GHIG is happy to be collaborating with the Johns Hopkins Medicine Distinguished Speaker Series (JHMDSS) to co-sponsor a talk by Dr. Anthony Fauci–a pioneer in the field of HIV basic science, current director of the National Institute of Allergy and Infectious Diseases (NIAID) and winner of several prestigious international awards, including a Lasker Award (2007) and Presidential Medal of Freedom (2008). Dr. Fauci is going to speak on emerging infections (i.e., novel infectious agents like SARS and H1N1) in the context of globalization. His talk will then be followed by a panel discussion on the topic by professors across the JHU campuses with expertise on everything from disaster preparedness to infectious diseases/ microbiology to science and the media to modeling epidemics, moderated by the Director of the Center for Global Health, Dr. Thomas Quinn. At our last journal club, GHIG got together and drafted a list of questions for the panel. In the meantime, we look forward to this exciting event!
Tag Archives: HIV
Politics, Partnerships, and Principles: Ethical Issues in Conducting HIV Clinical Trials Abroad
Where do we go from here?
This year agai
n, we observe World AIDS Day with perhaps more questions than answers. Although the past year has brought some small successes, with the first evidence of efficacy for vaginal microbicides. UNAIDS estimates that the rates of new infections have decreased by 20% from 1999, but they still outpace treatment capacity, and with donors cutting back promised funds, incertitude rules the day.
The theme of this year’s World AIDS Day is universal access and human rights, areas in which there is a long, long way to go. Africa still accounts for over 60% of total HIV infections, and 90% of infections among children. Although millions of people in low- and middle-income countries (LMICs) are receiving antiretroviral treatment (ART), only 37% of adults and 28% of children in LMICs who need ART were receiving it as of December 2009. Tellingly, the regions where progress has been slowest are those where prevention and treatment interventions are still not widely accessible to vulnerable groups such as sex workers, injecting drug users, and men who have sex with men, populations whose rights are all too often ignored and violated. But it’s not all gloom and doom. Some 20 years ago HIV was still a death sentence for most, and few dared to imagine that millions of poor people would get access to ART. The road ahead is a bit rockier than we would like, but not as steep as it once was.
Leprosy: The Orphan Disease
“Do we still have leprosy?”
A businessman in Bombay asked me this when I told him about my research. I had a hard time stifling laughter (totally inappropriate, but I was pretty tired), because for the last six weeks, six days out of the week, all I had seen were cases of leprosy: in government hospitals, skin clinics, VD (venereal disease) clinics, NGOs, and even swanky private establishments.
WHO blister packs of multidrug therapy (MDT) for leprosy - Rifampicin, Clofazimine, Dapsone
Leprosy is almost everywhere and simultaneously nowhere in India. The country carries 1/3 of the global burden of disease. In December 2005, India achieved the WHO’s standard of leprosy elimination (less than 1.0 cases per 10,000), with the goal of eradication in 20-25 years. As of 2009, however, the WHO reports India to have a 1-2.0/10,000 prevalence rate of leprosy. And prevalence is often higher in some areas. So, while the countrywide picture is quite good, urban and rural pockets still carry a large burden of disease.
Bombay supposedly has a low prevalence (0.53/10,000), but as R. Ganapati, former head of the Bombay Leprosy Project, states, in areas of poverty — especially the city’s sprawling slums — the prevalence can be much higher (3-4/10,000). I did some of my research at the BLP, which is close to Bombay’s large Sion government hospital, in the Sion-Chunabhatti district of the city. The expansive Dharavi slum (made famous and notorious in the movie ‘Slumdog Millionaire’) feeds into this area, and many leprosy patients come fom here to BLP and other NGOs for care.
Atlas and Axis 