Trump’s administration issued a rescue and medical services on Tuesday, offering a postponement for a global HIV treatment program that stopped last week.
The resignation, announced by Foreign Minister Marco Rubio, appeared to allow HIV to distribute drugs, but if the resignation was extended to preventive medicines or other services offered by the program, the President’s Emergency Plan for AIDS relief. , it was not immediately clear.
Still, the future of Pepfar remains at risk, with possible consequences for more than 20 million people – including 500,000 children – who could lose access to life rescue drugs. Without treatment, millions of people with HIV in low -income countries will be at risk of full aids and premature death.
“We can quickly return to the point where the pandemic explodes, as it was behind in the 1980s,” said Dr. Steve Deeks, a HIV expert at the University of California, San Francisco.
“This can’t really happen,” he said.
On Monday, Trump’s administration ordered health agencies in other countries to immediately stop distributing drugs for HIV purchased with US aid. The directive came from a freezing – which can be permanently – in Pepfar’s activities, a $ 7.5 billion program supervised by the Foreign Ministry.
Since began in 2003, Pepfar has been estimated to have saved more than 25 million lives. More than 5.5 million children have been born free of HIV that would otherwise have been infected.
Only in South Africa, the termination of Pepfar will add more than half a million new HIV infections and more than 600,000 relative deaths over the next decade, according to one estimation.
The organization employs 270,000 doctors, nurses, pharmacists and other health workers. They had said not to report to work or serve patients.
The end of the Pepfar will “create instability and possibly collapse the AIDS programs of several countries that will be difficult to repair if and when Pepfar funding will again become available,” said Dr. Salim Abdool Karim, an infectious epidemiologist in infectious disease Kwazulu-Natal University in Durban, South Africa.
Dr. Abdool Karim said countries should stop relying on Pepfar and supporting their own citizens, a goal that worked by staff and program partners. But in the ideal case this shift will gradually happen, over the years during which Pepfar will train local health workers and prepare them for the transition, he said.
“This is not a bad opportunity for countries to take more responsibility,” he said. “But I think they can’t do it if it is done in this kind of random and unscheduled way.”
Here is what they expect from others from the unexpected pause of Pepfar.
Sudden stops in HIV treatment can quickly become dangerous.
Every day, more than 220,000 people receive HIV medication in Pepfar -funded clinics. The number included more than 7,400 children under 15, according to figures published Tuesday by the Amfar, the AIDS research institution.
Medicines work with the suppression of HIV in the body. When patients come out of the drugs, the virus grabs the opportunity to recover – and quickly. Within a week, HIV levels will rise from undetectable levels to more than 100,000 copies per milliliver of blood.
“This may be a time when you are in danger of passing the virus to others,” said Dr. Sallie Permar, pediatrician and HIV specialist in Weill Cornell Medicine.
The virus will then begin to attack a particular type of immunocyte, dragging the body’s ability to prevent other infections, including tuberculosis, which often accompanies HIV infection.
HIV levels that cause first can cause flulike symptoms, including sore throat, swollen glands and fatigue. The immune system will probably order enough power to suppress the virus temporarily, but HIV is experienced to hide until it finds the right opportunity to reappear.
When this occasion occurs, “they can develop aids and progress,” Dr. Deeks said.
Children can be one of the toughest hits.
Pepfar is known for funding HIV treatment programs, but its funds also go to medicines for prevention, promotion and testing and to support orphans and women who face gender -based violence.
Loss of resources for each of these efforts will derail the fight against AIDS, said Dr. Glenda Gray, a pediatric expert on HIV at Wits University in South Africa.
“If the HIV test falls from the road, it is unlikely that we will be able to diagnose even people who need to be converted into treatment,” he said.
If a pregnant or breastfeeding woman has H.IV. But she is not tested and not treated, she can pass the virus to her child. The higher its viral load, the more likely it is to happen.
Children with HIV are less likely to be diagnosed by adults and may not be treated until the virus makes them very ill. This development can be much faster for children than in adults, Dr. Gray said: “And obviously, children who are not treated are likely to die.”
The inconsistent treatment leads to resistance to medicines.
As people lose access to medicines, they may try to spread their supplies with alternating days or share their pills with others. If the virus reproduces in people with only partial protection, it may learn to avoid these defenses and become medication resistant.
People living with the virus can then pass the durable virus to others.
“This is becoming a big problem, because now, suddenly, cheap front -line drugs may not work when we have to resume them in treatment,” said Dr. Abdool Karim.
A virus that is resistant to treatments will also be better in avoiding the vaccines tested.
“Not only do we consider more resistance to medicines, but we are looking to lose any ability to make an effective vaccine,” Dr. Permar said.
The end of the Pepfar can also affect Americans.
More than one million Americans live with the virus and more than 30,000 are infected each year. If HIV becomes resistant to available medicines, it is not likely to remain in low -income countries. The Americans will also be in danger.
They can also deal with indirect damage from the end of Pepfar. Creating huge populations of immunosuppressed people may mean that other pathogens have the opportunity to spread. For example, dangerous Covid variants, including Omicron, are believed to have evolved into immunosuppressed people with HIV
At the same time, people worldwide have benefited from tests performed under the auspices of Pepfar, showing the importance of HIV treatment early, proving that pregnant women can breastfeed safely as they are treated and that HIV infections can be avoided Long -acting drugs.
“America has received an amazing love all over the world because of what has been done,” Dr. Deeks said.
“From a humanitarian point of view, I can’t imagine that someone really wants to go this path together,” he added. “This makes no sense at any level.”
