistant HIV Can Be Transmitted From Mother to Child, Study Says

[May 02, 2007]

Strains of drug-resistant HIV can be transmitted from mother to child and remain in an infant's immune system for years, according to a study published in the April 5 issue of the Journal of Infectious Diseases, Reuters Health reports. Deborah Persaud of Johns Hopkins University's School of Medicine and colleagues studied 21 HIV-positive infants in 10 U.S. states (Reuters Health, 4/30). The infants started antiretroviral therapy at an average age of 9.7 weeks and were treated for up to 96 weeks (Persaud et al., Journal of Infectious Diseases, 4/5).

The study found that five infants acquired a drug-resistant strain of HIV from their mothers. According to the researchers, the virus moved quickly to inactive CD4+ T cells. The virus was resistant to a class of antiretroviral drugs, known as non-nucleoside reverse transcriptase inhibitors, but another class of antiretrovirals, called protease inhibitors, were effective, the study found. According to Persaud, the drug-resistant HIV strains acquired by the infants from their mothers likely will never be cleared with currently available treatments (Reuters Health, 4/30). The researchers wrote that the "high rate, types and early archiving of drug-resistant HIV-1 suggests testing be considered for infants, especially when an NNRTI-based regimen is planned." They concluded that "drug-resistant outcomes in infants should be an important secondary end point in" mother-to-child transmission trials (Journal of Infectious Diseases, 4/5).

The study is available online.

Recent Releases

Report Examines HIV/AIDS Among Blacks

[May 02, 2007]

"Improving Outcomes: Blueprint for a National AIDS Plan for the United States," Open Society Institute: The report finds that the U.S. has not made sufficient progress against HIV/AIDS, especially among blacks. It makes several recommendations for the fight against the disease, including the need to focus prevention and treatment efforts among blacks. The report also says that there is a need to implement new approaches, focus federal funding on concrete results, and increase the use of evidence-based, cost-effective strategies that have been shown to be successful (OSI release, 5/1).

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