The HIV vaccine is on the horizon

HIV / AIDS - Cure On The Horizon?

If UNAIDS has its way, the AIDS pandemic should end by 2030. But the road to get there is rocky, because the infection rates have not fallen for five years. In some regions of the world they are even increasing sharply.

But first a look into the half-full glass: Anyone who was asked about the greatest health risk around twenty years ago on the street had only one answer: AIDS - a disease like something out of a horror film. In many countries there were entry restrictions for people infected with HIV; the US only lifted theirs in 2008. But the situation back then can no longer be compared with that of today: the introduction of highly active antiretroviral therapy has turned the fatal disease into one that enables an almost normal life expectancy. And this year's World AIDS Conference in Durban will again discuss healing scenarios - which, in the opinion of almost all experts, is only a matter of time. By the way: 17 countries around the world still have entry restrictions for people infected with HIV.

 

There is a time in the history of AIDS control before and after the Vancouver World AIDS Conference. Because twenty years ago - in July 1996 - the "highly active antiretroviral therapy" (HAART) was presented there. It enables the virus in the human body to be controlled. What back then had to be bought with relatively severe side effects is now possible with the further development of antiretroviral substances with significantly less stress for the patient.

Just a cure that still doesn't exist today. This virus disease has been around for 35 years. It killed 35 million people - as many as Canada - and 1.1 million in 2015 alone.

UNAIDS target: 90 - 90 - 90

With its goal of ending the pandemic by the end of 2030, UNAIDS wants to make itself superfluous. Of the 36.7 million people infected with AIDS, every second person has access to therapy: "Every five years we have doubled the number of people receiving life-saving treatment," said UNAIDS Director Michel Sidibé in the run-up to World AIDS Day on December 1st 2015 said. According to UNAIDS, 17 million are currently being treated. If things continued at this pace, AIDS could be stopped, said Sidibé.

 

That is why the goal of UNAIDS compact is: 90 - 90 - 90: 90 percent should know their HIV status in the future, 90 percent of them should be in antiretroviral treatment and 90 percent should have their viral load under control. Using the opportunities of prevention, further improving the access of the infected to therapies, combating stigmatization and discrimination and hoping for the successes of science and industry, this should seal the end of the disease. In an interview with Pharma Facts, the German virologist Prof. Joachim Hauber outlines how he sees the future of HIV treatment: “The existing combination therapies will certainly be refined even further. Patients will probably have to take fewer pills overall in the future. Medicines are to be expected which will have an effect of several weeks and months. Certainly there will be more attempts at healing research in the future. In ten to 15 years it can be expected that these will enable a functional cure in individual cases. ”For this, however, novel combinatorial therapeutic approaches would have to be developed.

Use the opportunities of prevention

What worries the experts: Since the peak in 1997, the number of new infections has been reduced by 40 percent. But they haven't been sinking for five years; in some regions they are even increasing sharply. According to a UNAIDS analysis, the number of people newly infected with the HI virus in Eastern Europe and Central Asia rose by 57 percent between 2010 and 2015. It is also increasing again in the Caribbean (9 percent), as well as in the Middle East and North Africa (4 percent). "The power of prevention is not being used," said UNAIDS Director Sidibé. The “prevention gap” urgently needs to be closed.

The prevention gap is above all a justice gap: "Access Equity Rights Now" is therefore the central theme of this year's AIDS conference. According to the UNAIDS Prevention Gap Report, around 6.2 percent of the world's population live in eastern and southern Africa, but around half of those infected with HIV worldwide, i.e. around 18 million people. Half of them do not know their HIV status - the first important prerequisite for treatment. And again, only half of that half are treated with antiretrovirals. For comparison: In Germany there are 83,400 people who know their HIV status - over 80 percent of them are receiving appropriate therapy.