Yesterday’s posting may have fooled some (I hope not so) but nevertheless contained some truths that would not  surprise many of those working in the field. Later that day, Bloomberg published an interesting piece about Pre-Exposure Prophylaxis (PrEP) and the forthcoming results of several clinical trials testing the approach.

On the outcomes of PrEP and expectated financial returns for the Pharmaceutical industry, Simeon Bennett and Tom Randall quoted Boston-based Josh Schimmer, an analyst at Leerink Swann & Co saying that “The approach may help curb the AIDS pandemic in poor countries and bring Gilead $1 billion a year in additional U.S. sales. Most investors aren’t alert to the potential benefit.”

On the big agencies coming together to discuss access, the journalists quoted CDC researcher Dawn Smith “If it’s highly efficacious, and if countries and UNAIDS and WHO and other public health agencies believe that it has a role to play in reducing new HIV infections, then we will find a way to make it available”

And on the philanthropists jumping on the bandwagon, “If the tests are successful, PrEP distribution programs could begin in developing countries in 2012, said Bill Gates, co-founder of Microsoft Corp. and the Bill & Melinda Gates Foundation”.

On the difficulty to deliver an intervention, which in this case would cost billions to treat healthy people whilst million still don’t have access to life-saving medication, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, is quoted saying “If we can’t get 70 percent of the people who are infected in low- and middle-income countries on therapy, how are we going to get people who aren’t even infected on therapy?”

On prioritisation, Francois Venter, president of the Southern African HIV Clinicians Society, a professional group based in Johannesburg said that “Identifying people who are at sufficient risk of contracting HIV to receive PrEP will most likely be too difficult in Africa, where everyone who is sexually active is at risk, [...] Deep down I have this horror that we’ll have an effective intervention very few people are going to use”.

Indeed, about 33 million people live with HIV, according to UNAIDS. Two-third leaves in Subsaharan Africa. In 2008, 2.7 million people were newly infected with the virus and 2 million died from AIDS-related complications. The majority of new infections takes place in Sub-Saharan Africa were delivering clean water still remains a challenge…

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