TAGline 2013
NEWS ON THE FIGHT TO END HIV/AIDS, VIRAL HEPATITIS, AND TUBERCULOSIS
TAGline Fall 2013: The Domestic Issue- Rising to the Domestic Challenge
The past decade has brought astonishing developments in HIV disease management...Yet the U.S. epidemic continues unabated. We are at a stalemate.
- U.S. TB Control: From Confidence to Crisis
Funding cuts and shifting budgetary priorities threaten tuberculosis gains
The United States is losing ground in its fight against the tuberculosis (TB) epidemic within its own borders.
- An Obligatory Overhaul to Address Domestic TB Drug Shortages
Bold strategies are required to remedy frequent stock-outs and supply interruptions
Drug shortages, especially of tuberculosis (TB) drugs, have become increasingly common in the United States.
- A Commitment to the HIV Continuum of Care
President Obama orders multiagency cooperation to achieve National HIV/AIDS Strategy goals, but without required funding commitment
If the United States is to effectively move toward the 2015 goals outlined in the National HIV/AIDS Strategy (NHAS), tighter collaboration between various federal agencies will be required.
- Engagement in Care: A Final Frontier of HIV Medicine
Getting more HIV-positive people linked to and retained in care requires innovation and research
Far too many people living with HIV aren’t accessing the care they need to benefit from the personal and public health benefits of antiretroviral therapy.
- Toward a Plan to End AIDS in New York State
A coalition of community groups push to end AIDS at the epicenter of the U.S. epidemic
A series of discussions to reenvision the state’s HIV/AIDS response to encourage the government to develop a New York State plan to end AIDS have begun.
- HIV Prevention Is the Surest Way to Fight AIDS
ACT UP/NY demands Department of Health accountability at the epicenter of the U.S. epidemic and commits to reinvigorate the national prevention agenda
New York’s Mayor Michael Bloomberg has put his personal stamp on campaigns against guns, cigarettes, and big soft drinks. But HIV prevention has been neglected for years.
- TAG’s Commitment to HIV Prevention
Though the number of new HIV infections in the United States is down from its peak in the 1980s, incidence has refused to budge below its decade-long average.
- Emerging Regulatory Issues in HIV Cure Research
The science of discovery comes with ethical challenges in human clinical trials
To prove their worth, potential curative strategies—whether based on a single approach or a combination—will need to be evaluated in human trials.
- Advancing Research, Securing Access
Now in its 20th year of publication, TAGline has long sought to inform its readers and TAG supporters of the myriad research and policy challenges we face as a community in the ongoing fight against HIV and two of its insidious comorbidities, viral hepatitis and tuberculosis. Many of these challenges are inextricably intertwined, as we highlight in this issue focusing on specific clinical research and treatment-access hurdles threatening progress for all three diseases.
- Ryan White at a Crossroads
Preparing to defend and reshape a still-critical program
An increasing demand for services, coupled with significant fiscal retrenchment among federal and state agencies, leaves the Ryan White HIV/AIDS CARE Act-funded program at a crossroads. But advocacy strategies are afoot, not only to work toward continuation of Ryan White funding past its September 30 expiration, but also to promote a long-overdue implementation-science agenda to maximize the effectiveness and efficiency of HIV services.
- The "G" Word
Gilead’s greed gives rise to a slew of advocacy priorities
Activists are decrying Gilead’s refusal to continue codeveloping a winning HCV drug combination with Bristol-Myers Squibb (BMS), opting instead to focus on co-formulations of its own promising agents. While a high-level petition continues to circulate, demanding that Gilead continue codevelopment with BMS, a much larger advocacy agenda remains to be addressed.
- TB Drugs for Children
Poor treatment options spur innovative research strategies
There is an old adage in pediatric medicine: children are not little adults. This is particularly true when it comes to tuberculosis, for which management strategies are largely the same, but dosing guidance and options leave a lot to be desired. Fortunately, a number of initiatives hope to remedy this situation in an effort to reduce global TB mortality among children—currently 100,000 deaths each year.
- Razing the House of Cards
The discovery of HAART and the push for evidence-based HIV treatment
This is the third in a series looking back at the first two decades of TAG’s work to speed up AIDS research. Here we look at the rise of highly active antiretroviral therapy (HAART) and the push for evidence-based HIV treatment.
- Preparing for Generics
The push for affordable HIV treatment doesn’t end with patent expirations
The United States is on course for some much-needed economic relief from the crippling cost of HIV treatment, with the anticipated arrival of generic versions of guidelines-preferred antiretrovirals. However, much preparation is required to maximize price competition, maintain patient choice, and ensure that savings are used to the advantage of people living with HIV.
- Undetectable Is Not Always Enough
Immunologic nonresponders face increased risk of illness, but lack therapeutic options
A subset of people on antiretroviral therapy (ART) experience limited or no recovery of CD4 T-cell counts despite achieving and maintaining undetectable viral loads. Various terms have been used to describe this phenomenon, with the most common being “immunological nonresponders” (INRs). Many studies have documented that INRs face an increased risk of illness and death compared with people with more robust CD4 T-cell gains. Yet there are no approved therapies to improve immune reconstitution, and clinical trials of potential candidates remain few and far between.
- Sanofi’s Double-Edged Sword
Rifapentine’s manufacturer helps to advance TB research while stalling accessSanofi-Aventis, manufacturer of the tuberculosis (TB) drug rifapentine (Priftin), can be credited for aiding research efforts to shorten and simplify treatment dosing for TB. However, the company’s pricing of the drug has hampered access to such regimens, even in resource-rich nations like the United States.
- A Necessary Transformation
Simultaneous, not sequential, evaluations of novel drug regimens needed to speed TB treatment research
New drugs, as components of novel regimens, are necessary to improve TB treatment. To expedite the development of these regimens, while simultaneously reducing the size, length, and cost of clinical trials, TB researchers, funders, and activists are working together to develop alternative study designs.
- Help Paying for HIV and Hepatitis Treatment
Health insurance co-payment (co-pay) programs and patient drug assistance programs (PAPs) are critical services for thousands of U.S. residents with HIV and/or viral hepatitis who face out-of-pocket expenses associated with their treatment. The Fair Pricing Coalition (FPC) has negotiated co-pay programs with virtually every major HIV and viral hepatitis drug manufacturer.