From the Guardian, by Sarah Boseley.

There appears to be real excitement at the International Aids Society conference in Rome (sadly I’m not there in person, but that is the feedback). There is still no vaccine on the horizon – once the biggest hope – but the news from recent studies that taking antiretroviral drugs protects people without HIV from infection (see the story here) and reduces the risk of people with HIV passing it to their partners (here) has changed the landscape. Suddenly we are in a world where Aids is more preventable than ever before – and both prevention and treatment come pill-shaped.

So there is no shortage of important people calling for more funds and more action to roll out drugs to the nine million people in developing countries estimated to need them right now. Michel Sidibé, executive director of UNAIDS, said it was an affront to humanity that there were gaps in coverage.

“We have to remember that history will judge us not by our scientific breakthroughs, but how we apply them,” he said.

There are practical difficulties in the way of getting the drugs to all who need them, but beyond the rhetoric and the big picture, there are organisations which are trying to find better ways forward. The Drugs for Neglected Diseases Initiative, for instance, which has been doing excellent work on a select group of conditions – human African trypanosomiasis, leishmaniasis, Chagas disease and malaria – has decided to take on the needs of children with HIV. Paediatric formulations of antiretrovirals are inadequate. Children are not small adults. They don’t just need a few less tablets – they need drugs that can be given in doses suitable for their weight and may need syrups rather than pills. This is Dr Bernard Pécoul, executive director of DNDi:

“There are millions of children with HIV/AIDS in low- and middle-income countries, but their needs are absent from the HIV research and development agenda, and this is largely because they are poor and voiceless and do not represent a lucrative market. Working with partners, we hope to help fill this terrible gap and offer improved treatment options for children with HIV/AIDS.”

Read the rest here.

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