Drug Resistant Strain of HIV Reported in U.S.

As if the worldwide HIV/AIDS epidemic isn’t bad enough, New York health officials reported in February that they had discovered what appears to be a quick progressing, drug-resistant strain of HIV dubbed 3-DCR HIV.

Drug resistant strains of HIV has become increasingly common in people with HIV as the disease adapts to various treatment therapies over time. But in this case the disease was drug resistant in a newly diagnosed individual, and the disease progressed to full-blown AIDS much faster than normal — taking only 2 to 20 months to progress to AIDS rather than the typical average of 10 years. According to news reports, the strain of HIV was resistant to 19 of 20 antiretrovirals used to treat AIDS.

On obvious possibility is that the man contracted this especially virulent form of HIV from unprotected sex with another HIV positive individual who has been undergoing anti-AIDS treatment. Or it could represent a spontaneous mutation of the disease that only this particular patient contracted.

Or, as infectious disease expert Dr. Craig Pringle speculated,

The extensive use of anti-retroviral drugs in the community may have selected this unwelcome triple drug-resistant variant. . . [And a possible] outbreak of HIV not amenable to treatment with currently available drugs is in the offing.

Such a possible outbreak would be devastating, especially if it made its way to the developing nations already plagued by the less virulent forms of HIV.


Drug-resistant HIV strain found. The BBC, February 12, 2005.

Multi-drug-resistant HIV strain raises alarm. Shaoni Bhattacharya, NewScientist.Com, February 14, 2005.

Is Arab World Ignoring HIV/AIDS Risk to Women?

At a UNAids meeting held in Amman, Jordan, UNAids Associate Director Dr. Suman Mehta warned that Middle Eastern and North African countries are not doing enough to address HIV/AIDS among girls and women.

Mehta charged that Middle Eastern nations are not accurately disclosing the extent of HIV/AIDS infection in their countries. According to Mehta,

It is not a question of resources and funds, it is a political and social problem … officials are not revealing the extent of the problem, and the community does not talk openly about it.

. . .

Low prevalence in the region should not be an excuse for inaction… all countries start with a low prevalence but then it grows out of proportion.

There are currently an estimated 540,000 people infected with HIV/AIDS in the Middle East and North Africa, but Mehta noted there is still a strong social stigma to HIV/AIDS infection,

[That] not a single one [girl or woman] is coming forward to say ‘I am HIV-positive’ says something about the fear, the scare, the discrimination and stigma attached to AIDS.

Dr. Hind Khattab, an Egyptian public health specialist, echoed Mehta’s words, telling the BBC,

The most important thing to do is not to wait until we are in a dangerous situation and then do something. This is the right time and we have to say that our women are vulnerable — not only those who [behave riskily] or those who are the spouses of men who have risky behavior, but we are in a situation where many of our countries are [at] war or are being attacked and the women are really at risk.


Aids threat grows for Arab women. Dale Gavlak, The BBC, February 23, 2005.

Meeting addresses social attitudes to HIV/AIDS. Jordan Information Center, February 2005

Latest UN Projections: World Population Will Reach 9.1 Billion By 2050

In February the United Nations Population Division released the 2004 revisions to its World Population Prospects publication, projecting how much further world population is likely to grow.

Under the UN’s medium variant scenario, world population will reach 9.1 billion in 2050. This represents a slight upward revision from more recent estimates that had world population reaching just 8.9 billion in 2050.

Almost all of that growth will occur in the developing world. Ninety-five percent of all population growth today is occurring in the developing world compared to just 5 percent in the developed world according to the UN Population Division. Of that estimated 9.1 billion, only slightly over 1.2 billion will live in countries that are currently designated as developed — about what the population of the developed world is today.

The medium variant assumes that the total fertility for women worldwide is going to drop from its current level of 2.6 to just slightly over 2 by 2050. If the worldwide TFR average were to only decline slightly to just over 2.5 — the high variant scenario — world population would reach 10.6 billion by 2050. If it were to decline faster, however, and fall to about 1.5 — the low variant — world population would reach just 7.6 billion in 2050.

Global life expectancy continues to rise. The Population Division reports that global life expectancy rose from an estimated 47 years in 1950-1955 to 65 years in 2000-2005. By 2045-50, global life expectancy is expected to rise to 75 years. In developed countries, where life expectancy averages 76 years today, it is expected to reach 82 years by 2045-50.

Those life expectancy projections assume that the developing world will be able to implement effective programs and policies to halt excess mortality due to HIV/AIDS. Whether or not this happens remains to be seen. As the Population Division reports, HIV/AIDS has taken a serious toll on life expectancy in some parts of Africa. In Southern Africa, for example, life expectancy fell from 62 years in 1990-1995 to just 48 years in 2000-2005, and is expected to drop even further to just 43 years over the next decade. The Population Division projects that 43 will represent a bottoming out of the crisis and that life expectancy in Southern Africa will then slowly begin to rise again.

One of the main effects of the worldwide decline in total fertility rates will be an aging of the population that is unprecedented in human history. According to the Population Division, the number of people over the age of 60 is expected to triple from an estimated 672 million in 2005 to a whopping 1.9 billion by 2050. There will also be a 4.5-fold increase in the number of people over the age of 80, from an estimated 86 million today to 394 million in 2050.


World Population Prospects: The 2004 Revision. (PDF) United Nations Population Division, February 2005.

Cheap Antibiotic Could Cut AIDS Deaths in Children

Following the publication of a study in The Lancet on its effects, the World Health Organization is recommending that HIV-postive children in the developed world be treated with a low-cost antibiotic that appears to dramatically reduce the risk of death among such children.

A British research team conducted a clinical trial using the antibiotic co-trimoxazole to treat HIV positive children in Zambia. The researchers ended the study ahead of time because the effect was so great. After 19 months, only 25 percent of children taking the co-trimoxazole had died compared to 40 percent of the control group of children who had been given a placebo.

WHO and UNICEF are now calling for all children who are HIV positive or whose HIV status is unknown to be treated with co-trimoxazole. The drug is cheap, costing less than 10 cents to treat a person per day, making it ideal for the developing world.

Researchers had initially feared that co-trimoxazole would not be effective due to relatively high levels of antibiotic resistance in Africa, but the drug proved effective in tackling the opportunistic infections such as pneumonia and tuberculosis which kill many children with AIDS.


New low-cost HIV treatment hailed. The BBC, November 19, 2004.

Antibiotic could halve AIDS-related deaths in children. Priya Shetty. SciDev.Net, November 19, 2004.

Cheap Anti-AIDS Drugs Hit Asia — Is That a Problem?

The New York Times recently reported on an odd problem — that there are too many companies making too many generic anti-retroviral drugs to treat HIV.

Typically, the complaint has been that anti-retroviral drugs made by pharmaceutical companies are too expensive for the developing world, and that what is needed are cheaper, generic drugs. But a report by Treat Asia finds that there are so many companies and drugs that Asia is at risk of rapidly creating drug-resistant versions of HIV.

According to the report, there are at least 27 companies in Asia manufacturing anti-HIV drugs, only three of which have met the World Health Organization’s quality standards.

In addition, throughout Asia there are few doctors to treat AIDS patients, so those who can afford the anti-retrovirals often obtain the drugs over-the-counter and self-medicate.

Kevin Robert Frost of Treat Asia told The New York Times,

Our point is if there is proliferation of the generic drugs, as many are calling for, where is the infrastructure to deliver them? In Asia, the availability of drugs is far outstripping the capacity to deliver them.


AIDS drugs’ fast rise in Asia risks resistant strains. Lawrence Altman, The New York Times, July 8, 2004.

The Developing World Needs More Condoms

At the XV International AIDS Conference in Thailand, Population Action International released a report claiming that developing nations are only receiving about 10 percent of the condoms needed to make a serious dent in the transmission of HIV.

In its 2004 update to its Condoms Count report, Population Action International estimated that the developing world needed 10 billion condoms in 2002, but aid agencies supplied only about 2.5 billion condoms.

It notes that in South Africa between 1998-2002, the number of donated condoms amounted to only 2.6 condoms per man per year (in contrast, more than 60 condoms are produced each year in the United States for each man).

PAI and others blame the United States in part for the Bush administration’s emphasis on abstinence as a solution to the AIDS crisis.


World falling short on condom provision. NewScientist.Com, July 12, 2004.

Counting Condoms: Donors Coming Up Short. Press Release, Population Action International, July 14, 2004.