Diary Prequel Package — page 21

- creating a prize --- say, $10 million --- as incentive to the first scientific team that develops a truely safe and effective vaginal microbicide that can be affordably mass produced. (Total global current microbicide R&D is now less than $50 million, as far as I can tell.) Would that work? Just how large an intellectual problem is anti-HIV microbicides? Isn't it a helluva lot easier than coming up with a 90+% effective preventive vaccine? So, we're working on that vaccine --- FINALLY. Why not a serious commitment to the microbicides, too? (Is it the word "vaginal"?) - linking treatment tightly with prevention education, in a quid pro quo manner (tax payers are subsidizing your HAART, and you are free to live without prejudice or discrimination, stay healthy and continue to have a rich, full life. BUT, you must in return understand you have a social responsibility, and cannot knowingly do anything that might spread your virus to others. This includes females, who, you African males disdain and consider subhuman. This includes male & female prostitutes who you pay to accept risk.) I know of no rigorous case controlled study done anywhere in the world that asks whether or not this will work. Have I missed them? But clearly, in the USA and Europe, a very significant %age of HAART recipients feel NO social obligation ---- why else would we have resurgent syphilis, gonorrhea, HIV and a national 14% DRUG RESISTANT HIV rate? What I'm really asking here is whether the fine difference between "treatment" and "cure" can be fully understood, and integrated into behavior, without intense counseling, etc. Obviously we have problems with comprehension here in the richest country in the world, especially among college educated white middle class males. - reassessing the results of the Levine Report and the seeming tendency for everything at NIH to revert. Would a serious recommittment to addressing long unanswered basic science questions be in order right now? - before we start mass distributing HAART, do we know: - which of the drugs are heat sensitive? What is the half life of a protease inihibitor that is stored under a tin roof in 90% humidity at consistent ambient temperatures above 90 degrees F? Are there Cold Chain issues with any aspects of HAART or OIs treatment? - which of the drugs have interactions with antimalarials? With antiparasitics? With rotgut booze? with other drugs that have undergone chemical change due to storage in above conditions? - what percentage of the target populations have TB, and what %age of deaths in the local HIV pop are due to TB? Do we know everything we need to know to guide co-treatment of TB and HIV with TB-DOTS and HIV_DOTS? - why TB DOTs has largely failed globally, resulting in MDR-TB strains surfacing in 112 nations over the last 6 years (when it was limited