The Department of State allows the resumption of medication distribution to HIV – for now

The Trump administration issued an exemption from saving medical drugs and services on Tuesday, offering relief on the global HIV treatment program, which was suspended last week.

The waiver, announced by the Secretary of State Marco Rubio, seemed to allow the distribution of medication to HIV, but whether the exemption expanded to preventive medications or other services offered by the program, the president’s emergency plan regarding AIDS assistance was not immediately clear.

Despite this, the future of Pepfar remains threatened, with potential consequences for over 20 million people – including 500,000 children – who can lose access to life -saving drugs. Without treatment, millions of people from HIV in low -income countries would be exposed to full AIDS and premature death.

“We can quickly return to the pandemic exploding place, as in the 1980s” – said Dr. Steve Deeks, HIV expert at the University of California in San Francisco.

“It really can’t happen,” he said.

On Monday, the Trump administration ordered healthcare organizations in other countries to immediately stop distributing medication at HIV purchased using the US AID. The directive resulted from freezing – which could become – in the activities of Pepfar, the $ 7.5 billion program supervised by the State Department.

Since the commencement of in 2003, it is estimated that Pepfar has saved over 25 million lives; Over 5.5 million children were born free of HIV, which would be infected differently.

In South Africa, the closing of Pepfar would add over half a million recent HIV infections and over 600,000 related deaths in the next decade, according to one respect.

The organization employs 270,000 doctors, nurses, pharmacists and other healthcare professionals. They were told that they would not report work or serve patients.

The end of Pepfar “would create instability and potentially collapsing AIDS programs in several countries that will be hard to fix, if and when the financing of Pepfar becomes available again,” said Dr. Salim Abdool Karim, an epidemiologist of an infectious disease at the University of Kwazulu-Natal in Durban, Republic South Africa.

Dr. Abdool Karim said that countries should stop relying on Pepfar and support their own citizens, the goal that employees and program partners worked on. But this change was best, for years, during which Pepfar would train local health care workers and prepare them for a passage, 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 such a case and unplanned way.”

Here’s what he and others expect from the unexpected break of Pepfar.

Sudden stopping of HIV treatment can quickly become threatening.

Every day, over 220,000 people receive HIV drugs in clinics financed by Pepfar; The number covered over 7,400 children under 15 years of age, in accordance with the data published on Tuesday by AMFAR, the AIDS Research Foundation.

Drugs work by suppressing HIV in the body. When patients leave the medicine, the virus takes the opportunity to reflect – and quickly. During the week, HIV levels will augment rapidly from undetectable levels to over 100,000 copies per milliliter.

“It can be a time when you are very vulnerable to transferring the virus to others,” said Dr. Sallie Permar, a pediatrician and HIV expert at Weill Cornell Medicine.

Then the virus will start attacking a specific type of immune cell, mutilating the body’s ability to reject other infections, including tuberculosis, which is often accompanied by HIV infection.

Growing HIV levels at the beginning can cause fluula symptoms, including a sore throat, swollen glands and fatigue. The immune system will probably attach the force enough to temporarily suppress the virus, but HIV is expert in hiding until he finds the right opportunity to re -appear.

When this opportunity arises, “AIDS and progress can develop,” said Dr. Deeks.

Children can be one of the most hard hits.

Pepfar is best known for financing HIV treatment programs, but its funds also apply to drugs for preventing, scope and testing as well as support for orphans and women experiencing gender -based violence.

The loss of resources for each of these efforts will derail the fight against AIDS, said Dr. Glenda Gray, an expert on pediatric HIV at the University of WITS in South Africa.

“If HIV tests falls in the margins, it is unlikely that we can even diagnose people who have to deal with treatment,” she said.

If a pregnant or breastfeeding woman has H.IV. But it is not tested and not treated, it can pass the virus to his child. The higher its viral load, the more likely it is that this will happen.

HIV children are less likely that they will be diagnosed than adults and may not be treated until the virus makes them clear. This progress can be much faster in children than in adults, said Dr. Gray: “Of course, untreated children may die.”

Incorrect treatment drives resistance to medicine.

When people lose access to medicines, they can try to spread their supplies alternately or share their tablets with others. If the virus repeats in people with only partial protection, it can learn to avoid these defense and become resistant to medicines.

People living with a virus can then pass on to another virus of a resistant virus.

“This becomes a substantial problem, because now suddenly our inexpensive first-line drugs may not work when we have to restart them during treatment,” said Dr. Abdool Karim.

The treatment resistant virus will also be better to test vaccine candidates.

“We not only look at greater drug resistance, but we look at the loss of any ability we had to create an effective vaccine,” said Dr. Permar.

The end of Pepfar can also affect Americans.

Over a million Americans live with a virus, and over 30,000 infections each year. If HIV becomes resistant to available drugs, it probably won’t stay in low -income countries. Americans will also be threatened.

They can also face indirect damage after Pepfar. Creating huge populations of people with reduced immunity can mean that other pathogens have the ability to spread. For example, it is believed that the threatening variants of Covid, including onikron, have evolved in people with reduced immunity

At the same time, people around the world have benefited from research conducted under Pepfar auspices, showing the importance of early HIV treatment, which shows that pregnant women can safely breastfeed if they are treated and HIV infections can be prevented by long -term drugs.

“America has gained amazing love all over the world because of what happened,” said Dr. Deel.

“From a humanitarian point of view, I can’t imagine that anyone really wants to follow this path,” he added. “It doesn’t make any sense at any level.”