Aids Drugs

KANSAS CITY, Mo. -- Early next month, someone at the Missouri Department of Health will pull 132 random numbers from a computer, and all over the state people with AIDS will find out which of them has a chance at a longer, healthier life.Faced with need that outstrips its budget, Missouri will hold the nation's first lottery to decide who gets costly new AIDS drugs called protease inhibitors.Protease inhibitors combined with older drugs such as AZT can reduce the amount of HIV -- the AIDS virus -- in some patients' blood to virtually undetectable levels and prolong their lives.

It's been a busy year so far at Powell Recovery Center in Upper Fells Point. About 40 new clients have walked into the drug treatment center since the state expanded substance-abuse coverage for low-income Maryland residents Jan. 1. State officials hope that getting more addicts into treatment will ease a major backlog, especially in Baltimore. While some centers worry that the expansion will prove burdensome, Powell Recovery's president sees only an upside: He predicts his center will be able to serve more than 2,000 drug users this year, up from 1,500 last year.

WASHINGTON -- In some of the strongest evidence thus far that a new generation of AIDS drugs can inhibit the human immunodeficiency virus, scientists yesterday reported that HIV became virtually undetectable in most patients six months after starting treatment with one of the new drugs in combination with two standard ones."

Rite Aid Inc. took over 25 Eckerd stores in Maryland yesterday, including nine in the Baltimore region, shoring up its position as the second-largest drugstore chain in the state. The Maryland stores are part of Rite Aid's $4 billion deal for the Brooks and Eckerd chains, which was announced in August and completed yesterday. In all, Rite Aid bought 1,854 Brooks and Eckerd stores, and six distribution centers in 18 states, making it the largest drugstore chain on the East Coast, the company said.

Gov. Parris N. Glendening submitted a supplemental budget yesterday that includes money to hire four extra Circuit Court judges for Baltimore and provide new AIDS-fighting drugs to more than 1,200 low-income residents.By recommending that the state spend $469,000 to hire the judges and nearly $78,000 for four clerks to support them, Mr. Glendening has cast his support for Baltimore lawyer and Orioles owner Peter Angelos, who has sought the additional judges to handle a backlog of asbestos-related cases.

WASHINGTON -- The Bush administration announced a significant shift in its AIDS policy yesterday, expediting the approval process for generic and combination anti-retroviral drugs so they can be bought at lower prices and provided more efficiently and safely to millions of infected people in Africa and the Caribbean. The expedited process is also designed to encourage manufacturers to create a single pill, consisting of two or three licensed anti-retroviral drugs that are more potent when taken together.

WASHINGTON -- The Food and Drug Administration has approved the antiviral AIDS drug DDC, but only to be used in combination with AZT, the most widely prescribed AIDS antiviral therapy.Also known as dideoxycytidine and zalcitabine, DDC is the third AIDS antiviral drug to be licensed since 1987, when AZT was approved. Last fall, the FDA approved the antiviral DDI.Antiviral drugs are considered the major tools in the fight against AIDS because they attack the underlying viral condition, rather than the individual infections and other illnesses that result from a damaged immune system.

WASHINGTON -- Rattled by a series of embarrassing demonstrations last week, members of Al Gore's campaign and White House staffs met with AIDS activists yesterday to try to persuade them that the vice president is trying to reduce the cost of AIDS drugs in Africa. But the activists emerged undaunted and unconvinced, pledging they would go forward with a planned series of protests, including an anti-Gore rally Monday night in Philadelphia. "It's full speed ahead," said Wayne Turner, a member of the AIDS group ACT-UP, who met with the Gore campaign's political director, Donna Brazile.

WASHINGTON - Bristol-Myers Squibb announced yesterday that it will sell AIDS medicines for less than $1 a day to countries in Africa, making it the latest company to enter into an escalating global drug price rivalry. With sub-Saharan Africa devastated by AIDS, pharmaceutical companies are under growing moral, political and economic pressure to help relieve the suffering of millions of diseased and impoverished people there. The drug companies recently have begun to respond, but their efforts remain controversial.

WASHINGTON -- The United States and South Africa have reached an agreement aimed at resolving a looming trade dispute over the production of patented drugs to treat AIDS.The U.S. trade representative, Charlene Barshefsky, announced Friday that South Africa had pledged to abide by World Trade Organization rules when it enacts a new law intended to make it easier to import and produce the drugs locally at lower costs.The United States, in turn, pledged to drop its demands that South Africa revise parts of the law that had prompted a legal challenge by U.S. and international pharmaceutical companies.

LOS ANGELES -- An experimental AIDS drug, part of a new class of medicines known as integrase inhibitors, worked faster in controlling HIV than one of the most widely used drugs on the market, according to a preliminary study released yesterday. The integrase inhibitor, used in a drug cocktail with two others, cut the amount of HIV in 90 percent of patients to undetectable levels in 24 weeks. Much of the reduction occurred in the first four to eight weeks, said Dr. Robin Isaacs, who led the research.

WASHINGTON -- AIDS and HIV patients, who have been seeking ever simpler treatments since struggling with a complicated regimen of as many as 25 pills a day a decade ago, can now take one daily pill. The new pill, Atripla, was approved yesterday by the Food and Drug Administration after an accelerated three-month review reflecting the major public health benefits anticipated by activists, doctors and health officials. Dr. Andrew C. von Eschenbach, the acting FDA commissioner, hailed the combination drug as a "landmark" that would "fundamentally change treatment" of acquired immune deficiency syndrome and the virus causing it. Since the difficult early days of treatment, AIDS cocktails have become simple enough that some patients swallow just a few medications a day. Atripla melds three widely prescribed drugs that have been available for several years and are often taken together.

UNITED NATIONS -- A three-day AIDS conference set a goal yesterday of doubling spending to slow the spread of the disease, and 14 countries announced an airline ticket tax to fund greater access to AIDS drugs. The special session on HIV/AIDS was marked by political haggling over the mention of condoms, safe drug use and sex education. Delegates agreed to refer to condoms specifically, but language on drug use and sex education is couched in euphemisms. U.N. Secretary-General Kofi Annan pleaded with the assembled representatives, who included African presidents, foreign ministers from around the world and U.S. first lady Laura Bush, not to let politics derail future progress.

MBABANE, Swaziland - One recent morning, Themba Ginindza opened the door to this African kingdom's AIDS council headquarters and sighed in disgust. He had come to show off a new, high-tech computer system, the latest government effort to quell the wrath of HIV. With nearly 40 percent of its adults infected, the kingdom holds the grim distinction of having the highest HIV infection rate in the world. The computer system, paid for largely by international donations, could make the distribution of lifesaving AIDS drugs swift and efficient, allowing doctors and nurses even in rural areas to access medical records, order blood tests and request drug refills for thousands of patients.

WASHINGTON - As the man in charge of the Bush administration's $15 billion plan to treat millions of HIV-infected people in underdeveloped nations, Randall Tobias might expect a hero's welcome at the International AIDS Conference opening today in Thailand. Instead, the U.S. global AIDS coordinator is likely to be greeted by the protests of activists opposed to the administration's policies and to Tobias. Tobias, some activists said, could expect a reception similar to the one given Health and Human Services Secretary Tommy G. Thompson at the last conference.

WASHINGTON -- The Bush administration announced a significant shift in its AIDS policy yesterday, expediting the approval process for generic and combination anti-retroviral drugs so they can be bought at lower prices and provided more efficiently and safely to millions of infected people in Africa and the Caribbean. The expedited process is also designed to encourage manufacturers to create a single pill, consisting of two or three licensed anti-retroviral drugs that are more potent when taken together.

WASHINGTON -- Though the AIDS epidemic is taking its steepest toll in some of the poorest regions of the world, the U.S. government and the U.S. pharmaceutical industry are fighting efforts to make the latest lifesaving drugs more widely available in those countries. The battle pits the drug companies' campaign to maintain exclusive control of the manufacture and marketing of their patented medicines against the desire by some countries to issue licenses for the drugs to local companies so that they can make generic versions that are more affordable to their impoverished citizens.

In one of the first efforts of its kind, Baltimore Health Commissioner Peter L. Beilenson plans to use city vans as "mobile pharmacies" that will deliver AIDS medications to patients in the city's hardest-hit neighborhoods. The program, scheduled to begin Sept. 1 in West Baltimore, is aimed at curbing the spread of viral strains that do not respond to treatment. The problem tends to occur when people begin taking medications but stop taking them regularly. Patients visiting the vans will be encouraged to take their medications in the presence of health workers, a strategy called "directly observed therapy," which has prevented drug-resistant tuberculosis in Baltimore.

GUGULETU, South Africa - AIDS has claimed the lives of Phumela Tsodo's 9-month-old daughter and a teen-age cousin, and earlier this year it nearly brought an early end to her own life, shriveling her to 55 pounds from 124 and leaving her hospitalized for months. But on a recent morning in the dimly lighted hallway of Guguletu Township's Community Health Center, Tsodo sat on a long wooden bench waiting to see a doctor, beaming as if she were holding a winning lottery ticket. Which in a way, she is. The soft-spoken 24-year-old is one of a handful of AIDS patients in South Africa who are receiving lifesaving AIDS drugs without charge.