In a recent report released by the UNAIDS, the number of new HIV (human immunodeficiency virus) infections has fallen by 19% since 1999. And of the 33.3 million people living with HIV, only a little over 5 million people are receiving HIV treatment. That is, roughly 15 percent of the world’s population. Ghastly, some might say, but improving, optimists would say.
According to the 2010 UNAIDS Report on the Global Aids Epidemic, 33 countries reported a 25% decrease in HIV incidence, and 22 of those 33 were sub-Saharan African countries. However, seven countries, five of them in Eastern Europe and Central Asia, reported a 25% increase in HIV incidence. To see an increase in HIV incidence at all in an informed world such as ours has really motivated me to find out if a magic elixir, a “cure-all drug,” such as an HIV vaccine would solve this four-decade old HIV/AIDS epidemic problem.
Many experts have suggested that the discovery and effective use of a vaccine, along with curative therapy, will be the doom of HIV/AIDS. Yes, a vaccine will be essential, but so will easily accessible, acceptable, and effective curative therapy. Unfortunately, an availability of these treatment options is not enough, as history has proved to us.
Vaccines have been around us for decades now, and yes, some have actually wiped away many infectious diseases. For example, polio, or poliomyelitis, has been completely eradicated in the western hemisphere. However, other infections for which vaccines have been created are still far from eradication. Tetanus, meningitis, and hepatitis B are a few. So why are we not able to eradicate a disease which we know causes much suffering?
The obvious answer is the unavailability of these vaccines in developing, third world countries, where the diseases are most likely to be found. More importantly, in rural cities across the world, one may have to travel 100km or more just to receive basic care—something almost impossible to do. In the case of the meningococcal disease, the vaccine is not readily available in developing countries despite convincing evidence that it can prevent meningitis and sepsis, which often leads to severe disabilities if not death. Other relatively new vaccines such as those against the influenza virus, or the flu, are still a rarity in the developing countries, where they are desperately needed.
Although the HIV/AIDS awareness has increased in recent years, there are still many misconceptions in developing countries. In a 2009 study by researchers in Zimbabwe, the percentage of people that believed they had a chance of being infected by HIV decreased by 10% from 1999 levels, but yet, the country seropositive level among adults aged 18 years and above was 14.4% (~15% in 1999) in a population of 12.8 million people. That is only a 0.6% decrease over a 10-year period.
Astonishing, the results may be. And yes, although countries like Zimbabwe have been slow to acknowledge the problem, they have been proactive about starting programs such as voluntary male circumcision and counseling and testing to slow down the incidence and prevalence of HIV.
Another important factor to consider for the HIV vaccine is the mode of deliverance. Ignoring industrialized nations for a second, sterility is not a common term to most third world countries. If these third world citizens were administered an HIV vaccine through injection, would they be setting themselves up for another potential infection such as hepatitis B?
Perhaps it would be necessary to spend more of our research and charity money to open up clinics in different rural, underserved areas of the world to raise awareness—something that has absolutely shown to be effective in lowering HIV incidence. If we rather spent more of our millions in grant money to educate people on how to practice safe sex or distributing free condoms, maybe the rate of HIV/AIDS would (or will) dramatically decrease.
The issues I have raised, though discouraging, are worth consideration. It simply is not enough to manufacture vaccines or drugs and think that patients will use them properly or have adequate access to them. It is tempting to think that a cure will mean the end of the HIV/AIDS epidemic, but we have cures for malaria, for instance, and yet close to a million deaths occur annually from the disease. What we need to do is continue bringing HIV/AIDS awareness to the people of this world.
Satyam H. Veean is a pre-medical student.