Tuesday, March 16, 2010

AIDS drug experiment on blacks, in Washington Times by Terry Michaels

Going too far to battle disease 

Tuesday, March 16
By Terry Michael

A pharmaceutical experiment on hundreds of mostly black homosexual men and heterosexual
women in Washington is about to be undertaken by U.S. AIDS czar Dr. Anthony S. Fauci with the enthusiastic backing of the District's black mayor, Adrian M. Fenty, voiced in a January announcement. The experiment radically departs from medical "best practices" of offering antiretroviral chemotherapy for life to HIV-positive persons only after they exhibit depressed levels of CD4 T-cells and are judged to be at significant risk of contracting opportunistic illnesses associated with AIDS.

The new effort, "test and treat," as it is called, will promote universal voluntary antibody testing of adults accompanied by immediate administration of the drugs despite a wealth of evidence that the chemicals often cause serious adverse side effects - potentially life-threatening effects. However, the experiment isn't focused on individual impact. Instead, it suggests that the goal is a benefit that might accrue to society if the chemicals decrease sexual retrovirus transmission.
One of the world's leading HIV-AIDS experts, Dr. Jay A. Levy of the University of California at San Francisco, responded, "No, I wouldn't," when asked for this article if he would take the drugs if he were a homosexual black man in Washington with a positive antibody test but with normal T-cell counts and no illness.

A conservative voice for years in the drug-intervention debate, Dr. Levy wrote in an article for the San Francisco Chronicle on Feb. 23, 2001: "The persistence of HIV in cells argues for a delay in initiating antiviral treatments. Unless the infected person is sick, the very real problems of long-term treatment must be considered: toxicity which may lead to damage of the pancreas, heart, kidney or brain, emergence of resistant viruses and suppression of the body's natural anti-HIV immune responses." With words presaging the suggestion that immediate drug intervention could have societal benefits with regard to transmission, Dr. Levy wrote, "The increased prevalence of resistant viruses in newly infected people reflects the widespread use of HAART [highly active antiretroviral therapy] and the misconception that this treatment will prevent HIV transmission."
Scheduled to start midyear, according to the National Institute of Allergy and Infectious Diseases (NIAID), the experiment is based on a controversial Jan. 3, 2009 article in the British medical journal the Lancet by Dr. Reuben Granich of the World Health Organization, titled "Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model."

Director of NIAID for a quarter-century, Dr. Fauci and his director of HIV programs, Carl W. Dieffenbach, announced the experiment with Mr. Fenty on Jan. 12 as part of a larger, $26.4 million study to combat what the District's HIV-AIDS agency claims is a "generalized epidemic" affecting 3 percent of adults and adolescents. Use of the word "epidemic" suggests widespread disease and mortality, though the vast majority of the agency's claimed cases have tested positive only for HIV antibodies and have experienced no illness from AIDS. Research shows "untreated" positives may not experience illness following an HIV test for 10, 15 or 20 years - or ever, in many documented cases.
Dr. Fauci and Mr. Dieffenbach published an article in the June 10, 2009 edition of the Journal of the American Medical Association in laudatory response to Dr. Granich's article. "A recent modeling study... reaches provocative conclusions and provides the theoretical basis for a new and potentially important public health policy strategy," they wrote. "This approach, referred to as 'test and treat,' predicts that [with] implementation of an annual voluntary universal HIV testing program for persons older than 15 years and with immediate initiation of [antiretroviral therapy] for those individuals who test positive regardless of their CD4 T-cell count or viral load, the HIV pandemic could be reduced within 10 years."

Critical peer reviews of Dr. Granich's work were published March 28, 2009 in the Lancet, months before Dr. Fauci and Mr. Dieffenbach published their paper. One notable alarm was sounded by Dr. Harold Jaffe of the Department of Public Health at the University of Oxford: "Within the field of communicable diseases, we are aware of little precedent for the approach of 'treating for the common good.' Treatment of diseases such as tuberculosis might have the effect of decreasing transmission, but the primary goal is to decrease morbidity and mortality for the affected person."
Dr. Levy of UC-San Francisco, whose own research has received major funding from NIAID and is sometimes called the "third co-discoverer of HIV," did not directly criticize the Fauci initiative but warned that the test-and-treat theory should be reviewed by an appropriate "human subjects committee."

Statutes mandate such panels for federal projects, a reaction to the U.S. Public Health Service's infamous mid-20th-century Tuskegee study of black men and women intentionally untreated for syphilis.

The local NIAID initiative will be in collaboration with the embattled District HIV-AIDS administration, cited by a Washington Post investigation in 2009 for misallocating millions of dollars, colluding with HIV-AIDS nonprofits siphoning tax dollars for never-delivered services.
The new $26.4 million would be added to the $85 million currently spent annually by the District's HIV-AIDS agency, which employs about 160 people, up from 125 just two years ago, though the number who have died in recent years from broadly defined "AIDS" continues to decline and is little more than the few hundred annual cases of death from accidents in the District. The District HIV-AIDS administration reported that 226 people died in 2006 of AIDS or "AIDS-related" causes, which increasingly are heart, liver and other ailments from adverse effects of antiviral drug treatment. That contrasts with more than a thousand cancer deaths and a thousand who die of heart disease annually in the District.

Not only are there relatively few deaths from AIDS in the District, the number of new AIDS (not HIV) cases reported in 2007 was 648 in a jurisdiction with a total population of slightly more than a half-million. That contrasts with a total of 238 new cases of AIDS reported by Canada in 2007 for its entire population of 34 million. Somehow, there were about 128 new AIDS cases per 100,000 residents in the District, compared with 1.4 per 100,000 in all of Canada - a 9,000 percent difference.
Either Canada is really bad at collecting numbers for an apparently sexually transmitted disease, District residents are hypersexually active, or the District's HIV-AIDS "epidemic" is grossly overstated by an agency charged with ineptness for years and always interested in sustaining its mission and budget.
Terry Michael is a Washington writer. http://www.washingtontimes.com/news/2010/mar/17/going-too-far-to-battle-disease/

Indiana man with HIV faces additional charges

by Associated Press
Posted on March 16, 2010

FRANKLIN, Ind. (AP) -- A suburban Indianapolis man who failed to warn sexual partners that he has HIV now faces more felony charges.

Johnson County Prosecutor Brad Cooper on Tuesday filed 15 additional charges against 47-year-old Tony Perkins, who used a dating site to meet women after being diagnosed with HIV six years ago.
The Greenwood man already faces up to six years in prison after pleading guilty last month to two counts of failure to warn partners. Cooper says the new counts represent 15 of 24 additional women who have come forward since February.

Police say nine women chose to remain anonymous, so no charges were filed on their behalves.
Cooper says none of the victims has tested positive for HIV so far.
Perkins is jailed without bond.

(Copyright 2010 by The Associated Press. All Rights Reserved.) http://www.whas11.com/news/Indiana-man-with-HIV-faces-additional-charges-87843867.html

Finances sank HIV vaccine facility bid

'No one is hiding anything,' Aglukkaq tells House committee
 Tuesday, March 16, 2010 | 4:03 PM ET 
CBC News

The decision not to build a planned multimillion-dollar HIV vaccine manufacturing facility in Canada was based on finances, not politics, the country's chief public health officer says.
Dr. David Butler-Jones and Health Minister Leona Aglukkaq both spoke Tuesday to the Commons health committee.

In February, the Public Health Agency of Canada confirmed that a facility to make HIV vaccines used by researchers worldwide in clinical trials wouldn't be built in Canada. The facility would have been the main project in the $111-million Canadian HIV Vaccine Initiative, a venture between Canada and the Gates Foundation that was announced three years ago.
In the February announcement, the agency said a study commissioned by the foundation concluded there was enough vaccine manufacturing capacity worldwide to meet research needs.
The four bids came from corporations and universities in Winnipeg, Peterborough, Ont., London, Ont., and Quebec City.

On Tuesday, Butler-Jones told MPs that peer reviewers ranked the four bids internally on scientific merit to advise the department. But none of the bids met key criteria of sustainability or financial capacity to continue, Butler-Jones said.
"There was a fair and open process," Butler-Jones said in response to questions to the minister on the review process from NDP health critic Judy Wasylycia-Leis. "You suggest somehow I would alter that. That's untrue," he said.

"No one is hiding anything," agreed Aglukkaq.

Gates and others in the field recognized that the research capacity issue was addressed in the past 18 months, which wasn't the case two or three years ago when the bidding process began, Butler-Jones said.

Both Butler-Jones and Aglukkaq said funding earmarked for the facility is still going to the Canadian HIV Vaccine Initiative. The federal government and the Gates Foundation are discussing how the money will be used.

Isotope costs

Bidders had spent up to $2 million, including $750,000 by Winnipeg, opposition MPs said.
Aglukkaq also answered questions about the shortage of medical isotopes. The price of available isotopes has gone up, and the world's two biggest isotope producers, Canada and the Netherlands, have taken their reactors offline.

The Dutch reactor will be shut down for six months and Canada's reactor in Chalk River, Ont., is not expected to be running until the end of May.

Aglukkaq said she has "committed to having discussions" with provinces and territories about the extra overtime costs they've faced in paying health-care workers mitigating the isotope shortage by working on evenings and weekends.

Liberal health critic Carolyn Bennett said the government should just go ahead and agree to pay the bill.

"Once you get the numbers from them, minister, will you be able to reimburse them for the money they've had to spend in hospitals and clinics because there have been no isotopes?" Bennett asked.
Aglukkaq replied that she has not received cost information from provinces and would not speculate on if they will be reimbursed.

The government is trying to help ease the shortage by turning to isotopes now being made at a refurbished reactor in Poland.

"We have expedited the reviews for submissions to increase the supply in Canada," Aglukkaq said.
Conservatives will also reintroduce bill C-6, a proposed consumer product safety bill that aims to modernize Health Canada's response to protect children from injury such as the power to search for, seize and recall dangerous consumer products. Aglukkaq gave the example of recalling cribs for amputation risk.

Before Parliament prorogued, Liberal senators tried to alter the bill in December with amendments to protect entrepreneurs and homeowners from its search-and-seizure provisions.

Read more: http://www.cbc.ca/health/story/2010/03/16/hiv-vaccine-isotopes-aglukkaq-butler-jones.html?ref=rss#ixzz0iNOtRaAp