The Trump administration on Tuesday has issued exemptions from life -saving drugs and medical services and provided a global HIV treatment program that stopped last week.
The exemption published by Secretary of State Marco Rubio seemed to allow the distribution of HIV drugs, but the exemption was expanded to other services, which is an urgent plan for AIDS relief provided by the program. It was not clear whether or not it was done.
Nevertheless, Pepfer's future is dangerous and has potential results to more than 20 million people, including 500,000 children, which can lose access to life -saving drugs. Without treatment, millions of HIVs in low -income countries have the risk of full -fledged AIDS and early death.
Dr. Steve Deaks, a HIV expert at San Francisco, said:
“This can't really happen,” he said.
On Monday, the Trump administration ordered health organizations in other countries to immediately stop the distribution of HIV drugs purchased with US assistance. The order is derived from the permanent frozen in Pepfar's activities, a $ 7.5 billion program directed by the State Department.
Since its launch in 2003, Pepfar has saved more than 25 million lives. More than 5.5 million children were born from the infected HIV in other ways.
In South Africa alone, the closing of Pepfar alone will add more than 500,000 new HIV infections and more than 600,000 related deaths in the next 10 years.
The organization employs 270,000 doctors, nurses, pharmacists, and other medical professionals. They were told not to report their work or provide services to patients.
At the end of Pepfer, “If Pepher's funds are used again, there is a possibility that AIDS programs in many countries will be unstable and potentially collapsed.” Dr. Sarim Abdorcarim, a university infectious epidemic, said. ,South Africa.
Dr. Abdool Karim said that the country should stop relying on Pepfar and support his citizens. This is the goal that program staff and partners were working on. But ideally, he said that the change gradually occurred, and that Pepfer would take years to train local healthcare professionals and prepare for the transition.
“This is not a bad opportunity for the country to take a bigger responsibility,” he said. “But if this kind of accident is done in a way that is out of the plan, they will not be able to do it.”
This is what he and others expect from the unexpected pause of Pepfar.
Sudden suspension of HIV treatment can be dangerous immediately.
Every day, more than 220,000 people pick up HIV medicine at the clinic where Pep fur provided funds. This number contains more than 7,400 children under the age of 15.
Drugs work by suppressing HIV in the body. When the patient takes off the drug, the virus sees the opportunity to rebound -and immediately. Within one week, the HIV level rises from an inseparable level to more than 100,000 copies per millilitle blood.
“It may be a very high risk of passing the virus to others,” said Dr. Sallie Permar, a pediatrician and HIV expert on Weill Cornell Medicine.
Next, the virus begins to attack a specific type of immune cells and inconveniates other infectious diseases, including tuberculosis, frequently associated with HIV infections.
At first, spikes at the HIV level can cause hellal symptoms, such as sore throat, swollen glands, and fatigue. The immune system may marshalling enough to temporarily suppress the virus, but HIV is mature to hide until you find an appropriate opportunity to reappear.
“They can nurture AIDS and progress,” said Deks when the opportunity occurred.
Children may be one of the most difficult hits.
Pepfar is the best -known HIV treatment program funding, but its funds are given to drugs for prevention, outreach, and tests, and have been supported by orphans and women who have experienced gender violence. It will also reach.
Dr. GLENDA Gray, a young child HIV expert in South Africa, said that the loss of these efforts would derine the battle with AIDS.
“It's unlikely that if the HIV test falls on the roadside, it is unlikely that you will be able to diagnose those who need to be treated,” she said.
If a woman in pregnancy or breastfeeding has H.IV, she has not been tested and has not been treated, so she can give her virus to her child. The higher the amount of virus, the more likely it will occur.
HIV children are less likely to be diagnosed than adults, and may not be treated until they become very ill. Dr. Gray said that this progression could be much faster than adults. “Obviously, unnecessary children are more likely to die,” he said.
Invisible treatments promote drug resistance.
If people lose access to the medicine, they may try to expand supplies alternately or to share pills with others. When viruses are reproduced to people with only partial protection, you can avoid them and learn to be resistant to drugs.
People who live with the virus can pass the resistant virus to others.
“That's a big problem. Suddenly, our inexpensive first selection may not work when we have to resume treatment,” said Dr. Abdor Calim. Ta.
For viruses that are resistant to treatment, it is better to avoid tested vaccine candidates.
“We are considering not only looking at more drug resistance, but also losing the necessary abilities to create effective vaccines,” said Palmer.
The end of Pepfer could affect Americans.
More than 1 million Americans live with viruses, and more than 30,000 people are infected each year. If HIV is resistant to drugs that are available, you will not stay in low -income countries. Americans are also dangerous.
They may also face indirect harm because they end the pepfer. Creating a huge group of immunodeficiency may mean that other pathogens have the opportunity to spread. For example, dangerous COVID variants, including Omicron, are thought to have evolved in HIV immune -failed people.
At the same time, people around the world have benefited from the exams conducted under the pepper's support, indicating the importance of treating HIV early, and safe as long as pregnant women are treated. It shows that HIV infection can be raised with breast milk and can prevent HIV infections with long -term action -type drugs.
“The United States has gained surprising amounts of love all over the world for what it has done,” said Deaks.
“From a humanitarian point of view, I can't imagine that no one really wants to follow this route,” he added. “This doesn't make sense at any level.”
