CNS / Conseil national du sida

Opinion on the over-the-counter HIV tests

2013-04-24T13:30:31Z

This Opinion was unanimously adopted by all members of the French National AIDS Council, present at the plenary session held on 20th December 2012.

Members of the « over-the-counter HIV tests» commission
Patrick Yeni, Président of the commission
François Bourdillon
Jean-Pierre Couteron
Samir Hamamah
Catherine Kapusta-Palmer
Marc de Montalembert
Marie Suzan-Monti

Rapporteurs
Laurent Geffroy
Michel Celse

Preamble

In a letter dated 8th August 2012, the Minister for Health and Social Affairs asked the French National AIDS Council to produce a new opinion on the issues relating to the marketing of over-the-counter HIV tests.

Over-the-counter HIV tests are single-use tests to detect HIV-1 and HIV-2 antibodies with the following characteristics:
They are carried out by the persons themselves with no need for third-party involvement;
They can be obtained over the counter and do not require any specific instrumentation beyond what is provided in the kit;
There are at least two stages to the test: self-sampling, then self-analysis of the result;
They can be used on two types of bodily fluids: Either a fingerstick capillary blood sample, or gingival crevicular fluid from an oral swab;
They are rapid tests which provide a result in a short timeframe, usually less than thirty minutes;
The results obtained must be confirmed by laboratory-based testing.

In the United States, home-based HIV tests for self-sampled capillary blood have had marketing authorisation since 1996. More recently, an oral swab over-the-counter HIV test was authorised in July 2012.

No over-the-counter HIV tests have been authorised for sale in the European Union under regulations governing medical devices.

In two previous Opinions published in 1998 and 2004, the French National AIDS Council expressed its reservations regarding over-the-counter HIV tests. Whilst acknowledging that they may increase screening amongst populations with no access to preventive care or who are wary of conventional testing, the Council considered that there were a number of disadvantages to these tests, in particular:
insufficient accuracy;
the absence of the support required in the event of a positive result;
no pre or post-test consultation;
the possibility of misuse under coercion.

In light of developments since these Opinions were published, notably in terms of home-based testing techniques and provisions for screening in France, the French National AIDS Council felt it was time to reconsider its reservations and more broadly speaking, examine the ethical, strategic and organisational issues that would arise should over-the-counter HIV tests be made available in France.

To this end, the French National AIDS Council set up a commission to hold hearings and review the literature. The commission has drawn up a Report based on this work. Prior to the vote to adopt the Opinion, the Council shared its initial conclusions with the National Ethics Advisory Committee (CCNE), also solicited for an Opinion on this matter, at a joint working meeting.

Blood donation: the French National AIDS Council is glad that blood donor selection criteria will be reviewed

2012-10-08T16:17:41Z

On World Blood Donor Day on 14 June 2012, Marisol Touraine, the French Minister for Social Affairs and Health, announced that blood donor selection criteria are to be reviewed in the near future. The minister is considering abolishing the current permanent contraindication covering men who have sex with men (MSM) and replacing it with a contraindication based on the criterion of “multiple relationships and sexual partners, whatever the sexual orientation and gender”.

The French National AIDS Council welcomes the announced review and is delighted that criteria that are not based on sexual orientation but instead on practices, situations and types of behaviour that present a proven risk of HIV/AIDS transmission will be taken into account in the future.

Although donating blood is not a right, as reiterated in the 2000s by the National Consultative Bioethics Committee and the French Equal Opportunities and Anti-Discrimination Commission, the exclusion of MSM donors may have been seen as discriminatory and stigmatising. Consequently, changes to the regulations in force must be subject to a broad-based consultation.

Whatever the final decision, the National AIDS Council wishes to reiterate the need to continue providing patients with a guarantee that blood products are safe.

AIDS 2012 in Washington : the French National AIDS Council presents a poster about innovative financing

2012-07-26T16:00:00Z

Presented on Thursday July the 26th, at the AIDS 2012 international conference in Washington, this poster is directly inspired by the Council's recommandations published in 2011' Opinion entitled "Defeating the global AIDS epidemic through innovative financing".

Amongst other recommandations, are the implementation of a financial transactions tax, and a reduction in the cost of treatments.

Click here to download the poster

AIDS 2012 in Washington: French National AIDS Council presents French policy on sex workers

2012-07-24T16:52:40Z

Tuesday July 24th, the French National AIDS Council has presented "Tightening the laws on prostitution in France: what impact on prevention?" during the session "Criminalizing Sex Work", at the international AIDS 2012 conference in Washington. This presentation was directly inspired by the Council's Opinion HIV and sex trade: towards a guarantee of universal access to prevention and care, published in 2010.

You can download the complete presentation, including the speech, in PDF format, or watch the complete Webcast of this session:

Laurent Geffroy, expert advisor for the CNS and presenting author of the Council's Opinion

For more information on our contributions to the conference, download the CNS' programme in Washington.

AIDS 2012 in Washington: French National AIDS Council presents French policy on illegal drug users

2012-07-23T14:00:00Z

Monday July 23d, the French National AIDS Council has presented "Tougher policy on French illegal drug users: what impact on risk reduction?" during the session "Drug Policy, Criminal Justice, and Human Rights", at the international AIDS 2012 conference in Washington. This presentation was directly inspired by the Council's Memorandum equivalent to opinion: impact of illicit drug policies on risk reduction for infectious diseases, published in 2011.

You can download the complete presentation, including the speech, in PDF format, or watch the complete Webcast of this session:

Laurent Geffroy, expert advisor for the CNS and presenting author of the Council's Opinion

For more information on our contributions to the conference, download the CNS' programme in Washington.

AIDS 2012 in Washington: French National AIDS Council takes part in a press conference

2012-07-23T12:00:00Z

Michel Kazatchkine, Françoise Barré-Sinoussi and Laurent Geffroy

Monday july 23d, the French National AIDS Council took part in a press conference organized by the Anrs at the international AIDS 2012 conference in Washington, with Nobel Laureate in Medicine Françoise Barré-Sinoussi and Michel Kazatchkine.

Françoise Barré-Sinoussi gave comments on the highlights of the plenary session that took place in the morning, where United States Secretary of State Hillary R. Clinton, amongst others, was invited to speak. She also talked about French President François Hollande's statement earlier that day, in which he declared his commitment to the fight against the HIV/AIDS epidemic, the French implication in the Global Fund and the importance of mobilizing financial resources through a financial transaction tax.

Michel Kazatchkine pointed out the alarming progression of people newly infected with HIV in Eastern Europe and Central Asia, although this number is decreasing on a global scale. This worrisome issue was the subject of the "Regional session on Eastern Europe and Central Asia", which Michel Kazatchkine had participated in a few minutes before the press conference.

Laurent Geffroy, expert-advisor for the CNS then gave an overview of the Council's contributions to the conference, particularly on the subjects of French public policies regarding illicit drug users and sex workers. He also described the CNS' poster on innovative financing mechanisms, including a Tax on the Financial Transactions and a price reduction of life-saving treatments.

For more details on these contributions, download the CNS' programme in Washington.

French National AIDS Council presentations and issues at stake at the Washington international conference

2012-07-20T12:52:53Z

The XIX International AIDS Conference on 22-27 July in Washington is due to be attended by over 20,000 delegates and constitutes a major gathering for those working worldwide to combat the epidemic. Apart from being on France's stand, the French National AIDS Council (CNS) will present three contributions selected by the organisers.

Drugs, prostitution, and innovative financing

The CNS will deliver presentations at two oral sessions on drug policy and prostitution and will present an analysis of the paradoxes of French public policy in these areas and its negative impact on prevention and healthcare access. At a time when the French government is considering holding a consultation on legislation on the sex trade, the CNS' contribution is set to shed light on the health issues that French policy on prostitution has so far failed to address.

The CNS will also present a poster on international HIV/AIDS control financing strategies, based on the promotion of innovative financing and mechanisms to reduce the price of treatments. In the current economic context, the CNS believes that it is vital that the major international financial backers, such as France, keep their commitment to allocate 0.7% of their GNP to public development aid and implement the financial transaction tax. The CNS wishes to reiterate that the objective of guaranteeing universal access to prevention, treatment and care would involve a 40% increase in annual investment, whereas international support dropped for the first time in 2010. Today, seven million people who are eligible for treatment – five million of whom live in Africa – do not receive the treatment they desperately need.

Click here to download the programme detailing the CNS' involvement in Washington

Finally, with the US Food and Drug Administration (FDA) recently having granted a supplemental New Drug Application (sNDA) for an antiretroviral treatment to be used as a primary prevention method, the Washington conference will be an opportunity for the CNS to publicise its recent Opinion on the potential benefits of the concept of HIV/AIDS pre-exposure prophylaxis and to help shed light on the issue. Regarding health policy in France, the CNS believes that the emphasis should be placed on speeding up and widening the implementation of a comprehensive combined prevention approach, bringing together increased promotion of screening and all the available prevention methods.

The Washington D.C. Declaration, launched to coincide with this XIX world conference, states that AIDS control has come to a turning point in its history. Scientific advances and the great efforts made in the fields of access to prevention, screening and effective treatments have brought the world to the brink of turning the tide on the AIDS epidemic. However, action and resources need to be scaled up to an unprecedented level in order to implement them.

In this respect, the CNS is glad that Marisol Touraine, France's Minister for Social Affairs and Health, and Geneviève Fioraso, the French Minister for Higher Education and Research, are scheduled to attend the conference, which constitutes a unique opportunity for governments to announce concrete and quantifiable commitments commensurate with the issues at stake.

Contact: Julien Bressy, Communication officer | +33(0)6 35 26 85 71 | julien.bressy@sante.gouv.fr

AIDS 2012 in Washington: French National AIDS Council presentations and issues at stake at the international conference

2012-07-20T12:52:43Z

French National AIDS Council calls for HIV/AIDS control measures to be scaled up on the eve of Camp David G8 Summit

2012-05-16T15:50:00Z

President of the French National AIDS Council (CNS) Patrick Yeni, has today sent the French President the Opinion adopted in October 2011 by the CNS Defeating the global AIDS epidemic through innovative financing.

Read the Press release including the details of this letter.

French National AIDS Council calls for HIV/AIDS control measures to be scaled up on the eve of Camp David G8 Summit

2012-05-16T15:50:00Z

The President of France will take part in the G8 summit at Camp David on 18-19 May. In its 12 April 2012 declaration released during the meeting of G8 foreign affairs ministers, the American presidency of the summit reiterated the need to support initiatives to promote universal access to HIV / AIDS prevention, treatment and care. The American presidency also reaffirmed its support for the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The G8 countries contribute 78% of the Fund's financing and France is one of the main contributors.

The mobilisation of the G8 countries is particularly important if universal access to HIV/AIDS prevention, treatment and care is to be provided in line with the Millennium Development Goals. At the present time, 7.6 million people are eligible for treatment – of whom 5 million live in Africa - but do not yet have access to these vital drugs. Furthermore, the cost of second and third-line treatments, which are vital for many patients facing therapeutic failure, is an obstacle to universal access for many low-income countries.

To meet the universal access objective, current annual investment needs to be increased by 40% and reach $25 billion a year, in line with the objectives set out in the UN Political Declaration on HIV/AIDS in June 2011. However, international financial support dropped in 2010 for the first time in a decade. Due to donors failing to fully meet their funding commitments, the Global Fund was forced to cancel several funding programmes scheduled for the following year.

In a complex financial climate and at a time when the number of new HIV infections is dropping, the G8 countries need to strongly reaffirm their commitment to HIV/AIDS control. France is promoting a financial transaction tax and must also champion innovative funding mechanisms, as they are the only means of meeting the considerable challenges of research and drug access.

To support and shed light on France's strong stance, Patrick Yeni, the President of the French National AIDS Council (CNS), has today sent the French President the opinion adopted in October 2011 by the CNS Defeating the global AIDS epidemic through innovative financing. In the opinion, the Council states that it is the right time to implement a financial transaction tax in order to provide significant additional resources for HIV/AIDS control. The Council also recommends that further international governmental action is taken beyond the scope of this mechanism alone and highlights the need to cut the cost of treatments. This would be made possible by the dispensations to intellectual property rules implemented in low-income countries. These measures now appear to be vital if the Millennium Development Goals are to be achieved.

Contacts :
Julien Bressy, communication officer:

+33(0)140566852 | +33(0)683561534 | julien.bressy@sante.gouv.fr

Laurent Geffroy, rapporteur:

+33(0)140566858 | +33(0)663936333 | laurent.geffroy@sante.gouv.fr