[Viva] FW: CTAC Daily Info - November 3

Wed Nov 3 20:50:59 PDT 2010

In this e-mail: 

 1.    Longer Hep C Treatment Improves Response in People Coinfected With
HIV 

 2.    Liver Cancer Survival Similar in HIV-Positive and HIV-Negative People

 3.    media coverage of campaign to reform Canada's law on compulsory
licensing of pharmaceuticals for export1.

Longer Hep C Treatment Improves Response in People Coinfected With HIV
http://www.aidsmeds.com/articles/hcv_coinfection_extent_1667_19323.shtml 

November 1, 2010

People coinfected with both HIV and hepatitis C virus (HCV) who fail to
respond rapidly to HCV treatment are more likely to achieve a cure for their
HCV if they extend their treatment by at least six months. These data were
presented <http://trs.scivee.tv/node/2325>  at the American Association for
the Study of Liver Diseases being held October 29 to November 2 in Boston.

Treatment for hepatitis C has both benefits and disadvantages. When it works
well—called a sustained virological response (SVR) and defined as achieving
and maintaining undetectable HCV levels for at least six months after
completing a course of treatment—it cures people of their infection. The
treatments can be quite toxic, however, and they must be taken for at least
six months. Moreover, they frequently fail to work for people infected with
genotypes 1 and 4, especially in people infected with both HIV and HCV.

The current recommended course of HCV treatment in coinfected individuals,
which consists of pegylated interferon combined with ribavirin, is 48 weeks.
Generally, about 40 to 50 percent of people with genotypes 2 or 3, and about
25 to 30 percent of people with genotypes 1 and 4, achieve an SVR. Recent
research has found that people who have a rapid virological response (RVR),
which is an undetectable HCV level four weeks after starting treatment, are
far more likely to have an SVR after completing treatment.

To determine the likelihood of achieving an SVR, based on a person’s rapid
response, and to determine whether adding an additional three or more months
of HCV treatment would help boost treatment responses in people who failed
to control their HCV well in the first few weeks of therapy, Pablo Barreiro
and his colleagues enrolled 185 HIV and HCV coinfected people into the
EXTENT study. Six possible courses of treatment were available to
participants, depending on their genotype, their RVR and their virological
response at 12 weeks.

In people who achieved an RVR, those with genotypes 2 or 3 continued HCV
treatment for a total of six months, while those with genotypes 1 or 4
continued treatment for one year.

People who failed to achieve an RVR, and who had less than a 2 log drop in
HCV levels by week 12, stopped treatment regardless of their HCV genotype.

People who failed to achieve an RVR, but who did see a 2 log or greater drop
at week 12 continued on until the six month point, when their HCV levels
were tested again. Those who still had measurable HCV levels stopped
treatment. Those who had undetectable HCV levels either remained on therapy
for a total of 48 weeks (genotypes 2 or 3) or 72 weeks (genotypes 1 or 4).

The EXTENT study had several notable findings. First, a rapid virological
response significantly predicted the likelihood of curing a person’s
hepatitis. In those with genotypes 2 or 3, a full 66 percent achieved an SVR
after just six months of treatment, and 65 percent of those with genotypes 1
or 4 achieved an SVR after 12 months of treatment. In the genotype 1 or 4
group, this represents a nearly 250 percent increase in efficacy over
standard cure rates for such individuals.

Second, an additional length of treatment helped improve cure rates in
people who initially failed to achieve an RVR. Seventy-seven percent of
those with genotypes 2 or 3 achieved an SVR with the longer 48-week duration
of treatment, while 62 percent of those with genotypes 1 or 4 achieved an
SVR after 72 weeks of treatment.

In contrast, the standard treatment duration worked miserably in people who
initially failed to control virus at four weeks. Just 17 percent of those
with genotypes 2 or 3 achieved an SVR after six months of treatment, and
only 9 percent of those with genotypes 1 or 4 had an SVR after the standard
12 months of therapy.

These data offer hope and guidance to people coinfected with HIV and HCV who
cannot wait for newer HCV therapies to become available and who must decide
whether to start HCV treatment and how long to take it.

2.

Liver Cancer Survival Similar in HIV-Positive and HIV-Negative People

http://www.aidsmeds.com/articles/hiv_hepatitis_cancer_1667_19331.shtml

November 2, 2010

Three-year survival rates after a diagnosis of hepatocellular carcinoma
(liver cancer) are similar between people living with HIV and HIV-negative
people, according to a study presented
<http://aasld2010.abstractcentral.com/planner?NEXT_PAGE=ITINERARY_ABS_DET_PO
P&SESSION_ABSTRACT_ID=665375&ABSTRACT_ID=894963&SESSION_ID=69606&PROGRAM_ID=
2691>  at the American Association for the Study of Liver Diseases being
held October 29 to November 2 in Boston.

Liver disease and liver cancer have become some of the leading causes of
illness and death in people with HIV in recent years—particularly among
people coinfected with hepatitis C virus (HCV) or hepatitis B virus (HBV).
What’s more, some studies have suggested that people with HIV are more
likely to progress to liver cancer and have more aggressive disease than
HIV-negative people. These studies, however, have often been quite small,
and their study designs have differed.

To better understand survival following a liver cancer diagnosis in people
with HIV, Anne Gervais, MD, from the Hopital Bichat in Paris, and her
colleagues examined the medical records of 687 people diagnosed with liver
cancer, 23 of whom were HIV positive.

Most all of the HIV-positive participants were coinfected with HCV or HBV,
nearly all were taking HIV antiretroviral (ARV) therapy, and the majority
had a CD4 count over 200 at the time of their cancer diagnosis. In most
regards, the HIV-positive and HIV-negative study volunteers were similar,
but the HIV-positive participants were much younger at the time of their
cancer diagnoses—49 years old on average—than the HIV-negative participants,
where the average age was 58.

Gervais’s team found that rigorous screening, the stage of the cancer and
estimates of the cancer’s speed of progression (a process called
preoperative surveillance) significantly affected survival rates among the
HIV-positive participants. People who had good preoperative surveillance had
much smaller tumors at the time of diagnoses and were far more likely to be
alive three years after receiving treatment than those who had poor
surveillance. The three-year survival rates were 63 percent in those with
good surveillance compared with just 17 percent in those with poor
surveillance.

One encouraging finding was that on average, people living with HIV had
similar three-year survival rates as HIV-negative participants. Overall
three-year survival was 42 percent among the HIV-negative volunteers and 39
percent among the HIV-positive volunteers.

“Screening of the HIV-positive population should be reinforced as the
prognosis after curative treatment is at least equal to that of HIV-negative
[patients],” concluded the authors.

3.

Media coverage of campaign to reform Canada's law on compulsory licensing of
pharmaceuticals for export

CANADIAN HIV/AIDS LEGAL NETWORK

UPDATE - November 2, 2010

For those interested, below is a compilation of some of the media coverage
over just the last 2 weeks of the campaign to reform Canada's Access to
Medicines Regime (CAMR), the 2004 law that enacted a WTO decision in 2003 on
the use of compulsory licensing for export of pharmaceutical products to
eligible countries lacking sufficient capacity to manufacture their own
lower-cost, generic medicines.

Also below is the text of the news release issued yesterday by the Canadian
HIV/AIDS Legal Network in response to the gutting of Bill C-393, aimed at
reforming CAMR with a "one-licence solution", by a slim majority of the
Parliamentary committee studying the bill, thanks to intensive lobbying by
the brand-name pharmaceutical industry.  The Bill has now been reported back
to the House of Commons, as amended by the committee.

The Legal Network and other advocates for Bill C-393 are examining options
for the next steps in the struggle to ensure meaningful reform that would
make CAMR a workable mechanism for supplying more affordable medicines to
countries in need, as one part of the overall global effort to scale up
access to treatment.  A number of hurdles still lie ahead, and the damage
done by the Committee will need to be reversed.  The campaign continues.

Richard Elliott
Canadian HIV/AIDS Legal Network
www.aidslaw.ca/camr

_____________________________

MEDIA CLIPPINGS: BILL C-393

- AMENDMENTS WATER DOWN ACCESS-TO-MEDICINE BILL Gloria Galloway, Globe and
Mail, November 2, 2010
http://www.theglobeandmail.com/news/politics/ottawa-notebook/amendments-wate
r-down-access-to-medicine-bill/article1781899/

- ACCESS TO MEDICINE BILL `GUTTED' BY PARLIAMENTARY COMMITTEE
Byline: Amy Minsky, Vancouver Sun - Mon Nov 1 2010
http://www.vancouversun.com/business/Access+medicine+bill+gutted+parliamenta
ry+committee/3763806/story.html

- CONSERVATIVES & LIBERALS GUT BILL TO SEND DRUGS TO AFRICA New Democratic
Party of Canada news release, Nov 1, 2010
http://www.ndp.ca/press/conservatives-liberals-gut-bill-to-send-drugs-to-afr
ica

- GARNEAU GUTS AIDS BILL AT COMMONS COMMITTEE Dale Smith Xtra, Monday,
November 01, 2010
http://www.xtra.ca/public/National/Garneau_guts_AIDS_bill_at_Commons_committ
ee-9363.aspx

- FAILING AIDS VICTIMS
Toronto Star - Mon Nov 1 2010
http://www.thestar.com/opinion/editorials/article/883744--drug-regime-failin
g-aids-victims

- OPINION: FEARMONGERING THREATENS DRUG BILL; LEGISLATION WOULD HELP GENERIC
MAKERS SUPPLY DEVELOPING COUNTRIES
Byline: Rachel Kiddell-Monroe, James Orbinski and Richard Elliott, Source:
Edmonton Journal, Page: A17, Edition: Final - Mon Nov 1 2010
http://www.edmontonjournal.com/business/Fearmongering+threatens+drug+bill/37
56623/story.html

- DRUG ACCESS BILL LOOKS DEAD
Amy Minsky, Edmonton Journal, October 29, 2010
http://www.edmontonjournal.com/business/Drug+access+bill+looks+dead/3744144/
story.html

- NDP MEDICINE BILL HAS K'NAAN, ATWOOD SIGNING SAME TUNE GLORIA GALLOWAY
Globe and Mail, October 28, 2010
http://www.theglobeandmail.com/news/politics/ndp-medicine-bill-has-knaan-atw
ood-singing-same-tune/article1777112/

- NDP'S ACCESS TO MEDICINES BILL FACES CHALLENGES Dale Smith Xtra, Thursday,
October 28, 2010
http://www.xtra.ca/public/National/NDPs_access_to_medicines_bill_faces_chall
enges-9354.aspx

- ACCESS-TO-MEDICINES BILL LOOKS LIKELY TO DIE
Byline: Amy Minsky, Source: Postmedia News The Province - Thu Oct 28 2010
http://www.theprovince.com/business/Access+medicine+bill+looks+likely/374299
6/story.html

- OPINION: LIFELINE FOR PATIENTS IN JEOPARDY
Byline: Rachel Kiddell-Monroe, James Orbinski and Richard Elliott, Ottawa
Citizen Special, Page: A15, Edition: Final - Thu Oct 28 2010
http://www.ottawacitizen.com/opinion/op-ed/Lifeline+patients+jeopardy/373817
0/story.html

- OPINION: LIFELINE FOR PATIENTS IN JEOPARDY
Byline: Rachel Kiddell-Monroe, James Orbinski and Richard Elliott, The
Gazette - Thu Oct 28 2010
http://www.montrealgazette.com/opinion/editorial-cartoons/Lifeline+patients+
jeopardy/3738170/story.html?id=3738170

- CAMR AT INDUSTRY COMMITTEE - MARATHON OF FAINT HOPE Hill Queeries:
Ottawa's federal politics blog Xtra.ca, Tuesday, October 26, 2010
http://www.xtra.ca/blog/ottawa/post/2010/10/26/CAMR-at-Industry-Committee-e2
8093-marathon-of-faint-hope.aspx

- FIXING ACCESS TO MEDICINES REGIME ESSENTIAL Richard Elliott - 26 October
2010 http://www.countercurrents.org/elliott261010.htm

- ACCESS-TO-MEDICINE BILL GETS GRIM PROGNOSIS The Globe and Mail - 26
October 2010
http://www.theglobeandmail.com/news/politics/access-to-medicine-bill-gets-gr
im-prognosis/article1773866/

- GRANDMOTHER SPEAKS OF STRUGGLE AGAINST HIV/AIDS Red Deer Advocate - 26
October 2010
http://www.albertalocalnews.com/reddeeradvocate/news/local/Grandmother_speak
s_of_struggle_against_HIVAIDS_105766893.html

- SYSTEM FOR SENDING AIDS MEDICATION OVERSEAS NEEDS OVERHAUL: ADVOCATES The
Vancouver Sun - 23 October 2010
http://www.vancouversun.com/health/System+sending+AIDS+medication+overseas+n
eeds+overhaul+Advocates/3722032/story.html

- SYSTEM FOR SENDING AIDS MEDICATION OVERSEAS NEEDS OVERHAUL: ADVOCATES
Leader-Post - 23 October 2010
http://www.leaderpost.com/business/System+sending+AIDS+medication+overseas+n
eeds+overhaul+advocates/3717263/story.html

- SYSTEM FOR SENDING AIDS MEDICATION OVERSEAS NEEDS OVERHAUL: ADVOCATES The
StarPheonix - 23 October 2010
http://www.thestarphoenix.com/opinion/System+sending+AIDS+medication+oversea
s+needs+overhaul+advocates/3717263/story.html

- OPINION: MP SHOULD BACK BILL C-393
Debby Andrews, CottageCountryNow.ca, October 13, 2010
http://www.cottagecountrynow.ca/opinion/letters/article/886992--mp-should-ba
ck-bill-c-393

- OPINION: PASS THE BILL
Hilary Elliott, Calgary Herald, October 19, 2010
http://www.calgaryherald.com/business/Pass+bill/3693035/story.html

________________________________

CANADIAN HIV/AIDS LEGAL NETWORK

For immediate release  / Également disponible en français

Ottawa, 1 November 2010 -- Activists for affordable medicines for developing
countries watched and listened in horror this morning as a majority of the
House of Commons Standing Committee on Industry, Science and Technology
destroyed the core reforms proposed by Bill C-393 to fix Canada's moribund
Access to Medicines Regime (CAMR).

Liberal MP Marc Garneau and the five Conservative members of the Industry
committee gutted the key clauses of Bill C-393 aimed at creating the
one-licence solution that has been endorsed by dozens of Canadian civil
society organizations and various international legal experts as a sensible
alternative to the current, dysfunctional mechanism in CAMR.  It also has
the support of more than 80% of Canadians and a growing list of prominent
individuals including former Prime Minister Paul Martin.

"This was a shameful display of putting the interests of the extraordinarily
profitable brand-name pharmaceutical industry ahead of the lives of millions
of poor people who need low-priced, affordable medicines," said Richard
Elliott, executive director of the Canadian HIV/AIDS Legal Network.  The
Legal Network has campaigned for years to reform CAMR to make it workable
and provided detailed analysis to the Committee outlining the rationale
behind the various provisions of Bill C-393.

CAMR was created unanimously by Parliament in 2004 to facilitate the export
of lower-cost, generic medicines to eligible developing countries.  In more
than six years, it has resulted in only one licence being issued to
authorize the export of one order of only one AIDS drug to one country
(Rwanda). 

Elliott said the evidence before the Committee was unequivocal that CAMR
needs to be fixed.  "The generic manufacturer that has tried to use CAMR has
indicated it wont try again unless the system is changed.  Humanitarian
organization Médecins Sans Frontières tried for months to use CAMR to
purchase medicines, but ultimately abandoned the effort.  No other
developing country has sought to use CAMR.  How much longer is the
government going to wait before it accepts that the system doesn't work?
How many more people have to die?"

"The experience illustrates that the current system is operationally flawed.
In particular, a major barrier has been the requirement that, in seeking a
licence to export, a generic drug manufacturer must identify in advance a
single developing country and a fixed maximum quantity of a medicine for
that country and then repeat a cumbersome licencing process every single
time.  The current regime is not economically viable for generic
manufacturers or procedurally user-friendly for developing countries," said
Elliott.

Bill C-393 as introduced sought to remove the current practical barriers to
making use of the regime.  The bill proposed putting in place a one-licence
mechanism that would enable a generic drug maker to get a single licence
authorizing exports of a medicine to any of the eligible countries already
in the current law, and to supply the quantities of medicines required by
countries as their needs evolve over time.

The five Conservative MPs who voted to gut Bill C-393 of its core provisions
are: Mike Lake (Edmonton Mill Woods Beaumont); Peter Braid
(Kitchener-Waterloo); Gordon Brown (Leeds Grenville); Dave Van Kesteren
(Chatham); and Cathy McLeod (Kamloops Thompson Cariboo), substituting for
Mike Wallace (Burlington).  The Conservative members then even voted,
unsuccessfully, against the watered-down bill being sent on to the House of
Commons.

The lone Liberal MP to join with the Conservatives in excising the key
feature of Bill C-393 was Marc Garneau (Westmount Ville-Marie).

Liberal MPs Dan McTeague (Pickering-Scarborough East) and Anthony Rota
(Nipissing-Timiskaming) voted in favour of keeping the core provisions of
Bill C-393 intact.

Bloc Quebecois MPs Luc Malo (Verchères-Les Patriotes) and Robert Bouchard
(Chicoutimi-Le Fjord) voted in support of keeping the key clause in Bill
C-393 intact, but stated that they anticipated some further issues to be
raised at future stages.

NDP MP Brian Masse (Windsor West) is the primary champion of Bill C-393,
taking over from his former caucus colleague Judy Wasylycia-Leis.

For more on Bill C-393 and Canadas Access to Medicines Regime, see
www.aidslaw.ca/camr.

-30-

For further information and interviews:

Christopher Holcroft
Principal, Empower Consulting for the Legal Network
Telephone: +1 416 996-0767
E-mail: chris_holcroft at yahoo.com

Gilleen Witkowski
Communications Assistant for the Legal Network
Telephone: +1 416 595-1666, ext.  240
E-mail:  <mailto:gwitkowski at aidslaw.ca> gwitkowski at aidslaw.ca

________________________________________________
Richard Elliott

Executive Director | Directeur général
Canadian HIV/AIDS Legal Network | Réseau juridique canadien VIH/sida
+1 416 595-1666 ext. 229
 <mailto:relliott at aidslaw.ca> relliott at aidslaw.ca |  <http://www.aidslaw.ca>
www.aidslaw.ca

Children Can't Wait! Dying for Drugs in Developing Countries - see
www.aidslaw.ca/camr
Les enfants ne peuvent attendre! Le manque de médicaments tue, dans les pays
en développement - voir  <http://www.aidslaw.ca/rcam> www.aidslaw.ca/rcam

Béatrice Cardin

Organizational Development and Communications Manager

Canadian Treatment Action Council (CTAC)

Phone/Fax:  (416) 410-6538 

 <mailto:ctac at bellnet.ca> ctac at ctac.ca 

w <http://www.ctac.ca/> ww.ctac.ca

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.resist.ca/pipermail/viva/attachments/20101103/daaf30e0/attachment.html>