August 29, 2003

AIDS expert speaks to Vanderbilt doctors

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Dr. Thomas Quinn

AIDS expert speaks to Vanderbilt doctors

The deadly march of AIDS across the African continent can be slowed, but it will take a substantial supply of medication and health care providers from countries like the United States, a leading AIDS expert told Vanderbilt doctors last week.

“It is feasible? The answer is, ‘Absolutely,’” said Dr. Thomas Quinn, a professor of medicine at Johns Hopkins University and senior investigator in the Laboratory of Immunoregulation at the National Institute of Allergy and Infectious Diseases.

The high cost of anti-retroviral drugs that block the AIDS-causing human immunodeficiency virus (HIV) from replicating has been a major stumbling block to providing treatment in sub-Saharan Africa, which accounts for 70 percent of the 42 million people worldwide who are living with AIDS. But generic forms of these drugs are now available, and some drug manufacturers have dropped their prices.

“Right now I can treat an HIV-infected person about as effectively as I could in the U.S. for $600 (a year) in Africa,” Quinn said during Medical Grand Rounds Aug. 21 in Light Hall. “Most Africans still can’t afford $600 a year, so there needs to be some sort of subsidy,” he added.

President George W. Bush has signed into a law a bill authorizing $3 billion to combat AIDS in several African and Caribbean nations in the coming year, but Congress has not yet appropriated money for the program.

Even if adequate funding for medications was available, however, “you just don’t go in there with these drugs without having somewhat of a (medical) infrastructure,” Quinn cautioned.

Chronic liver disease, diarrhea and other health conditions that are endemic in parts of Africa, for example, may make it difficult to administer some of the anti-retroviral medications. “There’s a lot still to be learned about how to use these drugs,” he said.

To that end, Quinn helped establish the Academic Alliance for AIDS Care and Prevention in Africa, a partnership of health care professionals and organizations, government officials and pharmaceutical companies. Based in Kampala, Uganda, the two-year-old alliance aims to provide treatment, train health care providers and conduct research “to guide that education and that care,” he said.

“What we want to move to Africa is the documented benefits of anti-retroviral drugs: increased survival, a decrease in opportunistic infections, a decrease in hospitalizations, … a decrease in perinatal transmission,” Quinn said. “It restores hope to the population, that they are no longer suffering a death sentence.

“It has a public health benefit,” he added. “If you have anti-retroviral drugs to offer the population, you now give them an incentive to come in and get tested.”

Quinn invited Vanderbilt physicians to volunteer to work in one of the alliance’s clinics. “We’re going to need staff who have some expertise in HIV care,” he said. “It’s a great experience.”

More information and application forms can be found on the alliance’s Web site

“It’s really a march against time,” Quinn concluded. “If we don’t come up with more pertinent ways of preventing the spread of this virus, whether it be vaccine or treatment or combinations of prevention, treatment and vaccines, this is going to continue to evolve and continue to cause more and more suffering of people around the world.”