REMARKS WITH SIR ELTON JOHN BEFORE THEIR MEETING

FROM:  U.S. STATE DEPARTMENT 

Remarks

John Kerry

Secretary of State

Outer Office

Washington, DC

October 24, 2014

SECRETARY KERRY: It’s my enormous pleasure to welcome Sir Elton John here to the State Department. We met a few years ago when we were talking and I was still in the Senate about the challenge of PEPFAR and creating the next AIDS-free – the AIDS-free generation. I want to thank Sir Elton for his tremendous leadership almost from the beginning of the challenge of HIV/AIDS. And his foundation, the Elton John AIDS Foundation, has been critical in bringing hope and help to a lot of people.

So it’s my pleasure today to be able to announce a $7 million partnership between PEPFAR and the Elton John Foundation which will help bring additional assistance to people and help us meet this goal of an AIDS-free generation. And I want to thank him very, very much for his extraordinary leadership. We’re going to continue to work together to bring this help to all those folks, particularly in the LGBT community, who need this particular assistance. And we think it’ll make a difference, as he has through the years. So thank you, sir.

SIR ELTON JOHN: Thank you. I’d like to thank Secretary Kerry for taking the time to see me, for his tireless work from the word “go” to create an AIDS-free world. He has been relentless in that. And also, hearing the Obama Administration’s loud, loud voice that everyone in the world should be – we should be living in an AIDS-free world, and that people, no matter who they love, who they are, should have a right to be AIDS-free.

To be able to combine with PEPFAR, from our foundation’s point of view, is a dream come true, because together, you double the effect. I think from the beginning of the AIDS crisis, there were so many different foundations, and what’s happened is that now, there’s a few of us left. We’re probably the smallest of them all, but we combine with PEPFAR and everybody else. We all work together to ensure that in this day and age, nobody gets left behind no matter what their sexuality, their color, or whatever. It’s important. If people get left behind, the disease will get left behind, and we will face an enormous uphill battle.

So this partnership that we’re doing today is an incredibly important step to, again, ensuring that people in the future will be living in an AIDS-free society. That’s been my goal ever since we started this foundation, and I know it’s Secretary Kerry’s goal as well and the Obama Administration’s goal. Together, we’re fighting it, and I’m very optimistic that we can make a huge difference. This is a very, very big deal. We’re opening this and doing this in South Africa, and – this first joint venture and it’s a historic adventure – a venture and an adventure.

So thank you, Senator Kerry, for your help; thank you, PEPFAR; and together, I think we will do great work, and we have a lot more work to do, but this is a good start.

SECRETARY KERRY: Thank you, sir, very, very much. Thank you. Nice comments.

SECRETARY OF STATE KERRY MAKES REMARKS AT UNAIDS

FROM:  THE STATE DEPARTMENT 

Remarks at UNAIDS

Remarks

John Kerry

Secretary of State

UN Headquarters

New York City

September 25, 2014

Well, thank you very much. Thank you for a generous introduction. Mr. Deputy Secretary General, thank you for your leadership and thank you for your important words here today. And thank you to the many activists out here, those of you who are championing this effort on the frontlines. We certainly welcome Victoria Beckham. Thank you for taking this on.

And I want to note that my old friend and our leader, Eric Goosby, Dr. Eric Goosby, is here. Happy to see him and all his great work. And I’m happy to see – (applause). I’m happy to see a colleague of mine who I got to serve with for a few years before I came onto this, but delighted to see Senator from Delaware Chris Coons here, his passionate voice in the Senate for this – (applause). And all of you, thank you for – now I’m getting whispered who I have to start – my good friend Michel is saying got to recognize – (laughter) there, there. If I do that, I’m never going to get through this. (Laughter.)

Mr. Deputy Secretary General, three years ago you set a tremendous goal for all of us. You said, "Zero new HIV infections, zero discrimination, and zero AIDS." And that goal has been set for us to achieve by 2020. In the refusal to allow AIDS to ravage yet another generation, you have showed an even bigger determination than we might have anticipated to meet our global responsibilities. And I want to thank you for the tremendous efforts by setting that target for all of us. And I believe it’s achievable, notwithstanding the difficulties that Jan just mentioned to all of us.

I want to thank President Burkhalter of Switzerland and President Mahama of Ghana and President Zuma of South Africa, and my good old friend Michel Sidibe, the executive director of UNAIDS, for their commitment to helping to write a new chapter in the fight against AIDS.

It’s more than fair to say that the work that we’re doing together here is work that was once just a distant dream. And we are making an AIDS-free generation a closer reality for a lot of folks all around the world.

Now I think about what the word " AIDS" meant when I became a United States Senator in 1985. Back then it was a death sentence. Back then many people in positions of responsibility – and I knew them, some of them – were not even comfortable saying the word or talking about it in a meeting or being present when it was discussed.

I think about what the word " AIDS" meant on a global scale back in the 1990s, back when Senator Bill Frist and I first began working together on this issue and when we started to join three words together in a sentence: " AIDS in Africa." It meant a looming death sentence for an entire continent, and thank God people of conscience and conviction decided that was unacceptable.

The truth is that in many ways, we’ve ended 1985’s meaning of " AIDS" as we knew it. It’s not an unspoken word, nor is it an automatic death sentence. And thanks to the President’s Emergency Plan for AIDS Relief, which grew out of our initial efforts in the Senate I am proud to say, we are on the road to do the same globally, notwithstanding pockets of greater emergence or pockets of resistance. But the reason we’re on the road is we know what we can achieve. We’ve seen what we’re able to do. We now have to complete the task to end the era of AIDS, period, full stop end the era. (Applause.)

Last year, I was honored to stand with President Obama as he announced that PEPFAR had not only met but exceeded his goal. That’s what I mean about we know we have the capacity: 6.7 million people are now receiving life-saving treatment, and that’s an astounding number, a fourfold increase since the beginning of this Administration, since Barack Obama came into office. And today, more than one million babies have been born HIV-free because of PEPFAR’s support. Now, these are a lot more than just numbers, and I think everybody in this room knows that better than any other people. Every one of these men, women, children has a unique contribution to make, and every one of those babies can now grow up to be a person, healthy, go to school, contribute to the workforce, realize dreams, and maybe even have sons and daughters of their own. Their lives remind us of what we have achieved, but more importantly, they remind us still of the miles we have yet to go in order to achieve the full-fledged AIDS-free generation.

So first, we need to continue to make strategic and creative investments that are based on the latest science and best practices. In a tight budget environment – and everybody faces that – every dollar, yen, and euro counts. And that’s why we need to focus on data, on mutual accountability, transparency for impact, and put our weight behind HIV prevention, treatment, and care interventions that work. We also need to continue to set benchmarks, and I’m very pleased that PEPFAR’s investment supports UNAIDS’s 90-90-90 targets. (Applause.) PEPFAR is laser-focused on achieving ambitious targets in the areas of high HIV prevalence, and the challenge is obviously big and it’s obviously important.

Second, we need to focus on the impact of HIV/AIDS on children, young women, and vulnerable populations. And that’s why the United States announced a new partnership last month between PEPFAR and the Children’s Investment Fund Foundation called Accelerating Children’s HIV/AIDS Treatment. This ambitious partnership will help 300,000 more children living with HIV to get the treatment that they need, and I’m proud to announce today that we are making nearly 500 million in PEPFAR funds available this year to support efforts for children, young women, and vulnerable populations. (Applause.)

Third, we need to double down on our new country health partnerships, which are focused on using data to change people’s lives on the ground. South Africa, Rwanda, Namibia are on the front lines of the transformation from direct aid to providing support for locally run, self-sustaining investments, and we need to back these efforts every step of the way.

Finally, we need to ensure that the post-2015 development agenda reflects the United States’s continued commitment to ending the HIV/AIDS epidemic and creating an AIDS-free generation. I want to emphasize: The United States commitment to fighting HIV/AIDS is undiminished, just as our work is unfinished. And our commitment has only been strengthened by the progress that we’ve made, the lives we’ve saved, and the fact that we’ve learned we know what to do, we just have to do it. That’s a story worth telling and it’s a story that compels all of us to continue.

So I will never forget just a few months ago walking into the Gandhi Memorial Hospital in Addis Ababa. And as I passed the front gate in the back with a group of doctors, nurses, and patients all assembled, I saw this big sign on the wall that read, " Ethiopia and the United States of America: Investing in a Healthy Future Together." That sign tells it all, and that sign is replicated all across communities in one place or another where this kind of help is coming to people. We know – we know that achieving an AIDS-free generation will continue to pose an incredible test. But we also know that with our work together, we can pass this test, we can see this fight across the finish line. And I’m convinced with the folks here and this commitment we are going to do just that. Let’s not stop. Let’s get the job done. Thank you. (Applause.)

NSF EXAMINES HIV BUDDING FROM CELLS

FROM:  NATIONAL SCIENCE FOUNDATION 

Catching HIV budding from cells: it all comes down to ALIX

Study shows last-minute role of specific protein named ALIX

The secrets of the AIDS virus may all come down to a protein named ALIX.

Researchers have devised a way to watch newly forming AIDS particles emerging or "budding" from infected human cells without interfering with the process.

The method shows that a protein named ALIX (which stands for "alg-2 interacting protein x") gets involved during the final stages of virus replication, not early on, as was believed. ALIX assists in separating new virus buds from a cell. These buds repeat the replication process and further infect their host.

"We watch one cell at a time" and use a digital camera and special microscope to make movies and photos of the budding process, says virologist Saveez Saffarian, a scientist at the University of Utah, and co-author of a paper on HIV budding published this week in the journal PLOS ONE.

"We saw ALIX recruited into HIV budding for the first time," he says. "Everybody knew that ALIX was involved in HIV budding, but nobody could visualize the recruitment of ALIX into the process."

The finding has no immediate clinical significance for AIDS patients because ALIX is involved in too many critical functions like cell division to be a likely target for new medications, Saffarian says.

"We know a lot about the proteins that help HIV get out of the cell, but we don't know how they come together to help the virus emerge," he says. "In the next 10 to 20 years, we will know a lot more about this mechanism."

Saffarian conducted the research with the paper's first author Pei-I Ku, as well as researchers Mourad Bendjennat, Jeff Ballew and Michael Landesman. All are with the University of Utah.

The research was funded by the National Science Foundation (NSF).

"This project has led to the development of an important technique in basic research in cell biology and virology," says Parag Chitnis, director of NSF's Division of Molecular and Cellular Biosciences.

"It's uncovering a new understanding of the viruses involved in human diseases," says Chitnis. "This is an excellent example of how purely basic research can lead to the fundamental understanding of topics of societal need."

Watch, don't touch, as HIV buds

Biochemical methods used for years involve collecting millions of viruses in lab glassware and conducting analyses to reveal the proteins that make up the virus--for example, by using antibodies that bind to certain proteins and using other proteins to make the first proteins fluoresce so they can be seen.

"You're not doing it one virus at a time," Saffarian says. "The problem is that you don't see the differences among similar viruses. And you don't see the timing of how various proteins come and go to help the virus get out of the cell."

Other methods freeze or otherwise fix cells as new HIV particles emerge, and use an electron microscope to photograph freeze-frame views of viral replication.

Saffarian employs technology known as "total internal reflection fluorescence microscopy" that looks at the dynamic processes in cells.

The method has been used to make images of the budding of HIV and a similar horse virus, EIAV.

But Saffarian says that the EIAV study didn't show ALIX becoming involved in HIV budding, and that it wrongly indicated that ALIX got involved early in the EIAV budding process, suggesting it did the same in HIV budding.

Ku, Saffarian and colleagues combined their microscopy method with an improved way of genetically linking a green fluorescent "label" to ALIX proteins in cloned cells so they could see the proteins without harming their normal function.

The researchers tried numerous so-called "linkers" and found the one that let them see the ALIX proteins as they became involved in HIV budding.

Neither the microscope technology nor labeling proteins with green fluorescence are new, but "what we did that is new is to connect these fluorescence proteins to ALIX using many different kinds of linkers," says Saffarian, to find one that let the ALIX protein function properly.

The problem with research that indicated ALIX was involved early in the budding process was that only one linker was used, and it impaired ALIX's normal function, the scientists say.

Looking at proteins forming HIV

When HIV replicates inside a human cell, a protein named Gag makes up most of the new particles--there are 4,000 copies of the Gag protein in one HIV particle--although other proteins get involved in the process, including ALIX.

Experiments like those by Saffarian use "virus-like particles," which are HIV particles stripped of their genetic blueprint or genome so they don't pose an infection risk in the lab.

"Virus-like particles maintain the same geometry and same budding process as infectious HIV," Saffarian says.

During budding, Gag proteins assemble on the inside of a cell membrane--along with ALIX in the late stages--and form a new HIV particle that pushes its way out of the cell--the process by which AIDS in an infected person spreads from cell to cell.

To look at the budding process, Ku and Saffarian placed human cells containing the particles in a small amount of liquid growth medium in a petri dish and placed it under the microscope, which is in a glass chamber kept at body temperature so the cells can remain alive for more than 48 hours.

A solid-state blue laser was aimed at the sample to make the green-labeled ALIX and red-labeled Gag proteins glow or fluoresce so they could be seen as they assembled into a virus particle.

With red-labeled Gag proteins and green-labeled ALIX proteins, "we could see ALIX come in at the end of the assembly of the virus particle," says Saffarian. Some 100 ALIX proteins converged with the roughly 4,000 Gag molecules and assembled into a new HIV particle.

Enter ALIX

ALIX then brought in two other proteins, which cut off the budding virus particle from the cell when it emerged. ALIX's position during the pinching off of new particles hadn't been recognized before.

The researchers watched the virus particles bud one cell at a time: about 100 particles emerged during a two-hour period. Most of the ALIX proteins left when HIV assembly was complete and returned to the liquid inside a cell.

Saffarian says the discovery that ALIX doesn't get involved until the late stages of HIV budding suggests the existence of a previously unrecognized mechanism that regulates the timing of ALIX and other proteins in assembling new HIV particles.

"We discovered that the cellular components that help with the release of the virus arrive in a much more complex timing scheme than predicted based on the biochemical data," he says.

"The outcome of this study is promising because it uncovers a new regulatory mechanism for recruitment of cellular components to HIV budding sites, and opens the door to exciting future studies on the mechanism of HIV budding."

STATE DEPARTMENT DEPUTY SECRETARY BURNS MAKES REMARKS AT 'AFRICA HEALTH FORUM'

FROM: U.S. DEPARTMENT OF STATE
Remarks at the Africa Health Forum
Remarks
William J. Burns
Deputy Secretary
Dean Acheson Auditorium
Washington, DC
April 19, 2013

Thank you. Good morning. It is truly a pleasure to welcome all of you to the second day of the Africa Health Forum, and I greatly appreciate this opportunity to appear before you.

I want to thank the World Bank and Harmonization for Health in Africa for partnering with the State Department to convene this important meeting and the many distinguished ministers, bilateral and multilateral development partners, major foundations, and private sector leaders for joining us today.

I also want to thank Assistant Secretary for Global Affairs at the Department of Health and Human Services, Dr. Nils Daulaire, and Dr. Ariel Pablo-Mendez, Assistant Administrator for Global Health at USAID, for their support in organizing the U.S. contribution to the forum and for their exceptional work on health systems strengthening and health care finance reform.

Finally, please allow me to extend my deepest gratitude to my friend and colleague, Ambassador Eric Goosby, for his extraordinary lifelong service to public health and his commitment to the treatment and eradication of AIDS here in the United States and across the world.

We gather here today amidst a dramatic transformation of the African continent from a region once defined largely by its problems, to a region defined increasingly by its possibilities… from a region afflicted by conflict, crisis, and impoverishment to a region known more and more for its economic growth, expanding democratic governance, and enhanced health and human development.

Rwanda, a country devastated by genocide less than two decades ago, is today on track to meet many of the Millennium Development Goals - life expectancy has doubled, maternal mortality and annual child deaths more than halved, and deaths from HIV, TB, and malaria have dropped by 80%.

In Ghana, economic prosperity and good governance have not only led to improved health outcomes, but also important innovations in health care delivery and education that are having an impact across the region.

As the continent evolves, and as governments take on greater leadership and responsibility for their own future, the nature of assistance and cooperation from the international community should evolve as well – from a donor-recipient relationship to more of a partnership.

This partnership – based on principles of country ownership, shared responsibility, and mutual respect – allows donors and partner countries to better meet the needs of the country’s population. Where transparency, good governance, and accountability are enshrined in law and in practice – our joint investments will yield more effective, more efficient, and ultimately more sustainable outcomes.

This is why sustainability and shared responsibility are two foundational principles of President Obama’s Policy Directive on Global Development and our global health diplomacy strategy.

Let me say just a few words about each.

First, to ensure that the results and significant investments we have all made to-date are durable, governments – in partnership with civil society and the private sector – should lead, implement, and eventually pay for all aspects of their health system. Partnership between Ministries of Finance and Health are critical and I am very pleased to see ministry representatives from over two dozen African countries here today.

It is this kind of dialogue that has made possible the significant transitions underway in health assistance programs across Africa, from Namibia - where thousands of PEPFAR-funded essential health care workers are now fully financed by the Government of Namibia, to Ethiopia - where U.S.-selected partners are providing technical assistance and cooperation to local partners instead of directly implementing programs themselves.

None of us are under any illusion that these transitions are easy or risk-free. But you have shown that they are possible. And this is why we must be systematic about capturing lessons from recent successful transitions from donor dependence to country ownership, just as we continue to benefit from lessons learned in transitions in family planning that began several decades ago and documented by colleagues from USAID and UNFPA present here today.

Second, the decision to elevate shared responsibility to the core of our policy approach was conscious and deliberate. The only way we can eradicate polio, reach the goal of an AIDS-free generation, eliminate the effects of neglected tropical diseases, roll back malaria, and end preventable maternal and child deaths, is if we do it together.

Our commitment to global health remains strong. Indeed, President Obama’s budget request for a $1.65 billion contribution to the Global Fund in fiscal year 2014 maintains our historically high level of support.

Consider the enormous progress in combating HIV in South Africa.

Over the last decade, the United States provided $3.2 billion to support South Africa’s fight against this epidemic. Through our joint efforts and mutual investments, millions of South Africans received treatment for HIV, and the rate of mother-to-child transmission plummeted to 2.7%. And today, South Africa is increasing its investments so that locally generated revenues are replacing hundreds of millions of dollars in external financing for antiretroviral therapy and other elements of the AIDS response.

This vision of strengthened country capacity, leadership, and ownership, is also driving the signing of more than 20 Partnership Framework agreements that bring together governmental and nongovernmental partners around a strategy to combat HIV/AIDS. And the strategy is working.

In Zambia, when the government introduced an innovative, evidence-based program and doubled its budget for antiretroviral drugs, the United States was able to provide an additional $30 million in funding. And today, through joint investment and collaboration, the number of people receiving antiretroviral treatment each year, exceeds the number of people infected with HIV, putting Zambia solidly on the path to an AIDS-free generation.

We need to sustain and accelerate this positive momentum. To do so, it is vital that we translate the conversations here in Washington into actions in your respective capitals. To better support your efforts, we will be sure to share the results of this forum with our Ambassadors, Mission Directors, and their teams at our missions across Africa.

Like all of you, I have no illusions about the challenges ahead, but I remain optimistic about Africa’s future. The work all of you are doing -- day in and day out -- to deliver improved health outcomes across the continent only reinforces that optimism, and that sense of possibility. I want to thank all the participants at this meeting and our development partners from around the world for all that you do. I wish you every success over the rest of the day, and in the months and years ahead.

Thank you.

LOS ALAMOS NATIONAL LABORATORY LOOKS AT HOW HIV ATTACKS

FROM: LOS ALAMOS NATIONAL LABORATORY
Research Deciphers HIV Attack Plan
Scientists get inside look at how AIDS virus grooms its assault team

LOS ALAMOS, N.M., March 29, 2013—A new study by Los Alamos National Laboratory and University of Pennsylvania scientists defines previously unknown properties of transmitted HIV-1, the virus that causes AIDS. The viruses that successfully pass from a chronically infected person to a new individual are both remarkably resistant to a powerful initial human immune-response mechanism, and they are blanketed in a greater amount of envelope protein that helps them access and enter host cells.

These findings will help inform vaccine design and interpretation of vaccine trials, and provide new insights into the basic biology of viral/host dynamics of infection.

During the course of each AIDS infection, the HIV-1 virus evolves within the infected person to escape the host’s natural immune response and adapt to the local environment within the infected individual. Because HIV evolves so rapidly and so extensively, each person acquires and harbors a complex, very diverse set of viruses that develops over the years of their infection. Yet when HIV is transmitted to a new person from their partner, typically only a single virus from the diverse set in the partner is transmitted to establish the new infection.

The key discoveries here are the specific features that distinguish those specific viruses which successfully move to the new host, compared with the myriad forms in the viral population present in a chronically infected individual.

"The viruses that make it through transmission barriers to infect a new person are particularly infectious and resilient," said Los Alamos National Laboratory scientist Bette Korber. "Through this study we now better understand the biology that defines that resilience."

The team set out to determine whether the viruses that were successfully transmitted to a new patient might share distinct biological properties relative to those typically isolated from people with long-term, chronic infection. To do this, the group at U Penn cloned a set of intact viruses from acute infection, and a set of viruses from chronically infected people, and characterized them by measuring quantities that might be related to the virus's ability to successfully establish a new infection. They discovered several clear correlations. For example, transmitted viruses were both more infectious and contained more protective "envelope" per virus; envelope is the protein the virus uses to enter host cells.

The team identified an additional interesting property that could be a general characteristic of new viral infections: the transmitted HIV was capable of replicating and growing well in the presence of alpha interferon. Alpha interferon production is part of our innate human immune response to a new infection. As soon as a new viral infection is initiated in our bodies, local immune cells at the site of infection start secreting molecules called cytokines that have general antiviral activity and can inhibit the production of the newly infected virus. Alpha interferon is one of these potent cytokines.

In the early days of an HIV infection, this innate immune response increases to an intense level, called a "cytokine storm," which gradually recedes during infection. For a newly transmitted HIV to successfully establish infection, it must grow and expand in the new host while facing this cytokine storm. Although typical chronic viruses are sensitive to and inhibited by alpha interferon, transmitted HIV-1 viruses grew well in the presence of interferon.

U.S. VA SUPPORTS WORLD AIDS DAY

Photo:  U.S. Naval Hospital Ship Mercy.  Credit:  U.S. Navy

FROM: U.S. VETERANS ADMINISTRATION

December 1 is World AIDS Day
The U.S. Preventive Services Task Force recently released its recommendations that all Americans ages 15 to 65 should be tested for HIV at least once in their lifetime.

VA is ahead of the curve and has recommended routine HIV testing for all Veterans since 2009. VA policy is to test every Veteran at least once in their lifetime.

Currently, over 1.2 million Veterans, representing 20 percent of Veterans in care, have a documented HIV test in their electronic medical record. Routine HIV screening allows for care for HIV positive Veterans and reduces the potential for the virus to be transmitted to others.

VA’s Office of Public Health is encouraging VA staff to offer every Veteran an HIV test. Working together, we can create an AIDS-free generation!

To reinforce the importance of World AIDS Day, VA is issuing a unique and comprehensive HIV Prevention Manual, which is a compilation of VA policies and strategies to address primary and secondary HIV prevention.

Designed as a tool for front-line health care providers, it is an extremely valuable resource.

On World AIDS Day, VA joins the AIDS community in its "Facing AIDS" initiative, a campaign to help reduce stigma and promote HIV testing by putting a face to those with HIV and the people who support them.
"An estimated 1.2 million Americans are living with HIV, and yet one out of five doesn’t know it," according to Dr. Maggie Czarnogorski, Deputy Director of VA’s HIV, Hepatitis, and Public Health Pathogen Program. "World AIDS Day is an opportunity to take action. VA is the largest provider of care to those living with HIV/AIDS in the United States. By diagnosing HIV infection as soon as possible, Veterans can receive excellent care and remain healthy for many years to come."

Join VA in recognizing World AIDS Day. Say yes to the test!