The Ministry of State allows the distribution of HIV – medicine to resume – so far

On By Littum

The Trump administration on Tuesday issued an exception to life -saving medicine and medical services that offer a postponement to a worldwide HIV treatment program that was stopped last week.

The coat announced by Secretary of State Marco Rubio seemed to allow for the distribution of HIV medicine, but whether the exception is extended to preventive drugs or other services offered by the program, the president’s emergency plan for AIDS was not immediately clear.

Still, Pepfar’s future remains in danger with potential consequences for more than 20 million people – including 500,000 children – who could lose access to life -saving medicine. Without treatment, millions of people with HIV in low -income countries would be at risk of full -blown AIDS and premature death.

“We can very quickly return to where the pandemic explodes as if it were back in the 1980s,” Dr. Steve Deks, an HIV expert at the University of California, San Francisco.

“This really can’t happen,” he said.

On Monday, the Trump administration ordered health organizations in other countries to immediately stop distributing HIV medicine purchased with US help. The directive came from a freezing – which can become permanent – in the activities of PepFar, a $ 7.5 billion program that is monitored by the Ministry of State.

Since it started in 2003, Pepfar is estimated to have saved more than 25 million lives; More than 5.5 million children are born free of HIV, which would otherwise have been infected.

In South Africa alone, Pepfar’s shutdown would add more than half a million new HIV infections and more than 600,000 related deaths in the next decade, according to an estimate.

The organization employs 270,000 doctors, nurses, pharmacists and other health workers. They were told that they should not report to work or to serve patients.

Pepfar’s end would “create instability and potentially collapse several countries’ AIDS programs that will be difficult to repair if and when pepar financing becomes available again,” Dr. Salim Abdool Karim, an epidemiologist for infectious diseases at the University of Kwazulu-Natal in Durban, South Africa.

Dr. Abdool Karim said that countries should stop relying on pepar and support their own citizens, a goal that the program’s staff and partners had worked against. But ideally, this shift would gradually happen, for years when Pepfar would educate local health workers and prepare them for the transition, he said.

“This is not a bad opportunity for countries to take a greater responsibility,” he said. “But I think they can’t do it if it’s done in this kind of random and non -planned way.”

Here’s what he and others expect from Pepfar’s unexpected break.

Each day, more than 220,000 people pick up HIV medicine at clinics funded by PepFar; The number included more than 7,400 children under the age of 15, according to data published Tuesday by Amfar, Foundation for AIDS research.

The drugs work by suppressing HIV in the body. When patients go off the drugs, the virus seizes the opportunity to rebound – and quickly. Within a week, HIV levels will skyrocket from undetecting levels to more than 100,000 copies per year. Ml of blood.

“It may be a time when you are very much in danger of passing on the virus to others,” Dr. Sallie Permar, a pediatrician and HIV expert at Weill Cornell Medicine.

Then the virus will begin to attack a particular type of immune cell and lame the body’s ability to avert other infections, including tuberculosis, which often accompany HIV infection.

Spiking HIV levels can first cause flulse symptoms, including sore throat, swollen glands and fatigue. The immune system is likely to marry enough power to temporarily suppress the virus, but HIV is adept at hiding until it finds the right opportunity to reappear.

When this apartment arises, “they can develop aids and progress,” Dr. Deks.

PepFar is best known for financing HIV treatment programs, but its funds also go to medicine for prevention, outreach and testing and for supporting orphans and women experiencing gender-based violence.

The loss of resources for each of these efforts will derail the fight against AIDS, Dr. Glenda Gray, a pediatric HIV expert at Wits University in South Africa.

“If HIV tests fall by the road, we will be unlikely to be able to even diagnose people who need to be treated,” she said.

If a pregnant or nursing woman has H.IV. But has not been tested and not treated, she can transfer the virus to her child. The higher her viral load, the more likely it is to occur.

Children with HIV are less likely to be diagnosed than adults, and it may not be treated until the virus makes them visible very ill. This progression can be much faster in children than in adults, Dr. Gray, “and obviously are children who are untreated probably to die.”

When people lose access to medicine, they can try to spread their supplies on changing days or to share their pills with others. If the virus replicates in people with only partial protection, it can learn to avoid these defense and become resistant to the medication.

People living with the virus can then pass on the resistant virus to others.

“It will be a big problem, because now suddenly our cheap first -line medicine may not work when we need to restart them on the treatment,” Dr. Abdool Karim.

A virus that is resistant to treatments will also be better at avoiding vaccine candidates tested.

“Not only do we look at more drug resistance, but we look at losing the ability we had to make an effective vaccine,” Dr. Permar.

More than a million Americans live with the virus, and more than 30,000 are infected every year. If HIV becomes resistant to available medicine, it probably won’t remain in low -income countries. Americans will also be in danger.

They can also meet indirect damage from ending pepar. Creating enormous populations of immunocompromised people can mean that other pathogens have an opportunity to spread. For example, dangerous covid variants, including Omicron, are assumed to have evolved with immunocompromised people with HIV

At the same time, people all over the world have benefited from trials performed under Pepfar’s auspices, showing the importance of treating HIV early, demonstrating that pregnant women can safely breastfeed as long as they are treated and that HIV- Infections can be prevented with long -acting drugs.

“America has had an amazing amount of love around the world because of what it is done,” Dr. Deks.

“From a humanitarian perspective, I can’t imagine anyone really wanting to go along this path,” he added. “This makes no sense at any level.”