August 2004 HIVAN/ECI Public Health Journal Club

The August Journal Club at the Nelson R Mandela School of Medicine was devoted to report backs from the XV International AIDS Conference in Bangkok. Topics covered were:

• Antiretroviral treatment highlights, by Dr Robert Pawinski, and
• An overview of the Global Fund to fight AIDS, Tuberculosis and Malaria, by Dr Karen Michael.


Dr Robert Pawinski reported on papers on ARVs which were presented in the Basic Science and Clinical Care tract at Bangkok. The first area covered related to viral behaviour. One conclusion coming out of this field was that the amount of replication of the HI-virus depends on viral diversity (sub-types B and C have greater diversity and appear therefore to have greater transmission rates). Looking secondly at the World Health Organisation, Dr Pawinski reflected that there was general consensus that d4T, 3TC and Neviripine was a robust combination of triple therapy. He also noted that two new drugs had been developed: Reverset (or d4FC) and SPD754. On the theme of structured treatment interruption (STI), one thought emanating from Bangkok was that STI was not a feasible way forward. Dr Pawinski outlined the HIV-NAT0014, the FOTO and the ESS40013 trials to show the apparent lack of success of STI and to emphasise the need for further investigation on this topic. Fourthly, some miscellaneous complications of ART were highlighted. Considering the diversity of papers and literature on these topics, Dr Pawinski concluded his talk by providing helpful links to various sites. (Please contact Dr Pawinski on telephone (031) 260 4667 or [email protected] for a copy of his PowerPoint presentation.)

Dr Michael began her presentation by stating that ?“The Global Fund operates as a financial instrument and not as an implementing agency?”. She went on to describe what the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) is and how it works. Although only 30 months old, the Global Fund has already disbursed US$3.1 billion to 296 projects in 129 countries. The Fund has been shown to be genuinely committed to distributing money to fight disease in an open and transparent manner, however, there is doubt as to whether the Fund can meet its current commitments, as the relevant countries are not contributing the agreed-upon 15%.

Dr Michael's presentation can be downloaded on the rigthhand side of this page

Biosketches:

Robert Pawinski: Dr Pawinski is the recently appointed Director of the Enhancing Care Initiative, KZN PLUS, and the Director for the ECI KZN GFATM Project at UKZN.

Karen Michael: Karen Michael has a Masters in Development Studies from the University of KwaZulu-Natal. She majored in Philosophy and studied Health Economics at the University of Wales through a DFID Technical Cooperation Award. She is about to register for her second Masters degree pursuing her interests in Health Economics. She is the resident Health Economist and programme manager at Enhancing Care Initiative KZN PLUS and is co-facilitating the Health Economics Interest Group with Nicola Deghaye. Apart from her rather obvious interests in Economics, Karen is an avid rock-climber and has a rather morbid fascination with plagues and epidemics.