Students Join Global War Against AIDS

In the last 25 years, AIDS has killed more than 25 million people worldwide. Among the regions hardest hit is sub-Saharan Africa, where 72 percent of the 42 million people with AIDS live and where thousands of deaths and new infections are reported every day. Meanwhile, the area suffers from a critical shortage of health-care workers.

In recognition of the Student Global AIDS Week of Action, February 26 through March 2, students from Boston University School of Medicine and School of Public Health have joined forces with Physicians for Human Rights, Student Global AIDS Campaign (SGAC), University Coalitions for Global Health, and the American Medical Student Association to confront this health-care crisis. Workshops and lectures on the treatment and prevention of HIV/AIDS will be presented at the Medical Campus throughout the week. 

BU Today spoke with Jirair Ratevosian (SPH’07), president of the BUSPH Rotaract Club, about the latest HIV/AIDS treatments.

BU Today: What are the biggest public health issues related to HIV/AIDS?
Ratevosian: The biggest public health issues related to HIV/AIDS are the health worker shortage in Africa and its impact on AIDS treatment and prevention; HIV prevention and treatment for the millions of injection drug users; the promise of microbicides; coinfections with other deadly diseases, such as tuberculosis and malaria; and rationing antiretroviral therapy in resource-poor settings, as well as barriers to treatment worldwide.

What are students doing to fight HIV/AIDS?
All students must fight their hardest to prevent one more person from getting HIV. All students should raise their voices and advocate for the issues that are related to HIV/AIDS, not only during the Week of Action but every chance they get. In the past, student activism has been responsible for many victories, including additional funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria and increased access to more affordable antiretroviral therapy. For more information, go to the American Medical Student Association.

What is the connection between HIV and malaria?
Both are diseases of poverty, and both are causes of poverty. To a considerable extent, both are concentrated in the same geographical regions. People who have compromised immune systems are more vulnerable to malaria, so the resulting coinfection and interaction between the two diseases have major public health implications, because individuals are at greater risk of transmitting HIV through increasing viral loads.

What are some of the gender and global disparities involving HIV/AIDS?
According to many estimates, the rate of HIV infection among women and girls is rising dramatically in much of the developing world and has reached an alarmingly high level in sub-Saharan Africa, where young women ages 15 to 24 are three times more likely than young men to be infected.

Gender inequality in many developing countries puts women at increased risk of HIV transmission because of rape and domestic violence, marriage to older men, lack of education, sex trafficking, poverty, transactional sex, lack of power to negotiate condom use, and other harmful norms about the submissiveness of women to men. Promising new microbicides are meant to help alleviate some of the gender disparities involving HIV/AIDS.

What are microbicides?
Microbicides — the most promising prevention tools that will give women power over AIDS — are considered by many to be the most important innovation in reproductive health since the pill. The term “microbicide” refers to a number of different topically applied substances that help prevent the sexual transmission of HIV, as well as other sexually transmitted infections (STI). However, microbicides are not yet available, and the ongoing research is controversial.

Because of the gender disparities involving HIV/AIDS, microbicides would fill an important gap in our ability to prevent HIV and STI by giving women tools to safeguard their health. Student activism is crucial to passing relevant legislation and increasing funding for future research. For more information on the history of microbicides and current research and advocacy efforts, visit the Global Campaign for Microbicides.

What is the Treatment Access Campaign?
In the last decade, the price of first-line antiretroviral drugs fell drastically — from $10,000 per patient per year to $140 — thanks to low-cost generic production. However, because of growing resistance to these first-line drugs and side effects, there is an urgent need for new “second-line” drugs. Unfortunately, affordable global access to these drugs is nearly nonexistent. Led by efforts of the Student Global AIDS Campaign, activists have pressured pharmaceutical companies and governments around the world to change their policies and practices.

One of two companies targeted by SGAC in the Treatment Access Campaign is Abbott Pharmaceuticals. Abbott’s Kaletra is among these critical second-line drugs. Abbott received FDA approval in October 2005 for a new version of Kaletra that is a significant improvement for use in resource-poor settings. Sadly, this new formulation is not available to people living with AIDS in the global south. This year, SGAC is launching an expanded campaign to push government and corporate decision-makers to do what’s right — to make “universal access” a reality, not just a catchphrase. 

What does the white lab coat display in the School of Medicine’s basement symbolize?
This empty white coat display is a powerful image meant to visually demonstrate the missing health workers in the fight against AIDS.

The health worker shortage in Africa is at a crisis point, and the World Health Organization estimates that sub-Saharan Africa will face a shortage of more than 800,000 doctors, nurses, and midwives and an overall shortage of 1.5 million health workers. The reasons that drive the shortage of health-care workers include migration of trained and talented individuals to other nations (brain drain), poor economic policies that lead to a broken health system, and unrealistic expectations of community health workers, who receive little or no compensation or training.

Student activism (filling out a postcard, writing or calling your representatives in Congress) is important to urge Congress to make global health a priority and appropriate $8 billion in new money over five years to fund the training and retention of the African health-care workers who will be needed to reach universal access by 2010.

For a complete list of scheduled events on the BU Medical Campus for the Global AIDS Week of Action, sponsored by the BU Student Global Health Organization, BUSPH Rotaract, the Health and Human Rights Caucus, the American Medical Writers Association, and the newly formed BU Physicians for Human Rights chapter, click here. Events are free and open to the public.

Vicky Waltz can be reached at vwaltz@bu.edu.