Born Free of HIV in West Africa

In the business world, people talk about “Return on Investment” or “ROI”. What’s that mean? Well, usually hat it means – what’s the reward for the funds we invest. At GAIA Vaccine Foundation, our ROI can be measured in smiles, in healthy babies who do not have HIV infection, in lives saved. What’s that ROI? Priceless. And unlike many not-for-profits, GAIA donor dollars go directly to programs. GAIA VF supporters have satisfaction of knowing that lives can be dramatically improved, and the knowledge that – during the greatest pandemic in human history, GAIA VF is leading the way.

How so? We understood the importance of improving access to treatment and invested in building the Hope Center Clinic in 2008 to make HIV treatment accessible. The clinic brings HIV medications right to patients in their neighborhood. We predicted that improving access would reduce HIV transmission, and we were right! In fact, one of the key discoveries in HIV/AIDS in recent years has been that “Treatment is Prevention”. In May 2011, a study involving 1,763 HIV-sero-discordant couples (one partner was HIV positive, the other was not) was stopped before its original closing date because an interim analysis showed a 96% reduction in the HIV transmission rate (See Cohen M.S. et al. N Engl J Med. 2011).

Based on the published data, our success at HCC and the global trend to make HIV treatment available as a means of prevention, our next step is to petition the Malian government to provide Treatment as Prevention at our HCC and follow the impact on the community. In the absence of a vaccine, if providing access to medication can lead to eradication of AIDS, we’re ready to spring into action.

What does the new finding that treating HIV can prevent HIV transmission and the call for Universal Access mean for the rest of the world? It means that the gap between the number of people needing to be treated and the funds available to make that treatment accessible just got wider. Recent reports show a 7% decrease in philanthropic donations for AIDS, from 2009. GAIA Vaccine Foundation’s achievements have proved that each donor’s support is critical to further our mission and improve access to HIV care. In this special World AIDS Day 2011 update, we are pleased to report that the support that we generously received from all our donors allowed us to go above and beyond the objectives that were set for our program.

Through donations and grants, GAIA VF created one of the first clinics in West Africa to distribute village-level HIV care. In January 2011, the Hope Center Clinic was awarded a “Ciwara” (highest honor) by the local Department of Health. As the next International AIDS Conference is taking place in Washington DC in 2012 we will be highlighting our success in oral and poster session. We just completed an evaluation of our Mother to Child HIV transmission prevention program (started in 2005) and data from the past 30 months of our universal access intervention in Sikoro have been analyzed. We are happy to share the results with you.

Assessing our PMTCT Program
In 2010 and again in 2011, volunteers from all over the world traveled to Mali to work on a major evaluation of our program. Our volunteers included Christina Gomez-Mira (U. Texas), Natasha Rybak (Brown U.), Emily Kossow (Wesleyan), Tonhu Hoang (Concord Academy), and Nick Platt (American University of Paris) worked on assessing the adult HIV care with Ali Bicki (U. Miami) while Danielle Poole (Brown MPH program) and Shahla Yekta, Ph.D. (URI) worked on the HPV vaccine studies.

Our efforts are yielding positive results. Mother to child transmission (MTCT) is near zero – only one mother transmitted the virus to her child. The mothers report that they are very satisfied with the care that they are provided at HCC’s “Chez Rosalie” (the MTCT prevention program). In 2011 a second study was conducted and a questionnaire related to both mother and children was submitted. This process allowed us to link the mothers enrolled in the PMTCT program to their newborn and previous children and identify risk factors for transmission.

PMTCT in numbers (2005-2011)
10,150   pregnant women in prenatal care
9,060     pregnant women tested for HIV
198        pregnant women diagnosed with HIV
156        newborns in care
129        babies fed with formula

Evaluating our HIV care Program
We recently evaluated the efficacy of HIV treatment with “tri-therapy” in terms of AIDS-related infections, changes in weight, and CD4 counts over a 30 month study period. More than 60% of the patients increased their weight and CD4 counts and the percentage of patients with opportunistic infections was significantly reduced.

2011 Hope Center Clinic Achievements
200     HIV-infected adults and children in care
20       newborns tested by PCR for HIV
37       children in care
86       new HIV+ patients on treatment
830     patients received nutrition support
62%    improved their viral load while under ARV
61%   of patients had opportunistic infection (OI) at beginning of therapy; <17% had OI after 7-15 months

HPV vaccine Project – Preparing for Trials
Danielle Poole (with help from Kate Tracy, University of Maryland) carried out a study to evaluate whether women (and men) in Mali are ready to accept vaccination with HPV vaccine, the newly approved vaccine that prevents cervical cancer in women and anal warts in men.

This study is supported in part by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The KAP and WTP studies will enable GAIA VF to collect information and data necessary for introducing the Gardasil vaccine in Mali; a clinical study is anticipated for next year. This project helps GAIA filed personnel develop the necessary experience, protocols, put an infrastructure in place, and also enables us to train medical personnel. The goal is to lay the groundwork for all vaccine studies to come.

December 1st is World AIDS Day: Honor the Day with a donation!
This year the UNAIDS objectives are: “Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths.” Help us stop HIV/AIDS!