Thailand Blacklisted From Receiving New AIDS Drugs

[Pepe']

More light reading,

Internationally, there are 36 million HIV-infected individuals and 24 million people have already died from AIDS. A major focus within our laboratory has been to define the unique epidemiologic, clinical, virologic, and immunologic features of HIV-1 and HIV-2 infections in developing countries and in the U.S.

In a multicenter study on perinatal transmission in the U.S., we determined that elevated RNA viral levels at birth were suggestive of in utero infection and that a high plasma RNA viral load in the first two months of life (>300,000 copies per ml) was strongly associated with rapid progression to AIDS or death. None of the infants with <70,000 copies/ml progressed to AIDS, suggesting that antiretroviral therapy in infants with high viral loads should result in improved survival and delayed progression.

We subsequently studied maternal HIV RNA levels, which were found to be highly predictive of risk of perinatal transmission. For example, transmission rates increased from 0% to 40% for mothers with RNA levels <1,000 to over 100,000 copies/ml, respectively. The highest risk of transmission occurred in women with RNA levels >100,000 copies/ml who were not on zidovudine (63% transmission). Maternal viral load was the strongest of four independent predictors of transmission risk that included zidovudine use, duration of ruptured membranes greater than 4 hours, and birth weight <2500g. Additional studies on HIV viral load demonstrated that at the time of an acute opportunistic infection, HIV RNA may increase three to fivefold, which subsequently declines to the baseline viral RNA level 3 months following successful treatment. The changes in viral RNA correlated best with changes in cytokines associated with immune activation.

In Pune, India, we have screened 8,134 patients attending STD clinics, of whom 23% were HIV positive. In a prospective study, the incidence rate of HIV infection was 16.2% among female sex workers, 7.4% among men and 6.6% among married spouses of these men. The high frequency of multiple STDs and HIV infection coupled with low rates of condom use and low AIDS awareness highlights the rapid spread of HIV into both high and lower risk populations in India. In this study of 3,874 HIV antibody-negative persons, 58 were p24 antigen positive and subsequently seroconverted. Unprotected sexual contact with a commercial sex worker in the presence of an active genital ulcer at the time of screening was significantly associated with seroconversion. Signs and symptoms independently associated with p24 antigenemia included fever, arthralgias, and night sweats. Thus, screening for p24 antigen in HIV antibody-negative persons was found to be a reliable and effective method for determining recent risk behavior and identifying clinical signs of acute primary HIV infection.

In a community-based STD mass treatment campaign of 14,000 individuals in Uganda, there was a 60% in reduction in the prevalence and incidence of bacterial STDs, but the incidence of HIV infection was unaffected. Additional future studies will address the effect of mass treatment of STDs during pregnancy on perinatal outcomes.

In men, plasma HIV RNA levels after acute HIV seroconversion are an independent predictor of progression to AIDS. We identified a gender difference in viral load between men and women in a cross-sectional study and the predictive value of an RNA level for progression to AIDS appeared to be different in men and women. We therefore conducted a nested case-controlled study of RNA levels in both male and female injecting drug users in order to provide a longitudinal perspective on viral levels in men and women who progress to AIDS compared to male and female non-progressors. Initial median viral load levels after seroconversion were significantly lower in women compared to men (15,000 copies/ml) compared to 150,000 copies/ml). Similarly, median plasma viral load was significantly lower among female compared to male non-progressors (12,000 vs. 61,000), and the initial viral load in women at seroconversion did not predict progression to AIDS, although the viral load was highly predictive for AIDS in men.

Among both men and women there was a steady increase in viral load levels among rapid progressors compared to controls and the difference between genders appeared to dissipate after four years of infection. This study demonstrated that plasma HIV RNA levels were significantly lower in women than men at the time of serconversion although this difference subsequently diminished after four years of infection. Plasma viral load at seroconversion in women is not as predictive of progression to AIDS as it is in men, and consequently viral load differences in women compared to men need to be taken into account when considering when to initiate antiretroviral therapy.

Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen in the United States with an incidence of 4.5 million cases annually. The objectives of this project are to assess the frequency of C. trachomatis infections in selected populations, to develop and evaluate sensitive nucleic amplification assays for diagnosis, and to study the immunopathogenesis of C. trachomatis and C. pneumoniae infections.

Using molecular amplification assays, we screened over 2,000 male and 20,000 female patients in Baltimore. The overall prevalence of chlamydia ranged from 7% in family planning clinics to over 20% in adolescents. In a prospective study of 3,202 sexually active adolescents aged 12 to 19 years, chlamydia infection was found in 24% of first visits and 14% of repeat visits; 29% of adolescent females have at least one positive test in a one-year period. Females aged 14 years had the highest age-specific chlamydia prevalence rate of 27.5%. The chlamydia incident rate was 28 cases per 1,000 person-months with a median time of 6 months to re-infection. With such high rates of infection, we recommend screening all sexually active adolescent females for chlamydia infection at least twice yearly.

We also screened urine by ligase chain reaction (LCR) for C. trachomatis in 13,204 new female U.S. Army recruits from 50 states and four territories. The overall prevalence was 9% with a peak of 12% in 17-year-old females. Recent vaginal sex, young age (<25 years), being African American, having more than one sex partner, and inconsistent condom use were independently associated with chlamydia infection. In this national survey, we documented that the prevalence of chlamydia infection was very high in female military recruits and that all recruits should be screened and treated for chlamydia in order to reduce infection, transmission, and sequelae.

Internationally, in a community-based trial of mass STD treatment in the Rakai district of Uganda, we documented relatively high rates of chlamydia and gonorrhea in 15-24 year-olds (5%). Ten months after mass antibiotic treatment, there was a 50% reduction in both chlamydia and gonococcal infection. This study also demonstrated that the vast majority of STD infections are asymptomatic (80%), and that mass antibiotic treatment is effective in lowering infection rates. Future studies will address the effectiveness of mass treatment in limiting HIV transmission.

We recently demonstrated a direct correlation between C. pneumoniae and atherosclerotic heart disease by the recent isolation of C. pneumoniae in an explanted heart with severe coronary atherosclerosis. C. pneumoniae has also been demonstrated in nearly 50% of coronary and carotid atheromas by immunocytochemistry and/or PCR. In vitro studies have demonstrated that C. pneumoniae can infect and proliferate in coronary artery endothelial cells and aortic artery smooth muscle cells. In preliminary animal studies, C. pneumoniae-inoculated mice appeared to have an increased rate of atheroma formation in the carotid artery and aortic artery compared to control animals, suggesting an etiologic or co-factor role in the development of atherogenesis. Future studies will continue to examine the etiologic role and immunopathogenesis of C. pneumoniae in the development of atherosclerosis.

[Maestro]

Mods what do you think ?

Well, I am a mod – but that is entirely beside the point – and I shall attempt to tell you what I think.

For a start, I have to tell you that I am not an expert on HIV and AIDS. What I know is from reading the papers, and I have not taken a particular interest in the subject and most likely my knowledge is not up-to-date.

HIV infection is 99.9999% preventable.

I am inclined to agree that the only way to prevent a world-wide epidemic is prevention. This is where governments should spend their money.

As I said, I may not be up-to-date on the subject, but this is the current state of my knowledge:

1. AIDS is not curable. Any treatment, expensive or cheap, will only prolong the patient’s life.

2. HIV is treated with antiviral/retroviral drugs – I am not too familiar with the jargon – and this treatment will delay the onset of AIDS and in some cases will prevent the break-out of AIDS.

The life-prolonging treatment has a positive effect. It permits the patient to continue to work, to provide for his family, in essence to contribute to the gross national product (GNP). The other side of the coin is that the cost of the treatment is a drain on the GNP, but on balance it should be a net gain, hence the clamour for cheaper drugs.

Someone working in the field would consider that wives are usually NOT in a position to insist that the husband MUST WEAR A CONDOM ... etc etc ....

"Hi honey ... you have a penis so I no longer trust you ... even though we have been married 20 years ... start wearing a condom!" ... yeah that would work!

In this scenario given by jdinasia – and I grant that it is a very realistic scenario – let us assume that the wife, infected by her husband, is not promiscuous but that the HIV-infected husband continues to philander. He infects other, previously HIV-free woman, who in turn infect other, previously HIV-free men, and this cycle continues ad infinitum.

Now, I am going to say something that is very cruel, and any lambasting I may get for it will be fully warranted. Remember the outbreak of the Ebola virus in some African country a few years ago? I read an article where an epidemiologist explained that Ebola was not likely to cause a world-wide epidemic because infected persons died within a few days and thus had very little time to infect other persons and as a result very few other persons could get infected. Would it, then, not be better to leave HIV-infected persons untreated so that they should have a shorter remaining life span during which to infect other persons?

I give the answer myself: it would slow down the epidemic, but not prevent it or stop it. Even without treatment, a HIV-infected person will live up to another 10 years, or longer, if my limited knowledge on the subject is correct. In other words, the real problem of HIV is that it does not kill the infected persons fast enough. Which brings me back to the belief I expressed at the beginning: only prevention can rid the world of HIV and AIDS, unless a vaccine becomes available soon and everybody gets vaccinated.

So, whoever it was who called for mod action on Pepe’s posts: both Pepe and Jdinasia are correct, in my humble opinion. HIV is preventable, but it is not being prevented enough. Pharmaceutical companies will continue to have a field day, to research and develop new drugs and reap substantial profits, and the rest of the health care business (doctors, hospitals, pharmacies) will not be starving, either.

--

Maestro

[jdinasia]

Mods what do you think ?

Well, I am a mod – but that is entirely beside the point – and I shall attempt to tell you what I think.

For a start, I have to tell you that I am not an expert on HIV and AIDS. What I know is from reading the papers, and I have not taken a particular interest in the subject and most likely my knowledge is not up-to-date.

HIV infection is 99.9999% preventable.

I am inclined to agree that the only way to prevent a world-wide epidemic is prevention. This is where governments should spend their money.

As I said, I may not be up-to-date on the subject, but this is the current state of my knowledge:

1. AIDS is not curable. Any treatment, expensive or cheap, will only prolong the patient’s life.

2. HIV is treated with antiviral/retroviral drugs – I am not too familiar with the jargon – and this treatment will delay the onset of AIDS and in some cases will prevent the break-out of AIDS.

The life-prolonging treatment has a positive effect. It permits the patient to continue to work, to provide for his family, in essence to contribute to the gross national product (GNP). The other side of the coin is that the cost of the treatment is a drain on the GNP, but on balance it should be a net gain, hence the clamour for cheaper drugs.

Someone working in the field would consider that wives are usually NOT in a position to insist that the husband MUST WEAR A CONDOM ... etc etc ....

"Hi honey ... you have a penis so I no longer trust you ... even though we have been married 20 years ... start wearing a condom!" ... yeah that would work!

In this scenario given by jdinasia – and I grant that it is a very realistic scenario – let us assume that the wife, infected by her husband, is not promiscuous but that the HIV-infected husband continues to philander. He infects other, previously HIV-free woman, who in turn infect other, previously HIV-free men, and this cycle continues ad infinitum.

Now, I am going to say something that is very cruel, and any lambasting I may get for it will be fully warranted. Remember the outbreak of the Ebola virus in some African country a few years ago? I read an article where an epidemiologist explained that Ebola was not likely to cause a world-wide epidemic because infected persons died within a few days and thus had very little time to infect other persons and as a result very few other persons could get infected. Would it, then, not be better to leave HIV-infected persons untreated so that they should have a shorter remaining life span during which to infect other persons?

I give the answer myself: it would slow down the epidemic, but not prevent it or stop it. Even without treatment, a HIV-infected person will live up to another 10 years, or longer, if my limited knowledge on the subject is correct. In other words, the real problem of HIV is that it does not kill the infected persons fast enough. Which brings me back to the belief I expressed at the beginning: only prevention can rid the world of HIV and AIDS, unless a vaccine becomes available soon and everybody gets vaccinated.

So, whoever it was who called for mod action on Pepe’s posts: both Pepe and Jdinasia are correct, in my humble opinion. HIV is preventable, but it is not being prevented enough. Pharmaceutical companies will continue to have a field day, to research and develop new drugs and reap substantial profits, and the rest of the health care business (doctors, hospitals, pharmacies) will not be starving, either.

--

Maestro

Maestro ---- with an incubation period between 2 and 10 years before having symptoms ... your logic fails ....

Pepe ... life is not curable ... everyone dies

Edited March 16, 2007 by jdinasia

[Pepe']

Mods what do you think ?

Well, I am a mod – but that is entirely beside the point – and I shall attempt to tell you what I think.

For a start, I have to tell you that I am not an expert on HIV and AIDS. What I know is from reading the papers, and I have not taken a particular interest in the subject and most likely my knowledge is not up-to-date.

HIV infection is 99.9999% preventable.

I am inclined to agree that the only way to prevent a world-wide epidemic is prevention. This is where governments should spend their money.

As I said, I may not be up-to-date on the subject, but this is the current state of my knowledge:

1. AIDS is not curable. Any treatment, expensive or cheap, will only prolong the patient’s life.

2. HIV is treated with antiviral/retroviral drugs – I am not too familiar with the jargon – and this treatment will delay the onset of AIDS and in some cases will prevent the break-out of AIDS.

The life-prolonging treatment has a positive effect. It permits the patient to continue to work, to provide for his family, in essence to contribute to the gross national product (GNP). The other side of the coin is that the cost of the treatment is a drain on the GNP, but on balance it should be a net gain, hence the clamour for cheaper drugs.

Someone working in the field would consider that wives are usually NOT in a position to insist that the husband MUST WEAR A CONDOM ... etc etc ....

"Hi honey ... you have a penis so I no longer trust you ... even though we have been married 20 years ... start wearing a condom!" ... yeah that would work!

In this scenario given by jdinasia – and I grant that it is a very realistic scenario – let us assume that the wife, infected by her husband, is not promiscuous but that the HIV-infected husband continues to philander. He infects other, previously HIV-free woman, who in turn infect other, previously HIV-free men, and this cycle continues ad infinitum.

Now, I am going to say something that is very cruel, and any lambasting I may get for it will be fully warranted. Remember the outbreak of the Ebola virus in some African country a few years ago? I read an article where an epidemiologist explained that Ebola was not likely to cause a world-wide epidemic because infected persons died within a few days and thus had very little time to infect other persons and as a result very few other persons could get infected. Would it, then, not be better to leave HIV-infected persons untreated so that they should have a shorter remaining life span during which to infect other persons?

I give the answer myself: it would slow down the epidemic, but not prevent it or stop it. Even without treatment, a HIV-infected person will live up to another 10 years, or longer, if my limited knowledge on the subject is correct. In other words, the real problem of HIV is that it does not kill the infected persons fast enough. Which brings me back to the belief I expressed at the beginning: only prevention can rid the world of HIV and AIDS, unless a vaccine becomes available soon and everybody gets vaccinated.

So, whoever it was who called for mod action on Pepe’s posts: both Pepe and Jdinasia are correct, in my humble opinion. HIV is preventable, but it is not being prevented enough. Pharmaceutical companies will continue to have a field day, to research and develop new drugs and reap substantial profits, and the rest of the health care business (doctors, hospitals, pharmacies) will not be starving, either.

--

Maestro

--------------------------

Meastro,

Thank you for your very well thought out and objective reply. Especially for one who says he is not well versed about HIV.

I've been dealing with these patients for years. Sometimes I think it's killing me...

[Maestro]

Maestro ---- with an incubation period between 2 and 10 years before having symptoms ... your logic fails ....

You are right – and thank you for that information about the incubation period.

I didn’t realise there was any logic in my post. If you mean my question whether it would not be better to leave HIV-infected persons untreated so that they should have a shorter remaining life span during which to infect other persons, I agree with you that it would not eradicate HIV and AIDS.

If you refer to my conclusion that only prevention will eradicate HIV and AIDS I agree with you that there is not enough prevention to achieve eradication, if that is what you mean with failure. In view of the incubation period and assuming that the HIV-infected man in your scenario lacks sufficient knowledge about the risk of infection and the need for protection, and in fact does not know that he is infected, during the two to ten years until he develops symptoms, consults a doctor and is diagnosed correctly he can and probably will infect a number of other people, and these in turn will infect more people.

Which brings me back to the point that governments should spend more money on prevention, ie education about the risks and the need for protection. I know it won’t happen, not to a sufficient degree, and we do not need to debate this point here. There is another forum, Health, Body and Medicine, better suited for such discussion.

So, let us all get back on topic: Thailand Blacklisted From Receiving New AIDS Drugs

I have no love lost for Abbott – but that’s another story. I was under the impression that the WTO Agreement stipulated that a country’s government would have to initiate negations with the patent holder before issuing a compulsory licence but according to this post this is not necessary. Anyway, negotiations did take place, at the initiative of Abbott, who offered a small reduction in the annual cost of treatment, considered unacceptable by the Thai authorities. Was it clever of Abbott to then announce publicly that it will not bring new drugs to the Thai Market? I think it was not.

--

Maestro

[Ijustwannateach]

I'm cleaning things up a bit.

Pepe, more name-calling against the straight, married, heterosexual Thai men that you are potentially incorrectly blaming for spreading the disease and you'll get a holiday. Your medical points do not depend on gratuitous insults and they have been deleted along with all messages which refer to them. It might also be nice if we saw some of that "cutting edge" material you claim to be associated with in your own institution, rather than cut-n-paste from the USNIH website- perhaps in a new HIV thread in the Health subforum, where it would be more topical?

I've also removed an off-topic squabble, which I don't expect to see continue here. It would be nice if we all stayed more on topic for a little while.

[backflip]

"Which brings me back to the point that governments should spend more money on prevention, ie education about the risks and the need for protection."

"Education" generally doesn't work. A decade ago, SH shut down the gay bathhouses, and the HIV infection rate dropped quickly. Several lawsuits later, SF was forced to allow the bathhouses to reopen and...the HIV rate went through the roof. The methods of AIDs transmission is no secret, but are ignored.

[endure]

"Which brings me back to the point that governments should spend more money on prevention, ie education about the risks and the need for protection."

"Education" generally doesn't work. A decade ago, SH shut down the gay bathhouses, and the HIV infection rate dropped quickly. Several lawsuits later, SF was forced to allow the bathhouses to reopen and...the HIV rate went through the roof. The methods of AIDs transmission is no secret, but are ignored.

Education often work quite well viz. Khun Meechai and Cabbages & Condoms. It works well in co-operative societies and poorly in societies that value individualism.

[slimdog]

May 1983

April 17th 2003

April 18th 2003

These dates are quite important to me. April 17th was probably the worst day of my life, yet the following day was one of the happiest days of my life. On the 17th I was diagnosed as having advanced stage hiv, otherwise known as AIDS, the following day I along with my wife and children learned that they were all hiv-. The earlier date was the date I got infected. It wasn't intentional, it wasn't through promiscuous sex or using drugs, neither of which I have ever engaged in, it was a simple blood transfusion. Unfortunetely for me, testing of blood for hiv didn't start to happen until later on that year.

For some reason I managed to go 20 years, before I was diagnosed. I wouldn't say that the 20 years were entirely free of health problems, but all the probems I did have were minor, mostly a boil, which would appear, burst within a few days, and not re-appear for a year or two. Towards the beginning of 2000 the boils would appear a little more frequently, maybe every 4 - 6 months, but I was always able to link it with work, being both tiring and stressfull. The last thing I worried about was AIDS.

Prior to 2003, my wife had 2 AIDS tests, each time she got pregnant, the hospital would check for hiv along with confirming the pregnancy,all were clear. Yet for so many women, what is supposed to be one of the happiest days of their lives turns into a nightmare. Thankfully today, especially in places like Thailand, where most women get confirmation of pregnancy in hospitals (and therefore are hiv tested) the women are able to take ARV medication to minimize the chance of mother to child transmission. One of the wonderful things about newer ARV medication is that with each new drug that is introduced, the toxicity of the drug is reduced whilst still combating the disease.

ARV medication won't cure the disease, but doctors are now believing that close to normal lifespans can be achieved. It doesn't come without risk, but doctors are learning exactly what to look out for, what tests to perform etc in order to mimimize those risks.

Right from the beginning of the AIDS pandemic, healthcare officials have acknowledged that the only real way to combat the disease is through prevention. The problem is that the most effective form of prevention is by using Fear. Ironically, for a disease that attacks the immune system, being bombarded with "Prevention through Fear", actually increases peoples immunity, and they switch off. But the effect is that some of that Fear is transmitted, not in prevention, but in the way that the General Public deals with AIDS infected people. The fact is, that some of the most educated people, Westerners, are actually the worst offenders.

One of the first things I asked my doctor back in 2003 was how I could prevent both my wife, and in particular, my children from contacting the disease from me. His answer was quite simple, "The chance of you infecting your children is about zero, but be very careful around your children whenever they get ill, remember, your immune system is also about zero". At the time, my CD4 count (One of the measurements for the immune system) was less than 1% of what it should have been...

Anyway Maestro, thanks for letting me live

Pepe, All I will say is that I pray that you show a little more compassion to the patients you say you are taking care of than you have shown in earlier posts. But just to be on the safe side,I will take your advise and insist on a condom, the next time I have a blood transfusion...

Edited March 17, 2007 by slimdog

[ColPyat]

But just to be on the safe side,I will take your advise and insist on a condom, the next time I have a blood transfusion...

[Pepe']

I'm cleaning things up a bit.

Pepe, more name-calling against the straight, married, heterosexual Thai men that you are potentially incorrectly blaming for spreading the disease and you'll get a holiday. Your medical points do not depend on gratuitous insults and they have been deleted along with all messages which refer to them. It might also be nice if we saw some of that "cutting edge" material you claim to be associated with in your own institution, rather than cut-n-paste from the USNIH website- perhaps in a new HIV thread in the Health subforum, where it would be more topical?

I've also removed an off-topic squabble, which I don't expect to see continue here. It would be nice if we all stayed more on topic for a little while.

--------------------------------------------

I'm honestly confused. What rule am I in danger of breaking?

Also the Owen Clinic,that I claim to be associated with, doesn't have web site that I can cut and paste some of that "cutting edge" research from.

If you do have a specific question I would be happy to try and answer it.

Good Health,

Pepe'

[AGareth2]

The question surely is, as Anne Rand highlighted in her book Atlas Shrugged ,whether the owner of property has the right to deal with it as they choose.

[kdvsn]

I'm cleaning things up a bit.

Pepe, more name-calling against the straight, married, heterosexual Thai men that you are potentially incorrectly blaming for spreading the disease and you'll get a holiday. Your medical points do not depend on gratuitous insults and they have been deleted along with all messages which refer to them. It might also be nice if we saw some of that "cutting edge" material you claim to be associated with in your own institution, rather than cut-n-paste from the USNIH website- perhaps in a new HIV thread in the Health subforum, where it would be more topical?

I've also removed an off-topic squabble, which I don't expect to see continue here. It would be nice if we all stayed more on topic for a little while.

--------------------------------------------

I'm honestly confused. What rule am I in danger of breaking?

Also the Owen Clinic,that I claim to be associated with, doesn't have web site that I can cut and paste some of that "cutting edge" research from.

If you do have a specific question I would be happy to try and answer it.

Good Health,

Pepe'

Your offences are two fold. First, you injected talk of personal responsibility into a thread hel_l-bent on blaming all the world's ills on capitalism in general and America in particular. Second, you are an American, and therefore ignorant and incapable of learning.

There are only three things that you need to know about HIV/AIDS:

1) AIDS was caused by Ronald Reagan.

2) It has been propagated by greedy capitalists.

3) It is all the fault of Americans.

If you think otherwise, well, that must be because you are an American and possibly a Fundamentalist Christian.

[Pepe']

Pepe, All I will say is that I pray that you show a little more compassion to the patients you say you are taking care of than you have shown in earlier posts. But just to be on the safe side,I will take your advise and insist on a condom, the next time I have a blood transfusion...

Again someone please tell me what I said wrong. I can only gather that when I said it was all due to karma was not well received.

[Pepe']

I'm cleaning things up a bit.

Pepe, more name-calling against the straight, married, heterosexual Thai men that you are potentially incorrectly blaming for spreading the disease and you'll get a holiday. Your medical points do not depend on gratuitous insults and they have been deleted along with all messages which refer to them. It might also be nice if we saw some of that "cutting edge" material you claim to be associated with in your own institution, rather than cut-n-paste from the USNIH website- perhaps in a new HIV thread in the Health subforum, where it would be more topical?

I've also removed an off-topic squabble, which I don't expect to see continue here. It would be nice if we all stayed more on topic for a little while.

--------------------------------------------

I'm honestly confused. What rule am I in danger of breaking?

Also the Owen Clinic,that I claim to be associated with, doesn't have web site that I can cut and paste some of that "cutting edge" research from.

If you do have a specific question I would be happy to try and answer it.

Good Health,

Pepe'

Your offences are two fold. First, you injected talk of personal responsibility into a thread hel_l-bent on blaming all the world's ills on capitalism in general and America in particular. Second, you are an American, and therefore ignorant and incapable of learning.

There are only three things that you need to know about HIV/AIDS:

1) AIDS was caused by Ronald Reagan.

2) It has been propagated by greedy capitalists.

3) It is all the fault of Americans.

If you think otherwise, well, that must be because you are an American and possibly a Fundamentalist Christian.

--------------

Thanks, I'm glad we got that cleared up

[ChiangMaiAmerican]

For anyone interested, below is the link to some statistics on the demographics of HIV transmission in Thailand from the US Institute of Medicine. The studies were done in 2004 so ther may be some change. At that time there had been significant reductions in all major groups except IV drug users.

http://www.iom.edu/Object.File/Master/31/6...%20Thailand.pdf

During my active career in the US there was a period I cared for a lot of AIDs patients both pre and post protease inhibitors. I didn't plan it that way in fact I never wanted to care for AIDs patients. I learned a lot from my patients For several years I was specifically requested by an AIDs agency largely because I always try to approach patients from a non-judgemental standpoint.

My first patient was one who innocently contracted HIV from an infusion of clotting factors. She had a rare bleeding disorder made even rarer because hereditary bleeding disorders are not usually found in women. Like nearly all hemophyliacs in the US early in the Aids epidemic, she was given pooled cyroprecipitate containing the HIV virus. She died before the advent of protease inhibitors. I also cared for straight couples and individuals and gay couples and individuals of every race. In every instance these patients were just ordinary people. They had the same hopes and dreams as all of us. They had the same fear of death as most people. In many instances I was the ear that listened as they learned to cope with their own mortality. They had family's who loved them and who grieved at their passing.

As with poor people who are also often medically neglected, most who sit in judgement have never spent even a minute getting to know HIV patients as individuals. They pass judgement without having even a glimpse of the individual faces.

Edited March 17, 2007 by ChiangMaiAmerican

[kdvsn]

...

Edited March 17, 2007 by kdvsn

[Prakanong]

MSF condemns US drugmaker's ban in Thailand

Aid charity Medecins sans Frontieres (MSF) has condemned a US drugmaker's decision not to sell new medicines in Thailand, which is at loggerheads with Western pharmaceutical giants over generic drugs.

Chicago-based Abbott Laboratories said this week it would not market new drugs in Thailand in protest at the government's decision to override the patent on Abbott's anti-Aids drug Kaletra.

The medications withdrawn from the Thai market include a new version of Kaletra, as well as an antibiotic and a painkiller, a senior company official said.

MSF (Doctors without Borders) slammed the US giant's decision and argued Thai patients would "bear the brunt of Abbott's harsh decision."

"Our patients in Thailand, who still use the old version of the medicine, have been waiting for this new version for a very long time," David Wilson of MSF in Thailand said in a statement.

"The drug was registered in the US in October 2005, but still cannot be used in Thailand and many other countries where it is desperately needed. Refusing to sell the drug here is a major betrayal to patients," he said.

Abbott, for its part, accused Thailand of breaking patents "on numerous medicines."

Agence FrancePresse

I find this funny by MSF - they want it both ways the hypocritres.

They do admirable work on the ground in disaster area's but their political campaigning is getting in the way.

[Prakanong]

I'm cleaning things up a bit.

Pepe, more name-calling against the straight, married, heterosexual Thai men that you are potentially incorrectly blaming for spreading the disease and you'll get a holiday. Your medical points do not depend on gratuitous insults and they have been deleted along with all messages which refer to them. It might also be nice if we saw some of that "cutting edge" material you claim to be associated with in your own institution, rather than cut-n-paste from the USNIH website- perhaps in a new HIV thread in the Health subforum, where it would be more topical?

I've also removed an off-topic squabble, which I don't expect to see continue here. It would be nice if we all stayed more on topic for a little while.

--------------------------------------------

I'm honestly confused. What rule am I in danger of breaking?

Also the Owen Clinic,that I claim to be associated with, doesn't have web site that I can cut and paste some of that "cutting edge" research from.

If you do have a specific question I would be happy to try and answer it.

Good Health,

Pepe'

A cutting edge health clinic does not have a web site nor a place to publish its cutting edge research???

I work at a cutting edge company in the health care industry and can guarantee you we have many sites and our Dr's are required to publish all studies in the region I work in - this is in both ours and the public interest

[ChiangMaiAmerican]

Apparently our friend doesn't realize the Owen Clinic does have a website. It even hasd its own webmaster, " Mark is from San Diego and has been with the Clinic since 1998. He is the author and webmaster of the Owen Clinic website ". Owen Clinic is part of the University of California San Diego Medical Center. Information on the Owen Clinic can be found here:

http://health.ucsd.edu/specialties/owen.asp

This link is to the staff directory (includes volunteer staff):

http://health.ucsd.edu/specialties/owen/staff.htm

And this from the US Navy about the Owen Clinic:

"The UCSD Owen Clinic, established in 1982, is a multidisciplinary primary care clinic for adults with HIV infection. The clinic currently cares for over 2600 patients with support of the Ryan White Care Act. The Owen Clinic is the home of the San Diego AIDS Education and Training Center (AETC), which provides clinical training through a mini-residency program for physicians, nurse practitioners, physician assistants, and registered nurses."

The University of California San Diego Medical Center is heavily involved in HIV research. The Owen Clinic itself however would appear to a treatment and training center rather than a research center.

Again from the US Navy:

"UCSD has been among the leading academic institutions worldwide in HIV research since early in the AIDS epidemic. Following seminal observation on zidovudine therapy and the cognitive impact of HIV infection in the mid-1980s, UCSD emerged as a leader in the diagnosis and treatment of HIV and its clinical and behavioral complications. Internationally recognized programs were developed during the 1990s and grounded in productive collaboration by multidisciplinary groups of investigators. Over the past 16 years, UCSD faculty members have made a large number of primary, and often seminal, observations in the areas of basic virology, clinical virology and pathogenesis, experimental therapeutics, and neurobehavioral and health services research."

http://www.nhrc.navy.mil/programs/dhapp/tr...troduction.html

Edited March 17, 2007 by ChiangMaiAmerican

[ChiangMaiAmerican]

Another bit of information. The University of California San Diego Medical Center does have a website for the AntiViral Research Center they operate. The center's mission is, "is to develop and provide the highest-quality treatment and care for people living with HIV."

The wesite is here: http://avrctrials.org

They also list clinical trials on the site and publish an online newsletter discussing some of their cutting edge research. A sample of the newsletter is here:

http://avrctrials.org/Newsletter/2006_Fall..._Newsletter.pdf

Edited March 17, 2007 by ChiangMaiAmerican

[Flysiam]

Your offences are two fold. First, you injected talk of personal responsibility into a thread hel_l-bent on blaming all the world's ills on capitalism in general and America in particular. Second, you are an American, and therefore ignorant and incapable of learning.

There are only three things that you need to know about HIV/AIDS:

1) AIDS was caused by Ronald Reagan.

2) It has been propagated by greedy capitalists.

3) It is all the fault of Americans.

If you think otherwise, well, that must be because you are an American and possibly a Fundamentalist Christian.

Finally someone wo sees the light kdvsn for King of America!!!!!

[madi]

Often it is useful to understand something by reversing the game.

What would Thailand think it it s major company, Thai owned, was having its drug stolen by the United States or a European government? Of course Thailand would be outraged. They would be right to be angry and retaliate by refusing to sell those nations new drugs.

If you buy stock in a company, why would you continue to own it if governments were stealing from the company and the company stopped making profits? You would not. Companies would die and no drugs would be made.

No profit--no new drugs.

End of story

I know you from the left will never give up your hate for those who make more money than you but even you know that the governments are very poor at running businesses.

Why is it the communist Cuban government has not made your new drugs?

[gummy]

Often it is useful to understand something by reversing the game.

What would Thailand think it it s major company, Thai owned, was having its drug stolen by the United States or a European government? Of course Thailand would be outraged. They would be right to be angry and retaliate by refusing to sell those nations new drugs.

If you buy stock in a company, why would you continue to own it if governments were stealing from the company and the company stopped making profits? You would not. Companies would die and no drugs would be made.

No profit--no new drugs.

End of story

I know you from the left will never give up your hate for those who make more money than you but even you know that the governments are very poor at running businesses.

Why is it the communist Cuban government has not made your new drugs?

[/quote

re-arrange this phrase into another well known phrase or saying:-

"Talking arse stop your out of"

Then follow it !

Edited March 18, 2007 by gummy

[madi]

Another highly educated post from the left.

HAAAA HAAAAA

Whatever you say Red.

[garro]

Often it is useful to understand something by reversing the game.

What would Thailand think it it s major company, Thai owned, was having its drug stolen by the United States or a European government? Of course Thailand would be outraged. They would be right to be angry and retaliate by refusing to sell those nations new drugs.

If you buy stock in a company, why would you continue to own it if governments were stealing from the company and the company stopped making profits? You would not. Companies would die and no drugs would be made.

No profit--no new drugs.

End of story

I know you from the left will never give up your hate for those who make more money than you but even you know that the governments are very poor at running businesses.

Why is it the communist Cuban government has not made your new drugs?

Hmm, I think somebody has been watching a bit too much Fox news and has begun to believe it. This is the level of argument I would expect from a ten year old.

Drugs are not discovered by companies but by people many of who genuinely want to help their fellow man. Many of these drugs are adapted from from medicines/herbs already in existence. The drug companies hold onto patents for drugs they have 'discovered' for longer then the law permits by making slight (often non-therapeutic) changes and getting new patents.

The problem is not that I begrudge drug companies money they have earned but I object to the fact that their open greed means fellow humans will die. It is not only 'lefties' who object to this but also many people who could be considered from the right.

I am sorry to hear that you see nothing objectionable in this greed which costs so many lives.

[nick2k]

Often it is useful to understand something by reversing the game.

What would Thailand think it it s major company, Thai owned, was having its drug stolen by the United States or a European government? Of course Thailand would be outraged. They would be right to be angry and retaliate by refusing to sell those nations new drugs.

If you buy stock in a company, why would you continue to own it if governments were stealing from the company and the company stopped making profits? You would not. Companies would die and no drugs would be made.

No profit--no new drugs.

End of story

I know you from the left will never give up your hate for those who make more money than you but even you know that the governments are very poor at running businesses.

Why is it the communist Cuban government has not made your new drugs?

Hmm, I think somebody has been watching a bit too much Fox news and has begun to believe it. This is the level of argument I would expect from a ten year old.

Drugs are not discovered by companies but by people many of who genuinely want to help their fellow man. Many of these drugs are adapted from from medicines/herbs already in existence. The drug companies hold onto patents for drugs they have 'discovered' for longer then the law permits by making slight (often non-therapeutic) changes and getting new patents.

The problem is not that I begrudge drug companies money they have earned but I object to the fact that their open greed means fellow humans will die. It is not only 'lefties' who object to this but also many people who could be considered from the right.

I am sorry to hear that you see nothing objectionable in this greed which costs so many lives.

before I retired, I worked as an IT consultant for many bio-tech firms, and I assure you, they don't develop drugs solely for the good of mankind. they do it to make a living. to earn money so that they can raise a family. pay the mortgage for their house. provide food to eat.

your claim that the people who are refusing the new drugs are evil and greedy is just to avoid the obvious - one person stealing from another.

if you are so concerned about people dying because they are not getting the drugs they need, why don't you lobby the government you live in to provide restaurants where all people can eat for free? when you think about it, people can die if they don't have food to eat.

of course, you know this wouldn't work because then, nobody would work if they could get free food to eat. why work if you don't have to?

that was why communism the way mao, stalin, polpet, and even castro DOESN'T work. no incentives to do anything.

communism like the usa does it - WORKS! yes, you heard me right, the usa is probably more communist than all these so called communist countries. you tell me who donates the most money to the world. the usa does.

if all drugs currently existing were made free to everybody, there would be no new drugs developed in the future. the people who are capable of developing new drugs will not do so because there is no incentive for them to do so.

who in the hel_l would want to spend their own money looking for something that might not work? especially if there is no reward for doing so?

personally, I believe that people who invent new things deserve to have rewards given to them for improving mankind. they should not be looked at as greedy. without these kind of people, the drugs would not exist to begin with.

use your head - dummy.

[Mid]

use your head - dummy.

perhaps you should practice what you preach ................

if you think for one moment that you will not be personally affected by the consequences of failed HIV treatment on a National scale , well quite frankly your dreaming ...............................

[garro]

Often it is useful to understand something by reversing the game.

What would Thailand think it it s major company, Thai owned, was having its drug stolen by the United States or a European government? Of course Thailand would be outraged. They would be right to be angry and retaliate by refusing to sell those nations new drugs.

If you buy stock in a company, why would you continue to own it if governments were stealing from the company and the company stopped making profits? You would not. Companies would die and no drugs would be made.

No profit--no new drugs.

End of story

I know you from the left will never give up your hate for those who make more money than you but even you know that the governments are very poor at running businesses.

Why is it the communist Cuban government has not made your new drugs?

Hmm, I think somebody has been watching a bit too much Fox news and has begun to believe it. This is the level of argument I would expect from a ten year old.

Drugs are not discovered by companies but by people many of who genuinely want to help their fellow man. Many of these drugs are adapted from from medicines/herbs already in existence. The drug companies hold onto patents for drugs they have 'discovered' for longer then the law permits by making slight (often non-therapeutic) changes and getting new patents.

The problem is not that I begrudge drug companies money they have earned but I object to the fact that their open greed means fellow humans will die. It is not only 'lefties' who object to this but also many people who could be considered from the right.

I am sorry to hear that you see nothing objectionable in this greed which costs so many lives.

before I retired, I worked as an IT consultant for many bio-tech firms, and I assure you, they don't develop drugs solely for the good of mankind. they do it to make a living. to earn money so that they can raise a family. pay the mortgage for their house. provide food to eat.

I never said that companies were solely in the business of developing drugs for the benefit of mankind. I said there were many individuals who did do this work for the benefit of mankind. I am not sure how your job as an IT consultant can can put you in a position to comment on this. I have previously worked in hospitals where such work has been carried out.

your claim that the people who are refusing the new drugs are evil and greedy is just to avoid the obvious - one person stealing from another.

If you actually bothered to read my post you will see that one of my main objections is that drug companies re-patent drugs no longer covered by patents in order to extend their profits. They do this by making minor (often non-therapeutic) modiifications.

if you are so concerned about people dying because they are not getting the drugs they need, why don't you lobby the government you live in to provide restaurants where all people can eat for free? when you think about it, people can die if they don't have food to eat.

I don't live in a government??? I don't think that it is nice that people starve to death. I am all for free food.

of course, you know this wouldn't work because then, nobody would work if they could get free food to eat. why work if you don't have to?

that was why communism the way mao, stalin, polpet, and even castro DOESN'T work. no incentives to do anything.

I am not a communist but didn't Russia put the first man in space. That is an achievement considering, in your opinion, there is no incentive.

communism like the usa does it - WORKS! yes, you heard me right, the usa is probably more communist than all these so called communist countries. you tell me who donates the most money to the world. the usa does.

I will not reply to this as I am trying to avoid USA bashing. It would just be too easy

if all drugs currently existing were made free to everybody, there would be no new drugs developed in the future. the people who are capable of developing new drugs will not do so because there is no incentive for them to do so.

Who says? The science that medicine originated from was developed prior to capitalism.

who in the hel_l would want to spend their own money looking for something that might not work? especially if there is no reward for doing so?

The fact is that many of these drugs don't work or have devastating side effects. Have you not seen the amount of litigation against drug companies that is occuring

personally, I believe that people who invent new things deserve to have rewards given to them for improving mankind. they should not be looked at as greedy. without these kind of people, the drugs would not exist to begin with.

Many of the drugs did exist to begin with

use your head - dummy.

[Khun ?]

simple then as we know how it is transmitted then eliminate that and no drugs will be needed.

What is Thailand doing with it's Billions in reserve currency. As most Aids now days and the last several years is passed on by senseless means like prostitution and drug use. Why not stop that

and 90% of their costly problem will be gone.

Being Responsible may be to much for Thailand I guess.

Seems most of their whole countries economy is from foreign sources and technology.

They do own the rights to Jasmin rice and Karoake songs that they which they enforce.

I guess it is just too much to expect their own people to help themselves out and pay a little more tax

and act responsible. Better to let others come up with the products and technology for the fix

then try to steal it.

What a backwards way to do things in this day and age. No wonder Thailand attracts much of the

_ _ _ _ of modernized countries.