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  • Chart: AIDS Spending in the US, Compared
  • Boston powerpoint2

    1. 1. A community perspective By Kate Krauss, Executive Director AIDS Policy Project [email_address] Where are we in the search for a cure for AIDS?
    2. 2. What is a cure? A cure is a permanent remission in absence of requirement for therapy. A functional cure: Control of virus rather than elimination, without requirement for therapy. --The Division of AIDS, US National Institutes of Health March 26, 2011 Boston, Massachusetts
    3. 3. HIV Reservoirs <ul><li>Long-lasting groups of cells that are established shortly after HIV infection and can live for decades </li></ul><ul><li>Cannot be killed unless they are activated. </li></ul><ul><li>They are actual locations (the brain, the gut) </li></ul><ul><li>They are populations of cells </li></ul><ul><li>There is no agreement yet as to how to measure them--size, types of cells, functionality of cells </li></ul>
    4. 4. NEJM Brief Report March 26, 2011 Boston, Massachusetts
    5. 5. Gero Huetter, the physician who cured the Berlin Patient, receiving an award from the AIDS Policy Project and the Board of Supervisors on the steps of San Francisco City Hall. March 26, 2011 Boston, Massachusetts
    6. 6. Timothy Ray Brown March 26, 2011 Boston, Massachusetts The Berlin Patient
    7. 7. Two current strategies toward a cure <ul><li>Activate resting T cells (cells in the viral reservoirs), and use AIDS drugs to kill them--flush them out and kill them off. </li></ul><ul><li>Repopulate the immune system with cells that have become resistant or immune to AIDS. </li></ul> March 26, 2011 Boston, Massachusetts
    8. 8. Possible curative therapies being investigated <ul><li>HDACi - (Vorinostat)--a drug approved for skin cancer--clinical trials are starting in Melbourne, Australia and Chapel Hill, North Carolina </li></ul><ul><li>CCR5 gene therapy--Researchers are trying to duplicate the Berlin patient case. </li></ul><ul><li>Using zinc finger technology to snip out CCr5 receptors in patients’ own T cells or stem cells. </li></ul><ul><li>Combination strategies to target latency - similar to cancer approaches. These combinations all look promising in vitro eg. HDACi+ methylation inhibitors or other combinations. There may be more than one mechanism of latency or a need for one drug to activate the virus and another drug to kill it. </li></ul> March 26, 2011 Boston, Massachusetts
    9. 9. Paula Cannon and John Zaia, Los Angeles 2010 at AIDS Policy Project Town Meeting March 26, 2011 Boston, Massachusetts
    10. 10. Jay Lalezari’s People <ul><li>University of Pennsylvania and Quest Research in San Francisco </li></ul><ul><li>Remove T-cells from long-term survivors </li></ul><ul><li>Snip out the CCR5 receptors using zinc finger technology (Sangamo, Richmond, CA near Oakland). </li></ul><ul><li>Reinfuse the cells, this time without their CCr5 receptors </li></ul><ul><li>Therapy was safe; cells proliferated throughout the body and migrated to the gut. </li></ul><ul><li>Increase of 100 CD4 cells </li></ul><ul><li>Almost didn’t happen because of patient enrollment problems </li></ul> March 26, 2011 Boston, Massachusetts
    11. 11. Jay Lalezari, Boston, March, 2011 March 26, 2011 Boston, Massachusetts
    12. 12. What percentage of its research budget did the National Institute of Allergy and Infectious Diseases spend on AIDS cure research? In 2009, NIAID spent $40,652,172 on direct AIDS cure research. The total AIDS spending of NIAID in 2009 was $1.541 billion. Thus, NIAID spent less than 3% of it AIDS budget on direct cure research. An additional $20 million was spent on AIDS cure research for the brain at another branch of the NIH. March 26, 2011 Boston, Massachusetts
    13. 13. March 26, 2011 Boston, Massachusetts
    14. 14. Obstacles to a cure <ul><li>Lack of funding--NIH spends 3% of its AIDS research budget on a cure. </li></ul><ul><li>Lack of good ideas--best and brightest aren’t all at the table yet. Young researchers, foreign researchers, novel ideas. </li></ul><ul><li>Research models that do not encourage collaboration --Myelin Repair Foundation </li></ul><ul><li>Red tape at the FDA/NIH/IRBs based on misunderstandings of what is ethical for people with AIDS. A 3 year wait--and counting--to test one promising therapy in people. </li></ul> March 26, 2011 Boston, Massachusetts
    15. 15. What can we do to hasten a cure for AIDS? <ul><li>More funding--$60 M is not enough </li></ul><ul><li>More funding streams-Opportunity for philanthropists to make a big difference in the course of the AIDS epidemic </li></ul><ul><li>Make opportunities for new ideas </li></ul><ul><li>New models of research (in addition to current) </li></ul><ul><li>Remove roadblocks in getting INDs, funding </li></ul><ul><li>Voices of PWAs at the table--will inform clinical trial ethics, will help accelerate enrollment </li></ul> March 26, 2011 Boston, Massachusetts
    16. 16. AIDS Policy Project <ul><li>Diverse group of physicians, lawyers, advocates, community organizers launched a national advocacy campaign for a cure in November, 2009 </li></ul><ul><li>Found demoralized researchers--listen to radio interview on our web site </li></ul><ul><li>Learned that NIH was not tracking its spending on a cure. </li></ul><ul><li>Wrote first-plain English report on the cure. </li></ul><ul><li>Working with NIH and FDA to overcome obstacles and bring more researchers to the table </li></ul><ul><li>Finding new ideas, new and faster research models </li></ul><ul><li>Turned outward toward the public& AIDS community: writing articles and interviews, blogging, tweeting, etc about AIDS cure research. </li></ul><ul><li>ORGANIZING </li></ul>
    17. 17. AIDS Policy Project <ul><li>Grassroots AIDS cure conference on AIDS cure activism May 28, 29, and 30 in Philadelphia </li></ul><ul><li>Meeting between FDA, NIH, and advocates in April, 2011 in Baltimore </li></ul><ul><li>HIV provider conference in Palm Springs, CA on April 9 </li></ul>
    18. 18. March 26, 2011 Boston, Massachusetts Gero Huetter, physician who cured the first person with AIDS; and researcher Steve Deeks, MD at a meeting organized and attended by the AIDS Policy Project at the Zuni Café, San Francisco in June, 2010
    19. 19. March 26, 2011 Boston, Massachusetts AMSA and SGAC
    20. 20. March 26, 2011 Boston, Massachusetts Jose Demarco