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The untold Side of the movie "Dallas Buyers Club"
The movie Dallas Buyers Club brings attention to a little-recognized part of the AIDS activist movement: ....
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Exhorbitant Price New Hepatitis C Drug
Fair Pricing Coalition Condemns Gilead Sciences on the High Price of New Hepatitis C Drug Sovaldi™...
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Six Promising HIV Drugs in the Pipeline (2013-2014)
What new HIV medications do we have to look forward to over the next few years? How will these newer drugs improve upon the older ones? To shed some light on these questions....
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What Can We Look Forward to in HIV Cure Research
TheBodyPRO.com's Nelson Vergel sat down with leading HIV cure research activist Richard Jefferys for an update on current important aspects, and controversies, in HIV cure research....
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What Supplements Can I take with HIV medications?
Is it ok to supplement with Creatine (Cell-Tech), and Protein (Nitro-Tech) along with Glutamine...
Saturday, August 14, 2010
Tuesday, August 10, 2010
HIV, TB, Hep C, Immune therapies 2010 Pipeline Report
This report reviews the status of research of drugs for HIV, TB, Hepatis C, immune based therapies.
http://i-base.info/files/2010/06/2010-pipeline-webFINAL.pdf
http://i-base.info/files/2010/06/2010-pipeline-webFINAL.pdf
Fw: Hot Topics at The Body's "Ask the Experts" Forums
If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html
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Friday, August 06, 2010
What am I going to do now, Nelson?
| What am I going to do now, Nelson? Aug 6, 2010 Hi Nelson, I hope all is well. Last year you told me about the trial with ibalizumab at ACRIA and I received the meds for about 1 year. In the beginning of thet trial the virus became undectadable but then it started to go up again and they took me out of the study. I was in the trial for about 1 year. My doctor changed my regimen to recycle meds...I'm resistant to all of them. I am now on Aptivus, Viread, Norvir and Trizivir. Do you know of any other trials in NYC? Thanks for your help. | ||
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 | | Response from Mr. Vergel I am so sorry that your virus developed resistance to ibalizumab (Taimed's intravenous CD4 monoclonal antibody that may be given once every two weeks). I am working with ACRIA and two San Francisco doctors in setting up a small expanded access pilot to combine two investigational agents by early summer 2011, but we are still waiting for data. But it is not a done deal. However, one of the drugs may be ibalizumab. GSK-ViiV are testing a second generation integrase inhibitor (GSK572) in phase II now and we are really hoping it can help people with raltegravir resistance. Some preliminary data show that it may help those with certain integrase mutations. GSK is also testing two non nucleosides in early phase 2. So, it will take at least 8 months to know where we are going with these agents. AVEXA, an Australian company that has an interesting nucleoside, may be back in the picture after their board reconsidered not dropping their drug due to activist pressure. I am following that drug closely also. BMS seems to have an entry inhibitor but they are a company that does not like to share information with treatment activists, so it has been a challenge to get them to tell us anything. It is unfortunate that in 2010 we still have this lack of communication going (but they are rare among companies). Progenics also had a once a week subcutaneous entry inhibitor that looks very exciting. They are also a company that has refused to meet with treatment activists. They are small and may not understand the power that activists have in the present to help advocate for new drugs. Koronis (http://www.koronispharma.com/KP1461forHIV.html) also has an interesting nucleoside that works very differently than the ones we have right now, but they have not tested it in people like you with a failing regimen. Some of these companies may or may not agree to provide drug in a compassionate manner for one patient (but remember that you need at least two new active drugs to avoid functional monotherapy). But if your doctor wants to ask them, the FDA has set up a way to do so provided that the companies are willing to help. The FDA procedure is http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm163982.htm It is getting harder and harder for companies to justify spending money on new drugs that attack new targets since they perceive the treatment experienced market to be too small to justify the investment. And many doctors are telling them that people like you and me do not exist anymore. So, it is more important than ever not to fall asleep in treatment activism. I am focusing a lot of my energies in helping people like you who may fall through the cracks if we do not provide at least two drugs at the same time that your virus does not have resistance to. One more thing. This is anecdotal but I have seen people in salvage's viral load go down a lot with good daily prophylaxis for herpes (acyclovir, Valtrx, or Famvir) (http://www.aidsmap.com/page/1431675/) twice a day and also with the use of an antibiotic called minoxycline ( http://www.aidsmap.com/page/1438246/), plus their HIV drug regimen. Talk to your doctor about these if you are not taking them already. Keep in contact with me. I will keep everyone informed through this column as things progress. Hang in there and please keep in touch with me. Nelson |
Wednesday, August 04, 2010
New Book Removes Barriers for Men Who Need Testosterone Therapy
My Web page on amazon.com showing all my books in print and kindle versions.
http://www.amazon.com/-/e/B003E3RYKY
My book: Testosterone: A Man's Guide is up as of today!
I hope everyone enjoys it.
Nelson
http://www.amazon.com/-/e/B003E3RYKY
My book: Testosterone: A Man's Guide is up as of today!
I hope everyone enjoys it.
Nelson
Thursday, July 08, 2010
International AIDS Conference- My workshop on Nutrition and Metabolic Disorders
I am excited to have been invited to speak at the International AIDS Conference in Vienna in two weeks
This is my workshop
This is my workshop
Codes to get Medicare to pay doctors for injection Sculptra or Radiesse in faces of people living with HIV-related facial lipoatrophy
Wellcare put together a great summary of all codes used for reimbursement. Medicare decided in January 2010 to cover HIV facial lipoatrophy products as long as the patient has depression induced by this condition.
http://www.wellcare.com/WCAssets/corporate/assets/HS134_Dermal_Injections_for_Facial_Lipodystrophy_Syndrome.pdf
http://www.wellcare.com/WCAssets/corporate/assets/HS134_Dermal_Injections_for_Facial_Lipodystrophy_Syndrome.pdf
Monday, June 28, 2010
HPT/Axis, Inc. Awarded “Most Promising Life Science Technology Company” at 2010 Rice Alliance Life Science Venture Forum
This company is seeking to get approval of a drug protocol that will speed up the normalization of the Hypothalamus-Pituitary-Gonadal (HPG) Axis after long term use of anabolic steroids or testosterone for medical or non medical uses. Cessation of anabolics or testosterone replacement causes androgen -induced hypogonadism that can negatively impact someone's health if the HPG axis does not stabilize soon after these compounds are stopped. Depression, fatigue, sexual dysfunction, lack of motivation, and other health related problems can occur.
FOR IMMEDIATE RELEASE
June 24, 2010 --
HOUSTON – HPT/Axis, Inc. was named one of the most promising Life Science companies at the 9th Annual Rice Alliance for Technology &Entrepreneurship Life Science Venture Forum in Houston last week. Life Science companies showcased their new ventures for an audience of more than 400 attendees, including investors, venture capitalists, industry representatives, business leaders, advisors/mentors, service providers, and entrepreneurs.
June 24, 2010 --
HOUSTON – HPT/Axis, Inc. was named one of the most promising Life Science companies at the 9th Annual Rice Alliance for Technology &Entrepreneurship Life Science Venture Forum in Houston last week. Life Science companies showcased their new ventures for an audience of more than 400 attendees, including investors, venture capitalists, industry representatives, business leaders, advisors/mentors, service providers, and entrepreneurs.
Cynthia A. Doerr, M.D., partner, Essex Woodlands Health Ventures said of the presenters, “This is one of the most mature groups of healthcare-related company presentations that I have reviewed in Houston, and I intend to follow their progress closely.”
HPT/Axis, Inc., a Delaware C Corporation, seeks to profit from developing a treatment for the adverse effects that occur from the condition androgen-induced hypogonadism (AIH), a condition that occurs 100% of the time after stopping androgen or anabolic steroid use, both prescription and nonprescription, the only variables being the duration and severity. The effects of AIH include decreased sex drive,impotence, infertility, depression, obesity, decreased muscle strength and mass, cognitive impairment, and more.
HPT/Axis, Inc., a Delaware C Corporation, seeks to profit from developing a treatment for the adverse effects that occur from the condition androgen-induced hypogonadism (AIH), a condition that occurs 100% of the time after stopping androgen or anabolic steroid use, both prescription and nonprescription, the only variables being the duration and severity. The effects of AIH include decreased sex drive,impotence, infertility, depression, obesity, decreased muscle strength and mass, cognitive impairment, and more.
The Federal and State government have taken special notice for the period after androgen cessation. In 2005, the U.S. House of Representatives held a committee hearing, "Restoring Faith in America’s Pastime: Evaluating Major League Baseball’s Efforts to Eradicate Steroid Use," that took special notice of the adverse effects after stopping anabolic steroids, particularly depression and suicide. The Committee received testimony from several parents whose sons had committed suicide after stopping androgen use. Testimony from Kirk J. Brower, M.D., University of Michigan, stated, "[d]epressive episodes and suicide attempts are most likely to occur within three months of stopping [androgen] use." In that same year, Texas HB 3563, "Use Of Anabolic Steroids By Public School Students", was passed and signed into law. Of particular importance is the bill’s analysis citing the problem of "clinical depression when steroid use is stopped."
HPT/Axis’ drug candidate will be first-in-class, the standard of care treatment. Our treatments have intellectual property protection by pending novel method-of-use patents. HPT/Axis’ lead drug candidate, enclomiphene, is a repositioning of the current FDA approved generic drug clomiphene. Repositioning allows for an expedited path to FDA approval. The company recently completed a successful FDA pre-IND meeting, which gave a preliminary approval for the initiation of clinical trials.
HPT/Axis’ drug candidate will be first-in-class, the standard of care treatment. Our treatments have intellectual property protection by pending novel method-of-use patents. HPT/Axis’ lead drug candidate, enclomiphene, is a repositioning of the current FDA approved generic drug clomiphene. Repositioning allows for an expedited path to FDA approval. The company recently completed a successful FDA pre-IND meeting, which gave a preliminary approval for the initiation of clinical trials.
Michael Scally (mscally@hptaxis.com), HPT/Axis' President & CEO, stated, "Combining the number of men who stop using anabolic steroids, both prescription and nonprescription, there is a substantial current market for this indication, increasing by double-digits annually. We believe HPT/Axis is on a timeline for a FDA NDA within three to five years."
The one-day event culminated in an announcement of the Most Promising Life Science Companies chosen from nearly 40 competitors and judged by the Rice Alliance Information Technology Advisory Board, based on the companies’ elevator pitch presentations. The exercise simulates meeting an investor on an elevator and having only 90 seconds to convince them to invest in your company.
The one-day event culminated in an announcement of the Most Promising Life Science Companies chosen from nearly 40 competitors and judged by the Rice Alliance Information Technology Advisory Board, based on the companies’ elevator pitch presentations. The exercise simulates meeting an investor on an elevator and having only 90 seconds to convince them to invest in your company.
Rice Alliance Director Brad Burke, announced the winners of the Most Promising Life Science Company awards at the event. “Every year the quality of companies improves. Many of the companies at this year’s event have developed prototypes, obtained proven results and are on their second round of funding. This makes them more appealing to investors, who have also expressed appreciation for the quality of the companies.”
The Forum was supported by Baker Botts, LLP, Essex Woodlands Health Ventures, Winstead Attorneys and Santรฉ Venture with supporting sponsors Greater Houston Partnership and Houston Technology Center and media sponsors Houston Business Journal and the BusinessMakers Radio Show. Elevator pitches from the competition can be seen at www.alliance.rice.edu beginning July 6, 2010
The Forum was supported by Baker Botts, LLP, Essex Woodlands Health Ventures, Winstead Attorneys and Santรฉ Venture with supporting sponsors Greater Houston Partnership and Houston Technology Center and media sponsors Houston Business Journal and the BusinessMakers Radio Show. Elevator pitches from the competition can be seen at www.alliance.rice.edu beginning July 6, 2010
Wednesday, June 23, 2010
Pipeline Problems
by David EvansIn the past month, two companies shelved their once-promising experimental HIV drugs, citing the challenging nature of bringing a profitable product to market. Has the overwhelming success of modern-day HIV drugs jeopardized the future of new HIV treatment options?
The last three years, however, have been kinder to Sharp. In the space of about a year and a half, from June 2006 through January 2008, four new antiretroviral (ARV) treatments were approved, all of them with the potential to work against even the most drug-resistant HIV. After Sharp started a regimen with one of these new treatments, his virus became undetectable for the first time ever. His CD4 cells, which had been depressed for years, started to inch back up, and he continues to do well today.
Sharp is not alone in his Lazarus effect. Thousands of people with multidrug resistant virus, many of whom were once quite sick, have been able to push their viral loads to undetectable levels and restore their health with the newest antiretrovirals, often in combination with each other. But what happens if their HIV accumulates additional mutations and breaks through? Unfortunately, the number of promising agents waiting in the wings for people with drug resistant virus is dwindling.
Two companies, Avexa and Myriad Genetics, suspended development of their experimental ARV treatments over the past month. From press statements, it appears that both companies determined that their drugs—apricitabine (a nucleoside reverse transcriptase inhibitor) and bevirimat (a maturation inhibitor)—could not be brought profitably to market. While neither drug was perfect, or had a certain shot at FDA approval, some activists and researchers see their failure as evidence of a paradox—that today’s highly effective drugs are hurting the development of tomorrow’s promising agents.
“The very incentives that got industry involved to develop HIV drugs are now working against us,” says Jay Lalezari, MD, the director of clinical research at Quest Clinical Research in San Francisco, who specializes in the study of drugs for people with multiple drug resistance. “But, you know, money is a driver, and you don’t expect these companies to do it for nothing,” he laments.
“It’s getting harder and harder to hit a homerun with a new HIV drug,” says Bob Huff, a longtime HIV treatment activist from San Diego. “The current drugs are very good, and most doctors and patients are fairly satisfied…. The incentive for companies to invest in developing new HIV drugs is not strong right now.”
“It’s disconcerting,” Sharp agrees. “In terms of practical issues around drug development, we do need to put our heads together and strategize about fixing the things that are broken.”
Sharp is working with Huff and Nelson Vergel, an activist from Houston, to help identify novel ways for people who’ve run out of treatment options to get their hands on multiple experimental agents at one time. The three are also looking at creative ways for companies to get drugs approved that might only benefit treatment-experienced people, a market that is increasingly small and potentially less profitable than ever before.
Sharp, Huff and Vergel express concern about options for people who have already become resistant to current meds. With apricitabine and bevirimat now out of the picture, it only leaves a couple of drugs in an advanced state of development for people with multi-drug-resistant virus. Given the uncertain nature of drug development, however, those drugs could also tank or be delayed, and it could be quite a while before something new is approved.
Sharp is not hopeless, however, and cautions that, “There’s no reason to panic. I definitely don’t think this is the end of the world.”
Lalezari agrees that things are not so bleak, at least not yet. He points out that a number of his patients are still doing well clinically, despite going for many years with very low CD4 counts and detectable virus. He stresses that it is possible to pick a regimen and stick with it for a long time, even if your viral load remains detectable. He encourages people to sit tight on such a regimen and to “try to keep this dรฉtente with the virus, and we’ll see if gene therapies or other immune therapies can be brought to bear in the future.”
Vergel is another veteran of the treatment wars and knows what it’s like to face uncertainty. He says that if his current drug regimen fails, he’s not sure what he’ll turn to. He’s not despairing, however, because he feels that he and other activists are making progress with the FDA in figuring out how to make new treatment options available, even when the traditional avenues of approval are a challenge.
In the meantime, he distills his own positive outlook for the many hundreds of people with HIV he interacts with each year through his Internet and public speaking activities. As he sums it up: “You have to give them hope.”
A Good News, Bad News Story
“The bigger picture with HIV therapeutics is a good news, bad news story,” says Paul Sax, MD, clinical director of the HIV program at Brigham and Women’s Hospital in Boston. “The good news is that HIV treatment success is so high now. The bad news,” he adds, is that “the motivation to develop new drugs, especially drugs to treat resistant virus, has ironically never been lower. There’s this small group of people who have no options even with those newer drugs, and for them, the situation is very discouraging.”
Treatment success has made developing a new drug targeted toward drug-resistant virus problematic in several ways. First, we can no longer simply pit a new drug against a placebo, with no other active drugs to back it up. A number of studies have found that when people take only one active drug at a time, they quickly develop resistance to that drug. For this reason, federal treatment guidelines recommend waiting to start a new treatment, if possible, until two or three active drugs can be combined into a new regimen.
While combining two or three active agents is good for study participants, it's a headache for trial designers. This is because the difference between an experimental drug and a placebo are much smaller and more difficult to measure if their impact is masked by the potency of other powerful drugs.
Sax points to the failure of the drug vicriviroc to demonstrate efficacy over a placebo in treatment experienced participants as a perfect example of this dynamic at work. “The vicriviroc study had the old study design,” Sax explains, “which was [a background regimen chosen by drug resistance tests] plus or minus the [vicriviroc], and they didn’t see any benefit, unless you [only looked at people taking] one other active drug.”
To detect such slight differences you have to either recruit only people with one or fewer active treatments available or design trials with twice as many people. The first option goes against the grain of treatment guidelines, and Sax thinks that the challenging and slow recruitment for a number of recent studies targeting treatment-experienced patients makes it quite unattractive to the companies. Even more unattractive, however, is the second option which almost doubles the cost of the trial.
Vergel has been working with Lalezari and Steve Deeks, MD, professor of medicine at the University of California at San Francisco, to estimate the number of people in the United States with resistance to all of the existing drugs—the kind of people that Sax says would be a challenge to recruit.
Vergel estimates that there are at least 1,500 such individuals, but that number is not growing rapidly. While this may be good news from a public health perspective, it is bad news for people with highly drug-resistant HIV who are depending on the pharmaceutical industry to develop new treatment options. Corporate board members and shareholders demand the highest profit possible with the least expense. With clinical trials potentially getting more expensive and harder to recruit, and the market size staying small, it’s getting very difficult to meet those demands.
“We’re up against the fact that drug development is about making a profit,” Sharp says, “and unfortunately that’s what we have to deal with.”
What the Future Holds
Sharp, who works frequently with Vergel on treatment advocacy projects, says that there are promising treatments further back in the pipeline, and that still other more innovative types of treatment are finally reaching the point where they can move in to clinical trials designed to prove efficacy and safety. What’s more, Sharp remains devoted to advocacy related to eradication: the elimination of HIV from the body.
Lynda Dee, a veteran treatment activist and the president of AIDS Action Baltimore, confirms Sharp’s experience: “Activists have met with companies over the last year, and some have said that they have internal programs looking at new drugs and eradication,” she says. “I’m hopeful that this discontinuation of the development of [apricitabine and bevirimat] doesn’t mean that all of the industry has turned tail and left the HIV field.”
Lalezari thinks that an entry inhibitor from TaiMed Biologics, an integrase inhibitor from ViiV Healthcare, and an attachment inhibitor from Bristol-Myers Squibb might have a shot further down the road. He’s less sanguine than Sharp or Dee about the prospects for antiretroviral drug development in general, given the challenges involved. “I think we could enter a period where there’s an abrupt end to HIV drug development,” he asserts. “That’s not to say that there aren’t new modalities of interest…but in terms of new direct-acting antivirals, it’s going to be very difficult,” he predicts.
Protecting Your Options
Are we on the verge of returning to the days when the best that a long-term survivor could do was guard against opportunistic infections and pray to survive long enough to benefit from the next drugs to come out of the pipeline?
Perhaps not, according to Lalezari. “The thing about the treatment-experienced population, which is astonishing, is that I have a whole bunch of people that I have been following for a number of years now, who are doing just fine. They have detectable virus, and their [CD4] cells are less than 20, but their health is just great, which is not explained in my understanding of the universe.”
Sax stresses that going off treatment would be a lot worse than staying on a failing regimen. “You know, all attempts of treatment interruptions of people with drug resistant virus met with bad outcomes,” he says, “So one thing for sure, is that people should stay on something. The question of what is more difficult. It’s never been well studied.”
In the end, what’s at stake is whether new drug development can stay ahead of HIV-positive people’s needs for new treatment options. Vergel points out that those who’ve yet to develop drug resistance can preserve their future options by finding a tolerable effective treatment and adhering to it religiously. In this regard, the possibility of a dry spell in new drug approvals could encourage people not to take for granted that new options will inevitably keep coming down the pike. “Fear,” Vergel says, “can be a good motivator” by way of emphasizing the importance of treatment adherence.
For people who’ve run out of new options, there is still reason for hope. It is possible to stay clinically healthy despite a failing ARV regimen, as Sax and Lalezari point out, and there are ways to minimize the risk of developing resistance to the experimental agents that might come later. Vergel tries to remind people of that and tells them “to not come from a place of despair.”
Sax thinks it will be helpful for researchers and health care providers to pool together their knowledge and resources to figure out the best care models for people who’ve run out of treatment options, arguing that since few providers have large numbers of such individuals it is difficult to become an “expert” in treating them. He thinks that activists and groups such as the Forum for Collaborative HIV Research in Washington, DC, can aid in that process.
Despite the challenges involved in developing the next generation of HIV therapies, Sax believes in remaining optimistic, especially with his patients who’ve run out of options. He tells them: “Press on. Drug development has helped us in the past. We hope it does again in the future.”
Thursday, June 17, 2010
AIDS activists ask AVEXA not to leave patients behind
June 17, 2010
Dr. Susan Cox
Former Senior Vice President, Drug Development at Avexa
Cc: Nathan Drona, Chairman of the Board at Avexa
Stephen Kerr, Board Secretary
We, the undersigned, are asking the decision makers at Avexa to reconsider the decision to stop the development of apricitabine, a nucleoside analog that has shown good efficacy in patients with the most common nucleoside mutation, M184V. Physicians and a growing number of patients with limited treatment options have been counting on the approval of this drug to enable the construction of effective regimens. Apricitabine can mean the tipping point between success and failure of a salvage regimen – between life and death.
It is well known that the management of multidrug resistant HIV has improved dramatically with the recent approval of a number of highly effective antiretroviral drugs, including raltegravir, maraviroc, darunavir, and etravirine. Despite the impressive effectiveness of these drugs in clinical trials, a growing subset of patients continues to exhibit virologic failure in clinical practice – even when adherence is good. Most of these treatment failures likely occur because of an inability to construct a regimen containing two to three fully effective agents for individuals with extensive prior exposure to antiretroviral drugs. Some of these patients acquired drug resistance while participating in clinical trials. Failure rates in recent phase III studies such as DUET (etravirine and darunavir), MOTIVATE (maraviroc), and BENCHMRK (raltegravir) were in the 27-40% range. Many of the patients who experienced virologic failure while participating in these studies were subsequently unable to construct suppressive regimens.
The prevalence of multidrug failure in clinical practice is not well documented, however there are signs that the number of patients in need of new options is growing. Deeks and colleagues at UCSF/SFGH have an ongoing observational cohort of patients who have developed drug resistant HIV (the SCOPE cohort). Most of these patients have been able to construct a fully suppressive regimen and are currently doing well. However, of the original 300 patients, approximately 40 now have evidence of having failed all six therapeutic drug classes. These 40 patients have a GSS of either zero or one, and have no clear options for suppressing HIV replication. Many have advanced disease (CD4 < 100) and hence may not be able to wait for the development and approval of multiple new options.
A 2009 survey of 94 responding HIV clinicians in the United States
The options for constructing a three-active agent regimen for this growing population during the next four years appears to be few, which means that the chances for survival for those with lower CD4 cells counts are diminishing. Consequently, an early expanded access program that makes available current investigational agents that have progressed beyond phase II could help improve the outlook for survival for these patients in need. But the drugs must remain in development.
Other small companies developing new HIV drugs, such as TaiMed and Myriad have faced the same difficulties in finding partners that Avexa has. Of these companies’ drugs, though, apricitabine stands out as a member of a well-understood class, the one nearest to approval, and as an agent addressing one of the most common forms of drug resistance among all people with HIV (including those still naรฏve to treatment). For the salvage population, convenience in dosing is not the issue: activity is! In our recent meeting with the major HIV drug makers we have been raising awareness about the growing unmet need for new salvage options, and as they hear this message from community and clinicians, they have begun to pay attention. Researchers and statisticians are also working on creative ways to conduct registrational clinical trials in an environment when there are many effective options and a relatively small subject pool (the Forum for Collaborative HIV Research is holding a workshop on this issue in October 2010). Finally, the FDA has said it recognizes the need for new salvage therapies and appears willing to work with companies to bring new products to market in this difficult environment. The tide is turning; this is not the time to abandon apricitabine.
We the undersigned believe that apricitabine is a potentially important drug, and one of the few products currently in the pipeline that could help patients with multidrug resistance tip the balance in favor of viral suppression, health, and, for many, life itself. We ask that Avexa reconsider its decision not only based on potential sales but also on the survival of patients at risk.
Sincerely,
The Members of the AIDS Treatment Activists Coalition- New York , New York
The Members of the European AIDS Treatment Group- Brussels , Belgium
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