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Our World — 9 August 2008


MUSIC: "Our World" theme

This week on "Our World" ... New findings from the Phoenix Mars lander ... coordinating the response to AIDS and tuberculosis ... and the challenge of reaching one group of people with AIDS.

FROST: "Currently today, 86 countries criminalize sex between men. ... So you can see that kind of institutionalized homophobia makes it very difficult to address the AIDS epidemic in those men."

This week's International AIDS Conference, a new kind of microscope, and more. I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."

International AIDS conference ends in Mexico City

The 17th International AIDS Conference has just wrapped up in Mexico City.

The sprawling, six-day conference brought together about 25,000 people, including researchers, activists, political leaders and journalists from around the world.

Since 1985, these gatherings have provided a place for researchers to share their latest findings on HIV, the virus that causes the immune system disorder known as AIDS. The conferences have also been a forum for politicians to show their commitment to the cause, and for AIDS activists to promote more research, more programs for prevention and treatment of HIV, and more AIDS-friendly government policies.

VOA correspondent Greg Flakus covered the conference, and I reached him in Mexico City just before the event ended. I asked him first if he'd seen any progress at the conference in the search for a cure for AIDS.

FLAKUS: Well, Art, every year the researchers and scientists who come here present their papers on encouraging or promising lines of research, and they caution now that this is an incremental thing, that nobody should be expecting the announcement of a cure.

There was a presentation from the University of Texas medical school in Houston on an announcement that came just on the eve of this conference. They made the announcement that they'd found a protein on the HIV virus that remains constant. One of the problems with the virus is that it keeps mutating, and it's been very difficult for researchers to attack it because of that. But in order to infest itself into the host it has to have one part that's constant, and this is what Dr. Sudhir Paul and his colleague, Dr. Miguel Escobar have found by studying the virus there in Houston. They think that by using what they call abzymes to attack this, that they could destroy the virus. However it will take at least five years for them just to do the testing on this. So that's the problem with AIDS research. As the researchers say, this is something that's going to be incremental. It's going to take a lot of time and a lot of collaboration from people all around the world.

Q: Well, in the meantime we've got prevention. And I know from the AIDS conferences that I went to in the 1980s and '90s, prevention's always been an important part, not only of the fight against HIV/AIDS but also of these conferences. What is the latest word on prevention there in Mexico City?

FLAKUS: Well, prevention is probably the big topic here. You'll see condoms at every corner here, literally. Everywhere you go, different booths, different organizations are handing out condoms. And that's one of the big messages here, that education and the use of condoms and things that they know work from long experience now around the world, that this could drastically reduce the instance of AIDS.

Q: The United States in recent years has been a big AIDS donor with the PEPFAR program, the President's Emergency Plan for AIDS Relief. But PEPFAR has been pretty controversial because of its strong emphasis on abstinence as a prevention strategy. Did any of that controversy play out in Mexico City?

FLAKUS: Well not so much this year. In past years it's been controversial, and this year it's been low-key, the approach to that. And if anything, President Bush and the United States got some praise here from the Secretary General of the United Nations and various officials with this conference because of the increase in the amount of money that's given to HIV and AIDS research and treatment and so forth.

On the other hand, as I say, abstinence is not talked about much here. You do hear some people say that it's something that can be encouraged as part of an overall solution. But when you look at places where it's been tried, according to the people I've talked to, it has a 76 percent failure rate. So they say it's better to face the reality that people are going to have sex, people are going to use drugs intravenously, and so forth. And so it's better to concentrate on treatments that we know will work or the preventive we know work.

Q: Well, finally, Greg, can you give us a sense of what the atmosphere has been like? There are, what?, 25,000 or so people there?

FLAKUS: Yes, it's one of the biggest they've had. It's the first one in Latin America. I should mention that the main conference is taking place in this huge convention center here in Mexico City, the Centro Banamex. But outside they set up these two gigantic tents, and in there you have all the various representatives — the NGOs, various national AIDS foundations, you have different groups representing, for example, women, sex workers, you have several gay organizations represented there. All of these people are talking about prevention. They're talking about helping, for example, orphans. I talked to a group from Taiwan that has set up various shelters for people, not only in Taiwan but in mainland China. So there are a lot of things like that, where people come together and they share ideas. And so you learn from that.

Q: I guess that's why they call it the International AIDS Conference. VOA correspondent Greg Flakus was our man at the 17th International AIDS Conference. It just ended in Mexico City. Thanks a lot, Greg.

FLAKUS: Thank you, Art.

Men who have sex with men have greater risk of HIV infection

Also at the Mexico City AIDS conference, a new report released there by the American Foundation for AIDS Research, or amfAR, says the rate of HIV infections among men who have sex with men is many times greater than HIV infections in the general population. As VOA's Rosanne Skirble reports, activists are calling for targeted prevention programs and resources, especially in low- and middle-income countries, where the problem is most acute.

SKIRBLE: The amfAR report looks at the response of 128 countries to a 2006 United Nations initiative promoting universal access to HIV prevention, treatment and care. But the amfAR report focuses on one HIV-infected population group: men who have sex with men, better known by the acronym "MSM". The term describes this group's sexual behavior, and does not imply a homosexual lifestyle. Report co-author and Johns Hopkins University epidemiologist Chris Beyrer says a review of all published HIV data shows that MSM makes up a large and growing portion of the AIDS epidemic in every region of the world.

BEYRER: "In Latin America, these men were 33 times as likely as in the general population. And that was the most extreme that we saw. For Asia, men who have sex with men, were 18 times more likely to have HIV infection, and in Sub-Saharan Africa, which of course has been the area where the general population rates [of HIV infection] are the highest, men who have sex with men were still more than three times more likely to have HIV than adults in the reproductive age population."

SKIRBLE: amfAR CEO Kevin Frost says criminalization of male-with-male sexual activities is driving the MSM epidemic in many countries.

FROST: "Currently today, 86 countries criminalize sex between men. That makes it enormously difficult to reach this population. More than ten of those countries have laws that punish sex between men with more than ten years in prison, and seven make it punishable by death. So you can see that kind of institutionalized homophobia makes it very difficult to address the AIDS epidemic in those men."

SKIRBLE: The amfAR report links MSM prevalence to the failure of many countries to launch any kind of MSM-targeted response, as described in the U.N.'s 2006 call-to-action on HIV/AIDS programs. The report found that nearly half of all countries did not provide any data on MSM in response to the U.N. initiative. Among those nations that did, 71 percent have not launched any MSM-specific programs. amfAR's Kevin Frost says that must change.

FROST: "And, history, if it has taught us anything about this epidemic, it has taught us that if we are going to be effective in our response, our response has to be comprehensive, meaning it has to address all of the populations at risk, whether that is men who have sex with men or drug users or sex workers."

SKIRBLE: The report concludes that despite the upward trend in MSM-related HIV infections, resources to deal with them are scarce. In Latin America, for example, where the AIDS conference is being held, MSM represents 25 percent of the people living with HIV. But MSM programs get less than one percent of total spending on HIV/AIDS prevention. Co-author Chris Beyrer says it's essential that funding priorities be adjusted to address this problem.

BEYRER: "What we're trying to do, of course, is to use that data to advocate for resources. When you find this kind of a problem and you have the evidence, you want evidence-based approaches to prevention for these men, increased surveillance, health care access, antiretroviral therapy, condoms, lubricants. And that has to be paid for."

SKIRBLE: Chris Beyrer says failure to provide health care, prevention and treatment for the MSM population amounts to nothing less than a denial of basic human rights to health care and, ultimately to life itself. Rosanne Skirble, VOA News, Mexico City.


Stay tuned. We'll have one more AIDS report later on in the show. But first ...

Mars spacecraft finds unexpected material in red planet's soil

NASA scientists this week said the Phoenix Mars Lander has detected the presence of a chemically-reactive salt called perchlorate in the Martian soil.

Perchlorate is a mineral that also occurs naturally in soil here on Earth, in places like the Atacama Desert in Chile, where the soil has been described as Mars-like. It's a toxic material that is used in pyrotechnic devices like fireworks and automobile air bags.

Principal investigator Peter Smith of the University of Arizona says studies on Earth indicate that finding perchlorates in Martian soil doesn't rule out the possibility of life on Mars.

SMITH: "These compounds are quite stable in soil and water and do not destroy organic materials under normal circumstances. In fact, there are species of perchlorate-reducing microbes that live on the energy provided by this oxidant. In itself, it is neither good nor bad for life."

Smith added that the Phoenix scientists didn't expect to find perchlorate on Mars.

The announcement in a hastily-called telephone news conference came after several days of Internet rumors about some big discovery possibly relating to life on Mars, so big that even the White House had been given a special briefing, the rumors said.

But NASA spokesman Dwayne Brown said the rumors of a White House briefing were just that — rumors.

The Phoenix scientists are continuing their remote-control analysis of the Martian soil and promise to let us know just as soon as they have anything new to report.

Website of the Week features free, full-length documentary films

Time again for our Website of the Week, when we showcase interesting and innovative online destinations.

Smash hit movies from Hollywood, Bollywood and every place in between tend to crowd out smaller films and, especially, documentaries from your local cinema.

Well, now there's a new website that wants to help build an audience for documentaries via the Internet.

ALLEN: "We are in the business of providing award-winning documentary films free to audiences worldwide, via the web."

Rick Allen is the CEO of SnagFilms.com, a brand new site where you can watch full-length documentaries online.

SnagFilms features a range of high quality films, not only from top producers like National Geographic and the major American public broadcasting network, PBS, but also from smaller, independent filmmakers.

ALLEN: "Some of them known well to indy film fans and documentarians, and they've made one or more films that are often issues-based, and so deeply of personal importance to them, and therefore we think lending themselves well to the viral distribution that Snagfilms provides.

If you're a filmmaker, you can submit your festival-quality documentary to SnagFilms. For now, most of the films on the site are from the U.S., but Rick Allen says he hopes to expand with more international offerings.

One thing that sets SnagFilms apart is that viewers are encouraged to share the movies by posting them on their own website.

ALLEN: "Snag has the ability to take our films and open up your own virtual movie theater on any webpage, on your social network page — Facebook, MySpace — on your blog, so that your visitors, your friends can share the films that are important to you in the environment they're already congregating in."

You don't need to be a computer programmer to do this. It's as easy as copy-and-paste, or for many popular sites just a mouse-click or two.

A documentary film festival on your computer at SnagFilms.com, or get the link to this and more than 200 other Websites of the Week from our site, voanews.com/ourworld.

MUSIC: W. Bennett — "Pride in Our Heritage"

You're listening to VOA's science and technology magazine, Our World. I'm Art Chimes in Washington.

Tiny new microscope updates standard lab bench model

The Internet is a great new tool. Sometimes, though, what you need is a new version of an old tool. Reporter Eric Libby has a story about a 21st century update to a laboratory standby that's been around for more than 400 years.

LIBBY: The word "microscope" brings to mind a big, clunky, fragile piece of equipment. But Changhuei Yang from the California Institute of Technology and his colleagues invented a smaller, more portable version. Their optofluidic microscope is about a square centimeter in size, magnifies images by 10–20 times, and costs about $10 to make. The inspiration for the design came from floaters — the small specks of dust and debris that land on our eyeballs.

YANG: "And sometimes they get very close to the retina, and when that happens you can see them very clearly with very sharp resolution. They're actually very tiny, on the order of millimeters, but when you see them you can get a pretty big image of them. So this actually inspired us to think about whether we can actually a use similar principle to develop a microscope that doesn't actually use any lenses or any other complicated optics."

LIBBY: Based on this idea, Yang took a light-sensing chip from a digital camera and coated it with metal.

YANG: "And then what we do is we punch a line of very small holes on this layer of metal. So when we shine light down on this chip, the light can only pass through to the sensor underneath through the holes."

LIBBY: A sample from blood or saliva or water is placed on the chip. As it floats over the holes, objects and microorganisms in the fluid block light from reaching the sensor. These shadows can be converted into a two-dimensional image — just like in a camera — and downloaded to a computer. Yang says the device is not just simple and small.

YANG: "It's very rugged because there is no lens to break. We can make an iPod-sized [wallet-sized] device that can fit easily into a clinician's back pocket. It actually can use sunlight as its illumination source."

LIBBY: Yang sees this device becoming a common tool for doctors and aid workers. It can scan water sources for dangerous bacteria and parasites. Doctors can use it to diagnose diseases in patients living in remote areas. Yang says it may even help detect diseases before any obvious physical symptoms appear.

YANG: "Because it's small enough, we can start to think about creating [an] analysis device that's implantable into the human body. And this would be useful for tracking things that are floating in blood streams."

LIBBY: Patients could then be monitored more effectively and treated earlier. But Yang says this will not happen just yet. He is working to extend the lifespan of his microscope, which currently only lasts a few weeks. Nevertheless, Yang says the micro-microscopes should be available to clinicians within a couple of years. This is Eric Libby in Washington.

Experts urge coordinated response to AIDS and tuberculosis

Tuberculosis is one of the leading causes of death in people infected with HIV, accounting for about 13 percent of AIDS deaths worldwide. As Véronique LaCapra reports, doctors working with the World Health Organization stress the need to coordinate the response to these two catastrophic epidemics, and integrate TB screening and treatment into HIV care programs.

LaCAPRA: More than two billion people — one third of the world's population — are infected with tuberculosis bacilli, the bacteria that cause TB. The disease disproportionately affects the world's poor; the vast majority of TB deaths are in developing countries.

In the general population, one in ten people who are infected with TB will develop the disease in their lifetime. But for people who are HIV-positive, TB presents a much greater risk.

HAVLIR: "In patients who have HIV disease, TB is the major complication, or opportunistic infection, and also the leading cause of death."

LaCAPRA: Dr. Diane Havlir is the Chief of the HIV/AIDS Division at San Francisco General Hospital in California.

HAVLIR: "It's estimated that just over a third of all the people living with HIV, which means over 10 million people, are infected with tuberculosis."

LaCAPRA: Countries suffering the highest incidence of HIV and AIDS bear much of burden. According to the WHO, 85 percent of HIV-positive TB cases are in Africa.

Tuberculosis can be difficult to diagnose, says Havlir, particularly in developing countries, which often have limited diagnostic tools.

HAVLIR: "In most places of the world what's still used to diagnose tuberculosis is microscopic examination of sputum, which was developed over 100 years ago."

LaCAPRA: But using a microscope to look for TB bacteria in the thick mucus people cough up from their lungs often doesn't work

HAVLIR: "Only about 50 percent of patients who have tuberculosis and HIV will actually have the tuberculosis bacilli visible on the smear under the microscope. So people have tuberculosis in their body, but there's not enough in their sputum that we can actually see it, so that really makes the diagnosis challenging."

LaCAPRA: It's also challenging to recognize the symptoms of TB in someone with HIV. An otherwise healthy person who gets sick from TB usually develops pneumonia-like symptoms — coughing, fever, chest pains, and sweats.

But in people with weak immune systems, like AIDS patients, TB can spread throughout the body.

HAVLIR: "They can get tuberculosis in their lymph nodes, and get huge swollen glands. The glands can be in their belly and provide very severe abdominal pain. The tuberculosis can spread to their brain and they can have seizures and headaches. So once patients get AIDS and tuberculosis, the symptoms are really much, much more diverse."

TEXT: Havlir proposes that to effectively fight the spread of tuberculosis, HIV programs must make TB control a priority. She says the first step is to increase routine testing for TB in HIV clinics.

HAVLIR: "TB is a transmissible disease, and the sooner that we find [infected] people, the sooner we can treat people, and the less period of time that they are able to transmit tuberculosis to others."

LaCAPRA: Since TB is highly contagious — spreading through the air when someone with TB coughs, sneezes, or even talks — early diagnosis is critical to preventing an infected person from spreading the disease to others. Family members are especially at risk, as are other patients in a health care facility. Havlir says that just having TB patients wear a simple paper mask over their mouths can help prevent transmission.

Testing for TB can also provide direct benefits to the person getting tested, even if the results are negative. For an HIV-positive person who does not have TB, says Havlir, taking a single antibiotic called isoniazid may reduce their risk of getting TB in future by up to 60 percent.

HAVLIR: "Another tool that we have in order to prevent the risk of tuberculosis in our HIV-infected patients is HIV therapy itself. Because one of the reasons that our patients with HIV are so susceptible to tuberculosis is because their immune system is impaired. When we treat them for HIV their immune system improves, and they become less susceptible to tuberculosis."

LaCAPRA: Havlir discusses these and other strategies to coordinate TB and HIV control in the July 23 issue of the Journal of the American Medical Association. For Our World, I'm Véronique LaCapra.

MUSIC: "Our World" theme

That's our show for this week. If you'd like to get in touch, email us at ourworld@voanews.com. Or use the postal address —

Our World
Voice of America
Washington, DC 20237 USA

Rob Sivak edited the show. Eva Nenicka is the technical director. And this is Art Chimes, inviting you to join us online at voanews.com/ourworld or on your radio next Saturday and Sunday as we check out the latest in science and technology ... in Our World.

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