HIV/AIDS Progress

In the 30 years since it was first identified, the global response to AIDS has achieved significant results. More people than ever before have access to treatment, allowing them to manage their condition, and according to the United Nations rates of new HIV infections are falling by nearly 25 percent. In spite of these successes, it is important that efforts continue to ensure that progress is made towards further improving treatment options and outcomes.

Since 1981, a reported 25 million people worldwide have died from AIDS and an additional 34 million are infected with HIV. According to a recent United Nations report, in the 33 worst-affected countries, the rate of new HIV infections fell by 25 percent between 2001 and 2009, and in India and South Africa, the countries with the largest populations of individuals living with HIV, new infections fell by 50 percent and 35 percent, respectively. According to Michel Sidibé, Executive Director of UNAIDS, through the use of antiretroviral therapy (ART), “AIDS has moved from what was effectively a death sentence to a chronic disease…Antiretroviral therapy is a bigger game-changer than ever before – it not only stops people from dying, but also prevents the transmission of HIV to women, men and children.”

A decade ago, half of the population of several nations in southern Africa were expected to die of AIDS-related causes, but as ART has become more widely available, the death rate is dropping. An estimated 6.6 million people in low- and middle-income countries were receiving ART at the end of 2010 – a nearly 22-fold increase since 2001. In spite of this increase, reports indicate that there are 16 million people worldwide living with HIV/AIDS who could benefit from these medications but many do not receive them. Even in the United States and other developed nations, individuals living with HIV/AIDS are frequently put on long waiting lists to gain access to these life-saving drugs as the supply is not able to meet the demand for them.

While expanded access to ART can help to improve the lives of individuals with HIV/AIDS and help to prevent new infection, a major gap in treatment still exists. Access to treatment for children is significantly lower than for adults, and only 28 percent of all eligible children were receiving treatment in 2009, compared with 36 percent for people of all ages. In addition, while the rate of new HIV infections globally has declined, the total number of individuals with HIV remains high and certain groups, including women of reproductive age, remain at increased risk of infection. By ensuring that antiretroviral medications and education and treatment programs are widely available, it may be possible to further decrease the number of new HIV/AIDS infections worldwide as researchers continue to work to track the spread of the disease and find a cure.



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On Alzheimer's Disease

Dementia is not a specific disease, but rather a group of symptoms affecting intellectual and social functioning. The most common form is a progressive form of presenile dementia first identified in 1906 by Dr. Alois Alzheimer, known as Alzheimer’s disease. Experts indicate that the number of individuals with Alzheimer’s worldwide could increase from 35.6 million to 65.7 million by 2030, due in part to the growth in aging populations. Additional reports indicate that in the U.S. alone there are currently 5.3 million people living with the disease, and this figure is projected to increase to 16 million by 2050. While there is no cure for Alzheimer’s disease, through treatment and education, it may be possible to improve outcomes for those with the condition.

Accounting for 50 to 80 percent of dementia cases, Alzheimer’s disease is marked by the loss of intellectual and social abilities severe enough to interfere with an individual’s daily functioning. As it progresses, Alzheimer’s disease may lead to mood swings, distrust of others, social withdrawal, and depression. Though it is not a “normal” part of the aging process, the risk of developing Alzheimer’s disease increases with age. Approximately five percent of people between the ages of 65 and 74, and nearly half of those over the age of 85 have Alzheimer’s disease. Although there is no known direct cause for the disease or means to ensure its prevention, research suggests that there may be a genetic link to the development of Alzheimer’s, and that lifestyle choices like maintaining a healthy weight and exercising one’s body and mind can at least delay the onset of the condition.

Alzheimer’s disease is most often diagnosed using a combination of blood or spinal fluid tests to rule out other possible causes of dementia, and brain scans to locate any visible abnormalities. Though doctors can accurately diagnose 90 percent of Alzheimer’s patients, the condition can only be diagnosed with complete accuracy during an autopsy. A post-mortem microscopic examination of the tissues of the brain of individuals with Alzheimer’s, reveals two abnormal structures called “Plaques” and “Tangles,” which are damaging to nerve cells. Plaques contain deposits of a protein fragment called beta-amyloid and build up between nerve cells, while twisted fibers of tau protein known as Tangles form inside dying cells. Though researchers do not yet have a full understanding of the role that Plaques and Tangles play in the progression of Alzheimer’s disease, experts believe that they block the communication among nerve cells and disrupt cell activities. Recent research has shown that Tangles may offer some insight into how quickly Alzheimer’s disease will progress in an individual, leading to the development of potentially tau-lowering drug treatments.

New research suggests that large doses of vitamin B may halve the rate of brain shrinkage in individuals with mild cognitive impairment. Though the mechanism by which B vitamins slow the progression of Alzheimer’s has not been identified, some B vitamins have been shown to control levels of homocystieine, an amino acid associated with an increased risk of Alzheimer’s. These new treatments, as well as the medications commonly used to help improve some of the symptoms of Alzheimer’s, which include cholinesterase inhibitors and memantine can help to improve the lives of individuals with Alzheimer’s. On average, these live half as long as a peer who does not have the disease – meaning that a 75-year-old diagnosed with Alzheimer’s can expect to live another six years, while a 75-year-old without the condition may live 12 years. However, because of the variance in the severity of cases and the speed with which symptoms progress, the life-expectancy of individuals with Alzheimer’s varies greatly.

Further research related to testing, diagnostic, and treatment procedures may lead to improved outcomes for individuals with Alzheimer’s. By gaining a better understanding of this condition and its causes, it may be possible to slow or halt its progression and improve the lives of millions of elderly individuals worldwide.

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