TIME Davos

Bill Gates: HIV Vaccine a Reality by 2030

Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation gestures next to his wife Melinda French Gates during the session 'Sustainable Development: A Vision for the Future' in the Swiss mountain resort of Davos
Bill and Melinda Gates at the World Economic Forum in Davos, Switzerland on Jan. 23, 2015. Ruben Sprich—Reuters

New drugs would significantly impact the global struggle against the virus which has claimed the lives on millions over the past 30 years

Philanthropist and Microsoft founder Bill Gates believes an HIV vaccine, as well as new intensive drugs to combat the disease, will be available by 2030. That would significantly impact the global struggle against the virus which has claimed the lives of millions over the past 30 years.

Speaking the World Economic Forum in Davos, the billionaire founder of the Bill & Melinda Gates Foundation said the two “miracles” were within reach. “We’re pretty optimistic in this 15-year period we will get those two new tools,” he said. The Gates Foundation, founded fifteen years ago, spends tens of millions of dollars on medical research.

A vaccine is seen as pivotal in preventing new infections, while drug treatments would do away with the need for life-long treatment, he added.

[The Guardian]

TIME Infectious Disease

Unlicensed Cambodian Medic Charged With Murder After Allegedly Spreading HIV

212 HIV cases were found in the community where he practiced

An unlicensed medic is being charged with murder after Cambodian medical authorities found 212 cases of HIV in the district where he had been treating patients, allegedly with contaminated equipment.

Yem Chrin treated poor patients and was believed to have healing powers, Reuters reports. However, he did not have a medical license and was allegedly delivering injections and blood transfusions using unclean equipment. Authorities tested 1,940 people in the northwestern province where Yem Chrin worked, and 212 tested positive for HIV. Some children as young as 6 years old tested positive for the virus, according to al-Jazeera.

Yem Chrin allegedly told police that he sometimes used the same syringe on two or three patients before disposing of it.

The World Health Organization and UNAIDS found that “the percentage of people that reported receiving an injection or intravenous infusion as part of their health treatment was significantly higher among the people who tested positive for HIV than the people who were HIV negative,” in the area in which Yem Chrin treated patients, Reuters reports.

The development is a setback in Cambodia’s largely successful efforts to eradicate the virus since it first spread through the country in the 1990s.

[Reuters]

TIME HIV/AIDS

This Contraceptive Is Linked to a Higher Risk of HIV

Depending on the contraceptive they’re using, women may be at higher risk of getting HIV

When it comes to the double duty of preventing both pregnancy and HIV, condoms are the best option, especially in the developing world where treatment for the infectious disease is harder to access. But the same isn’t true of other contraceptive methods, according to the latest study in Lancet Infectious Diseases.

Lauren Ralph, an epidemiologist at University of California San Francisco, and her colleagues conducted a review of all of the available studies on hormonal contraceptive methods—including injections of Depo Provera and Net-En that work to prevent pregnancy for about 12 weeks, as well as the pill. Among 12 studies involving nearly 40,000 women in sub-Saharan Africa, those using Depo showed a 40% higher risk of getting HIV than those using other methods or no contraception at all.

Previous studies suggested that Depo, which is made up of a hormone that mimics the reproductive hormone progesterone, was linked to higher risk of infection, but other studies showed conflicting results. Ralph found that only Depo was associated with a higher risk of HIV infection; there was no similar increase among women using the pill, which is composed of two hormones, estrogen and a form of progesterone. The correlation remained even after they considered potentially confounding factors, such as the women’s condom use.

While the study didn’t address the reason for the difference between oral contraception and Depo, some research suggests that their differing hormone combinations may have varying effects on the structure of the genital tract, a woman’s immune response or her vaginal flora, all of which could influence her vulnerability to acquiring HIV.

The results raise a difficult question about whether the increased risk of HIV infection warrants removing Depo from a woman’s contraceptive options in places like Africa. Worldwide, according to the authors, 41 million women use injectable contraception, and they have played a role in lowering death and health complications among women of child-bearing age. “Whether the risk of HIV observed in our study merits complete withdrawal of hormonal contraception, especially Depo, needs to be balanced against the known benefits of highly effective contraception in reducing maternal morbidity and mortality worldwide,” says Ralph, who conducted the research while at University of California Berkeley. More research needs to be done to quantify the risks and benefits of providing Depo, and these calculations also have to be adjusted for specific regions and even particular clinics. “One thing to consider is whether women have access to other contraceptive options, whether they will be willing to take up these contraceptive options, and ensuring that women will be comfortable with them,” she says. “I would love to see these findings applied to specific regions. I think that would help women make the most informed decisions.”

TIME HIV/AIDS

African Countries Should Spend More in AIDS Response, Study Says

A mother holds the hand of her Aids stricken son in Rakai, Ugand
Getty Images

To meet AIDS eradication goals, study says funding should be re-allocated

Twelve African countries with the highest prevalence of HIV/AIDS are currently the largest recipients of international AIDS funding. But it’s now possible for many of them to make domestic spending on the disease a priority, a new study says.

As countries in sub-Saharan Africa gain better financial footing, funds from donor countries are tightening. Researchers from Harvard School of Public Health and the Results for Development Institute decided to test a couple of scenarios to see whether funding for the AIDS response could be re-allocated so African countries would finance a greater share.

Their results, published in the journal The Lancet Global Health, show that overall, the 12 countries—Botswana, Côte d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia—could provide a greater share of the costs of AIDS programs in their countries over the next five years. However, several countries will still need support from donors, even if they were to provide their maximum funds.

MORE: The End of AIDS

By looking at factors like expected growth and total government spending, and then comparing them to the countries’ AIDS needs, the researchers found that in most scenarios, AIDS expenditures for three of the upper-middle-income countries (Botswana, Namibia and South Africa) exceed their needs. In many cases, they found, these three countries could actually fund their needs solely from domestic resources. Other low-income countries like Mozambique and Ethiopia would still need to largely rely on donors.

Currently, the dozen countries are home to more than 50% of AIDS cases worldwide, as well as 56% of financial aid for the disease. They also account for 83% of funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which makes up one of the largest shares of international donations. In 2014, the United Nations program UNAIDS estimated that a “fast-tracked” response to ending the AIDS epidemic would mean we’d need $35 billion each year by 202o, but in 2012, only $19 billion was available and almost half came from international sources. To meet such goals, the researchers suggest their new funding strategy.

Almost none of the 12 countries meet possible financing benchmarks that the study authors believe to be reasonable. If the countries spent more domestically, researchers say that self-funding could increase 2.5 times and could cover 64% of future needs. That would still leave a gap of about $7.9 billion.

“Coupled with improved resource tracking, such metrics could enhance transparency and accountability for efficient use of money and maximize the effect of available funding to prevent HIV infections and save lives,” the study authors conclude. Sharing the financial burden of AIDS more equitably may be one strategy for eradicating the disease faster.

TIME Innovation

Five Best Ideas of the Day: January 6

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. China is the key to solving the problem of North Korea.

By Christopher Hill in Project Syndicate

2. Squeezing cells to make their walls temporarily permeable could open the door to new cancer and HIV treatments.

By Kevin Bullis at MIT Technology Review

3. Survivors of domestic violence are getting immediate protection from their abusers via videoconference with a court officer from their hospital beds.

By Laura Starecheski at National Public Radio

4. Japan is testing underwater turbines to harness the power of ocean currents for clean energy.

By Brian Merchant in Motherboard from Vice

5. Drones are the new tool of choice for biologists and ecologists studying endangered species.

By Aviva Rutkin in New Scientist

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME health

How the Mystery of AIDS Created Dangerous Myths

SIDA
Microscope view of HIV, 1985 Michel Setboun—Gamma-Rapho / Getty Images

Dec. 10, 1981: The New England Journal of Medicine publishes a series of articles about a new disease that appears to target gay men

The early days of the AIDS epidemic were dangerous not just because a killer virus was sweeping across America, but because the mysterious syndrome spawned its own damaging myths.

On this day, Dec. 10, in 1981, the New England Journal of Medicine published three landmark articles and an editorial attempting to make sense of the deadly immune deficiency, which had been identified a scant six months earlier. By December, according to the BBC, the condition had been found in 180 Americans and killed 75, nearly all of them gay men.

Doctor Michael Gottlieb was among the first to recognize the chilling threat the crisis posed. When the epidemic began, 33 years ago, Gottlieb himself was 33 and an assistant professor of immunology at the UCLA Medical Center, eagerly searching for interesting “teaching cases,” according to a profile in the American Journal of Public Health.

One case that caught his attention was a harbinger of the devastation to come: a young gay man with an array of serious health problems more common to organ transplant patients than otherwise robust young people. Gottlieb and his fellow immunologists found that the man had virtually none of the “helper” cells that fight infection. After coming across several similar cases, the doctor suspected that some new, unknown virus was responsible. He told the editor of the New England Journal of Medicine that it might be “a bigger story than Legionnaire’s disease.”

To warn the medical community, Gottlieb put out his preliminary findings in the weekly report issued by the U.S. Centers for Disease Control and Prevention. By the time the journal article came out in December, other doctors from around the country had reported similar cases and were hunting for a cause.

One early theory pegged the spread of the disease — which the CDC named AIDS — to a club drug called “poppers,” although the correlation quickly broke down. New evidence that the virus was transmitted through bodily fluids emerged when heterosexual drug users began reporting symptoms, apparently after sharing dirty needles.

By then, however, hysteria over the agonizing illness had led to a proliferation of myths about its transmission. Those myths lingered long after they were disproved, adding another layer of stigma for the syndrome’s victims.

For example, in 1988 — by which time AIDS was well enough understood to make such claims preposterous — a sensationalistic book, Crisis: Heterosexual Behavior in the Age of AIDS, stirred new panic with old assertions about how the syndrome was spread. According to TIME’s review of the book, the authors suggested that contracting AIDS was as easy as using the toilet after someone with the virus, being bitten by the same mosquito or even getting to second base. This last was meant as a literal warning to baseball players, not a metaphor for heavy petting: a player could catch the virus by sliding onto the base “if, by chance, an infected player has bled onto it,” the book warned.

When confused — and terrified — callers jammed AIDS hotlines, one epidemiologist fumed, “This is the AIDS equivalent of shouting ‘Fire!’ in a crowded theater.”

Read more about the early search for the HIV virus, here in TIME’s archives: Hunting for the Hidden Killers

TIME portfolio

The Best Pictures of the Week: Nov. 28 – Dec. 5.

From ousted Egyptian President Hosni Mubarak’s acquittal to protests over Eric Garner’s chokehold death verdict and the launch of NASA’s unmanned exploration spacecraft Orion to the White House’s Christmas decorations, TIME presents the best pictures of the week.

TIME Parenting

Feds Say Circumcision Best for Boys

The ruling came as part of the first federal guidelines to address the procedure.

The benefits of male circumcision outweigh the risks of the procedure, U.S. health officials said Tuesday, in the first federal guidelines about circumcision.

“Male circumcision is a proven effective prevention intervention with known medical benefits,” the Centers for Disease Control and Prevention (CDC) said. “Financial and other barriers to access to male circumcision should be reduced or eliminated.”

The CDC stopped short of explicitly telling parents to have their children circumcised, nothing that “other considerations, such as religion, societal norms and social customs, hygiene, aesthetic preference, and ethical considerations also influence decisions about male circumcision. Ultimately, whether to circumcise a male neonate is a decision made by parents or guardians on behalf of their newborn son.”

The guidelines specifically target adolescents and young men, populations who are more likely to be infected by sexually-transmitted diseases. The guidelines say that circumcision reduces the likelihood of infection with sexually transmitted diseases, and also reduces the risk of developing penile cancer. Overall, men who are circumcised are 44% less likely to be infected with HIV, the CDC said.

 

TIME Infectious Disease

NYC HIV Diagnoses Reach Historic Low

On World AIDS Day, the city announced a 40% decline in known cases since 2003

New York City’s HIV diagnoses have hit a historic low, a new report revealed on Monday, World AIDS Day.

The New York City Health Department report shows that 2,832 people were diagnosed with HIV in 2013 (the most recent data available), which represents an all-time low and a more than 40% decline in known cases since 2003. New AIDS cases also dropped to 1,784 in 2013 from 5,422 in 2003.

Still, more than three quarters of the city’s new diagnoses were among blacks and Hispanics, and men who have sex with men also represent a disproportionate number of new cases. “But, 2,800 individuals newly infected with HIV are still too many people. We must strive harder to reach communities of color, which bear the highest burden of HIV,” NYC Health Commissioner Dr. Mary Bassett said in a statement.

New York City, one of the most populous urban areas in the world, was one of the hardest hit at the beginning of the AIDS epidemic. During a World AIDS Day event, the Health Department recognized local organizations and individuals for their outstanding contributions in the city’s fight against the disease.

Other cities, like San Francisco, have made even greater strides in cutting their new diagnoses. As TIME recently reported, San Francisco is trying to get down to zero new diagnoses. The California city, which was also an epicenter for the AIDS epidemic, had only 359 new HIV diagnoses in 2013. Not only that, but 94% of HIV-positive people in San Francisco are aware of their status.

MORE: The End of AIDS

TIME health

World AIDS Day: The History of a Virus in 7 Stories

Track the history of the disease through the pages of TIME

Dec. 1 has been World AIDS Day since 1988 — but though the awareness and activism around the diseases has changed drastically during the years between then and now.

To see just how much our understanding and attitudes have evolved, take a look back at TIME’s coverage of AIDS through these seven essential stories:

Hunting for the Hidden Killers by Walter Isaacson, Jul. 4, 1983

This 1983 cover story wasn’t the first time AIDS appeared in the pages of TIME — in 1982, an article had explained the new “plague” to readers — but the tale of the “disease detectives” at the Centers for Disease Control and the National Institutes of Health highlights just how little was known about the disease:

Based on what is known so far, two theories have emerged. One is that AIDS is caused by a specific agent, most probably a virus. “The infectious-agent hypothesis is much stronger than it was months ago,” says Curran, reflecting the prevailing opinion at CDC. NIH Researcher Fauci, who staunchly believes that the culprit is a virus, has been collecting helper T-cells from AIDS victims to look for bits of viruses within their genetic codes. So far, however, this and other complex methods of detecting viruses have yielded nothing conclusive. Suspicion focuses on two viruses: one is a member of the herpes family called CMV; the other, called human T-cell leukemia virus, or HTLV, is linked to leukemia and lymphoma.

The other theory is that the immune system of AIDS victims is simply overpowered by the assault of a variety of infections. Both drug users and active homosexuals are continually bombarded by a gallery of illnesses. Repeated exposure to the herpes virus, or to sperm entering the blood after anal intercourse, can lead to elevated levels of suppressor Tcells. The immune system eventually is so badly altered that, as one researcher puts it, “the whole thing explodes.” Other experts combine the two theories, speculating that a new virus may indeed be involved, but that it only takes hold when a combination of factors affects the potential victim, such as an imbalanced immune system or certain genetic characteristics.

AIDS: A Growing Threat by Claudia Wallis, Aug. 12, 1985

As AIDS spread, so did awareness and knowledge — as well as paranoia:

Despite their physical ordeal, many AIDS sufferers say that the worst aspect of their condition is the sense of isolation and personal rejection. “It’s like wearing the scarlet letter,” says a 35-year-old Harvard-educated lawyer who was forced out of a job at a top Texas law firm. “When people do find out,” he says, “there is a shading, a variation in how they treat me. There is less familiarity. A lot less.” Sometimes the changes are far from subtle, according to Mark Senak, a lawyer at the Gay Men’s Health Crisis, a volunteer organization that helps AIDS patients in New York. “They’ll come out of the hospital, and their roommate has thrown them out–I mean literally,” he says. “Their clothes will be on the street.” Rejection of this sort is not unique to gay men. Senak cites the case of a heterosexual woman with AIDS whose husband and family refused to take her back home from the hospital.

Invincible AIDS by Christine Gorman, Aug. 3, 1992

As the ’90s began, the hope that modern science could quickly conquer AIDS began to fade:

Wars are usually launched with the promise of a quick victory, with trumpets primed never to sound retreat. And the campaign against AIDS was no exception. Soon after researchers announced in the mid-1980s that they had discovered the virus that causes AIDS, U.S. health officials confidently crowed that a vaccine would be ready in two years. The most frightening scourge of the late 20th century would succumb to a swift counterattack of human ingenuity and high technology.

But no one was making any victory speeches last week in Amsterdam, where more than 11,000 scientists and other experts gathered for the Eighth International AIDS Conference. The mood was somber, reflecting a decade of frustration, failure and mounting tragedy. After billions of dollars of scattershot albeit intensive research and halfhearted prevention efforts, humanity may not be any closer to conquering AIDS than when the quest began.

As if by Magic by Steve Wulf, Feb. 12, 1996

For more than a decade, AIDS had been a death sentence — but suddenly survival had a celebrity face. The NBA’s Magic Johnson was back in action:

If there was a bittersweet feeling to Johnson’s return last week, it came from the realization that his exile from the game had been largely unnecessary. When Magic announced to the world on Nov. 7, 1991, that he had contracted the AIDS virus, it seemed to many that he was pronouncing his own death sentence. Michael Cooper, a teammate at the time, left the press conference crying. Johnson had to quit basketball then, supposedly for the sake of his own health and definitely for the peace of mind of his peers. He made cameo appearances, first at the 1992 N.B.A. All-Star Game and then as a member of the USA’s Dream Team in the Barcelona Olympics, but when he tried to make a comeback in the fall of ’92, the fears of some outspoken N.B.A. players forced him to call it off.

But so much has happened in four years, in both AIDS research and AIDS education.

Hope With an Asterisk by Richard Lacayo, Dec. 30, 1996

In 1996, TIME named Dr. David Ho, an AIDS researcher, the Man of the Year — and, in a series of accompanying stories, explained why. That year, a cocktail of three drugs had changed what it meant to be an HIV patient:

In the history of the epidemic, there has never been a moment as intricate as this one. AIDS once again, as in the first years after it appeared, presents a predicament so new that no one is sure how to talk about it. When we say protease inhibitors work, what do we mean? Whom do they work for, how well and for how long? The only thing we know with certainty is that the conventions of language and sentiment that fit an earlier moment of AIDS, meaning all the years when death was at the end of every struggle, are unsuited to this one, when nothing is a foregone conclusion. Something powerful is happening. The new prospects for effective treatment insist that despair is an outmoded psychological reflex. Yet among people who live with AIDS, optimism is a suspicious character. Too many bright hopes of the past didn’t pan out. So this is a moment in which, for anyone with feeling and judgment, feeling and judgment are unsettled.

Death Stalks a Continent by Johanna McGeary, Feb. 12, 2001

In the U.S., the possibility was on the horizon: AIDS could be perhaps become a manageable chronic illness, or at least a rare disease rather than a plague. But that hopeful attitude was not a worldwide phenomenon, as a lengthy and moving cover story about African patients made clear:

AIDS in Africa bears little resemblance to the American epidemic, limited to specific high-risk groups and brought under control through intensive education, vigorous political action and expensive drug therapy. Here the disease has bred a Darwinian perversion. Society’s fittest, not its frailest, are the ones who die–adults spirited away, leaving the old and the children behind. You cannot define risk groups: everyone who is sexually active is at risk. Babies too, unwittingly infected by mothers. Barely a single family remains untouched. Most do not know how or when they caught the virus, many never know they have it, many who do know don’t tell anyone as they lie dying. Africa can provide no treatment for those with AIDS.

The End of AIDS by Alice Park, Dec. 1, 2014

The current issue of TIME presents pretty much the opposite picture from the one seen a mere three decades earlier. Whereas the syndrome’s first mentions were full of confusion and fear, today’s AIDS story — the tale of a program in San Francisco that aims to get everyone who’s positive onto medication — is about control and opportunity:

More than three decades later, the disease has killed over 650,000 Americans, and the HIV/AIDS landscape, thankfully, has changed. At its peak, there were 50,000 deaths from the virus per year; now the number is 15,000. Lately, the rate of new HIV infections has stabilized at about 50,000 annually, and more than 1 million people in the U.S. are now living with an HIV diagnosis.

Those trends are making it possible for public-health experts to shift the conversation toward reducing, and even eliminating, HIV infections. More people are living with the virus–successfully controlling it with medication–and far fewer have the immune-system crashes, cancers and infections that can come with full-blown AIDS.

And the face of HIV today is a world away from the gaunt faces and wasted spirits brought to life in Tony Kushner’s Angels in America and by Tom Hanks in Philadelphia. The reality is that it’s now possible to live, for nearly an average lifetime, without any obvious physical evidence of an HIV infection.

Read more: The Photo That Changed the Face of AIDS

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