New HIV treatment has actually raised concerns about attitudes that AIDS is a short-term problem
When Atripla, a combination treatment for HIV, was approved by the Food and Drug Administration (FDA) on July 12, the celebration was more muted than one might expect.
The treatment is a combination of three drugs: Truvada, a two-drug combination produced by Gilead Sciences, and Sustiva, produced in the US by Bristol-Myers Squibb and for most Third World countries by Merck. ATRIPLA is not a cure for HIV, but a means to simplify the lives of millions who suffer daily from the virus that causes AIDS.
It is this delineation that AIDS activists are fighting to explain - that the cocktail pill brings new hope to an AIDS community that has been struggling for 25 years with an enormous pill burden. But the new pill also brings with it new worries that drug enhancements and successes may cause even more lethargy than already exists in a young generation that did not grow up watching AIDS ravage its peers.
The development comes at time when activists in the US are worried that the public is "bored" with the disease.
"I hope to see that this simplification in the drugs is going to make people take that extra bit of consideration for themselves and get tested," says Keith Folger, former director of community mobilization for the National Association of People with AIDS and now an independent AIDS activist. "I think the majority of people, especially people not affected by this disease, are bored with the disease. It's showing in funding streams, in the amount people contribute voluntarily. Society is fatigued by this illness. They wanted a quick cure and they wanted it to go away. But it's getting worse."
According to Centers for Disease Control and Prevention (CDC) publication Morbidity and Mortality Weekly Report, more than 1 million people in the US are living with HIV/AIDS, and another 40,000 estimated cases are expected to occur this year. It is estimated that 250,000 people are living with the disease without knowing it.
Mark Senak, a Fleishman-Hillard SVP, called the drug development a "breakthrough" on his blog, Eye on FDA, but issued similar warnings.
"It is incumbent on the companies to ensure that this breakthrough does not signal that HIV is manageable, like diabetes," Senak wrote. "It should be an inherent part of any marketing campaign that the companies involved go to lengths to assure the at-risk population that this is not a cure. The possibility of resistance to any drug regimen is always a threat."
According to a survey of 385 HIV specialists and 400 HIV patients done by the American Academy of HIV Medicine, 91% of the specialists were "extremely" or "very" concerned about the dangers of drug resistance, while only 54% of HIV patients expressed this concern.
Despite statistics pointing to a need to educate the public, HIV prevention budgets are decreasing.
In 2006, funding for the National Center for HIV, STD, and TB Prevention at the CDC, which carries out most of the nation's HIV prevention activities, was reduced by $4 million from 2005. In addition, HIV/AIDS global funding makes up less than 1% of the US federal budget, according to The Kaiser Family Foundation, a nonprofit organization that provides analysis on healthcare issues.
It is this disparity between figures and attitude and budget cuts that prompt strong messaging.
"Twenty-five years into AIDS, in rich and poor countries alike, we still approach the epidemic from a 'crisis management' perspective of short-term goals and attempted quick fixes. We try to manage the epidemic like it is a passing emergency," said Dr. Peter Piot, UNAIDS executive director, during a speech given at the UN General Assembly High Level Meeting on May 31. "AIDS is not only an emergency. It is a massive and long-term problem - one of the make-or-break issues of our century."