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NIH Will Use Stimulus Funds to Test Feasibility of 'Universal' HIV Testing
  Tuesday, June 02, 2009
By Matt Cover
( - The National Institutes of Health will use taxpayer "stimulus" money to study whether the government can convince all Americans to undergo an annual HIV/AIDS test.
Dr. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, spoke on Capitol Hill Monday at an event highlighting how his agency plans to spend the $10.4 billion it received in stimulus funds. It is not clear how much of that money would go to the AIDS-testing feasibility study.
Fauci said universal voluntary testing is part of the government's strategy to end the HIV/AIDS "pandemic."
"It really is a three-prong approach to curb the HIV/AIDS pandemic," Fauci told an audience of mostly lobbyists. "They're all bold and none of them have been proven. They are in research to see if they're feasible. The first one is pre-exposure prophylaxisÉit means that you actually treat someone before they get infected."
Fauci compared his approach with malaria, where travelers are required to take medication when traveling to countries with high rates of the mosquito-borne infection. Fauci said if the government could test 95 percent of the public for AIDS every year, it could possibly "shut off" the spread of HIV.
Fauci called universal voluntary testing and immediate antiviral therapy a "very, very interesting concept." "If you model HIV globally [examine how it spreads] and you test everybody once a year and treat everybody who's infected, and you get 95 percent compliance, you can theoretically shut the virus off."
Fauci said federal stimulus money, originally intended to jumpstart the economy and invest in public works projects, would be used to study whether the government could achieve that 95 percent compliance rate.
"What we're going to do is do some pilot studies to determine the feasibility of (whether) you can get to the vast majority of people who are infected. We're going to start off first doing it within well-defined populations within the United States."
Dr. Fauci's three-prong strategy also includes finding a "cure" or a "functional cure," which involves giving HIV patients - who have been identified through the universal testing - the latest drugs and counseling to prevent them from spreading the disease.
Right now, he said, "we're only able to treat 30 percent of the people in the world who are infected because we don't get to them -- it's a logistical problem. If we do the math, we're never going to be able to treat our way out of the epidemic unless you stop therapy on some people who are doing well."
The HIV rate in the U.S., which has the same rate as Switzerland, is a "disgrace" and a "tragedy" according to Dr. Fauci. He says one of America's biggest problems is the failure to counsel at-risk groups such as homosexuals and intravenous drug users well enough.
According to Fauci, 33 million people worldwide are infected with HIV, and about half a million of them die every year. "In the United States we have been lulled into some complacencyÉthere are 1.1 million people in this country living with HIV," he said.
"We are doing a terrible job of reaching people who are infected and getting them either into therapy and or counseling them on how to avoid transmission. It's terrible, it's embarrassing and it's a tragedy."
Fauci said Washington, D.C., is the "epicenter" of the nation's HIV epidemic, a fact that he said made his three-prong strategy a necessity.
"We've reached a wall in preventing HIV infection. We've got to do something new, we've got to do something very different and bold because it's unacceptable to have 56,000 new infections (in the U.S.) each year." In the District of Columbia, 3 percent of the population is infected, Fauci said.
Despite admitting that far more Americans are felled by seasonal flu than by HIV, Fauci, when asked by, said the government's multi-billion HIV budget is justified because there is more opportunity for scientific breakthroughs in HIV research. He also said the HIV/AIDS virus has a higher death rate than the flu does.
According to CDC figures, approximately 56,000 people are infected and approximately 12,000 people die of HIV/AIDS in the U.S.A. each year. While an estimated 36,000 Americans die of the flu every year, hundreds of thousands come down with the infection and survive.
"The scientific opportunities for breakthroughs in HIV/AIDS are commensurate with the funding that you have. Can you ever tell scientists you have enough (money)? Enough is when you completely finish the problem. With HIV, we desperately need a vaccine. The mortality of influenza is less than a fraction of a percent a year," Fauci said.
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