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Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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A still image provided by KPIX TV and taken from the broadcaster's video footage shows Timothy Ray Brown during an interview at his home in San Francisco. Timothy Ray Brown, was a young HIV-positive American living and working in Berlin who had developed leukaemia and suffered a relapse after initial treatment. REUTERS/Courtesy KPIX TV/Handout Dramatic scientific advances since HIV was first discovered 30 years ago this week mean the virus is no longer a death sentence. Thanks to tests that detect HIV early, new antiretroviral AIDS drugs that can control the virus for decades, and a range of ways to stop it being spread, 33.3 million people around the world are learning to live with HIV. People like Vuyiseka Dubula, an HIV-positive AIDS activist and mother in Cape Town, South Africa, can expect relatively normal, full lives. “I’m not thinking about death at all,” she says. “I’m taking my treatment and I’m living my life.”   Nonetheless, on the 30th birthday of HIV, the global scientific community is setting out with renewed vigor to try to kill it. The drive is partly about science, and partly about money. Treating HIV patients with lifelong courses of sophisticated drugs is becoming unaffordable. Caring for HIV patients in developing countries alone already costs around $13 billion a year and that could treble over the next 20 years. In tough economic times, the need to find a cure has become even more urgent, says Francoise Barre Sinoussi, who won a Nobel prize for her work in identifying Human Immunodeficiency Virus (HIV). “We have to think about the long term, including a strategy to find a cure,” she says. “We have to keep on searching until we find one.”   The Berlin patient is proof they could. His case has injected new energy into a field where people for years believed talk of a cure was irresponsible. Timothy Ray Brown was living in Berlin when besides being HIV-positive, he had a relapse of leukemia. He was dying. In 2007, his doctor, Gero Huetter, made a radical suggestion: a bone marrow transplant using cells from a donor with a rare genetic mutation, known as CCR5 delta 32. Scientists had known for a few years that people with this gene mutation had proved resistant to HIV. “We really didn’t know when we started this project what would happen,” Huetter, an oncologist and haematologist who now works at the University of Heidelberg in southern Germany, told Reuters. The treatment could well have finished Brown off. Instead he remains the only human ever to be cured of AIDS. “He has no replicating virus and he isn’t taking any medication. And he will now probably never have any problems with HIV,” says Huetter. Brown has since moved to San Francisco. Most experts say it is inconceivable Brown’s treatment could be a way of curing all patients. The procedure was expensive, complex and risky. To do this in others, exact match donors would have to be found in the tiny proportion of people — most of them of northern European descent — who have the mutation that makes them resistant to the virus. Dr Robert Gallo, of the Institute of Virology at the University of Maryland, puts it bluntly. “It’s not practical and it can kill people,” he said last year. Sinoussi is more expansive. “It’s clearly unrealistic to think that this medically heavy, extremely costly, barely reproducible approach could be replicated and scaled-up ... but from a scientist’s point of view, it has shown at least that a cure is possible,” she says. The International AIDS Society will this month formally add the aim of finding a cure to its HIV strategy of prevention, treatment and care. A group of scientist-activists is also launching a global working group to draw up a scientific plan of attack and persuade governments and research institutions to commit more funds. Money is starting to flow. The U.S. National Institutes of Health is asking for proposals for an $8.5 million collaborative research grant to search for a cure, and the Foundation for AIDS Research, or amfAR, has just announced its first round of four grants to research groups “to develop strategies for eradicating HIV infection.”   Until recently, people in HIV and AIDS circles feared that to direct funds toward the search for a cure risked detracting from the fight to get HIV-positive people treated. Even today, only just over five million of the 12 million or so people who need the drugs actually get them. HIV first surfaced in 1981, when scientists at the U.S. Centers for Disease Control and Prevention discovered it was the cause of acquired immunodeficiency syndrome (AIDS). An article in the CDC’s Morbidity and Mortality Weekly Report of that June referred to “five young men, all active homosexuals” from Los Angeles as the first documented cases. “That was the summer of ‘81. For the world it was the beginning of the era of HIV/AIDS, even though we didn’t know it was HIV then,” says Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, who has made AIDS research his life’s work. In the subsequent three decades, the disease ignorantly branded “the gay plague” has become one of the most vicious pandemics in human history. Transmitted in semen, blood and breast milk, HIV has devastated poorer regions, particularly sub-Saharan Africa, where the vast majority of HIV-positive people live. As more tests and treatment have become available, the number of new infections has been falling. But for every two with HIV who get a chance to start on AIDS drugs, five more join the “newly infected” list. United Nations data show that despite an array of potential prevention measures — from male circumcision to sophisticated vaginal or anal microbicide gels — more than 7,100 new people catch the virus every day. Treatment costs per patient can range from around $150 a year in poor countries, where drugs are available as cheap generics, to more than $20,000 a year in the United States. The overall sums are huge. A recent study as part of a non-governmental campaign called AIDS2031 suggests that low and middle-income countries will need $35 billion a year to properly address the pandemic by 2031. That’s almost three times the current level of around $13 billion a year. Add in the costs of treatment in rich countries and experts estimate the costs of HIV 20 years from now will reach $50 to $60 billion a year. “It’s clear that we have to look at another possible way of managing of the epidemic beyond just treating everyone forever,” says Sharon Lewin, a leading HIV doctor and researcher from Monash University in Melbourne, Australia. In some ways, we have been here before. Early AIDS drugs such as AZT came to market in the late 1980s, but within a decade they were overtaken by powerful cocktail treatments known as HAART, or highly active antiretroviral treatment. HAART had a dramatic effect — rapidly driving the virus out of patients’ blood and prompting some to say a cure was just around the corner. But then scientists discovered HIV could lie low in pools or reservoirs of latent infection that even powerful drugs could not reach. Talk of a cure all but died out. “Scientifically we had no means to say we were on the way to finding a cure,” says Bertrand Audoin, executive director of the Geneva-based International AIDS Society. “Scientists ... don’t want to make any more false promises. They didn’t want to talk about a cure again because it really wasn’t anywhere on the horizon.”   The ultimate goal would allow patients to stop taking AIDS drugs, knocking a hole in a $12 billion-a-year market dominated by Californian drugmaker Gilead and the likes of Pfizer, GlaxoSmithKline and Merck. It’s unlikely to happen anytime soon, but Brown’s case has opened the door to new ideas. “What it proved was that if you make someone’s cells resistant to HIV...then all the last bits of HIV, that hang around for a long time in patients on treatment, did in fact decay and disappear,” says Lewin. Now scientists working on mimicking the effect of the Berlin patient’s transplant have had some success. One experimental technique uses gene therapy to take out certain cells, make them resistant to HIV and then put them back into patients in the hope they will survive and spread. At an HIV conference in Boston earlier this year, American researchers presented data on six patients who had large numbers of white blood cells known as CD4 cells removed, manipulated to knock out the existing CCR5 gene, and then replaced. “It works like scissors and cuts a piece of genetic information out of the DNA, and then closes the gap,” says Huetter. “Then every cell arising from this mother cell has this same mutation.”   Early results showed the mutated cells managed to survive inside the bodies of the patients at low levels, remaining present for more than three months in five. “This was a proof of concept,” says Lewin. Another potential avenue is a small group of patients known as “elite controllers”, who despite being infected with HIV are able to keep it under control simply with their own immune systems. Researchers hope these patients could one day be the clue to developing a successful HIV/AIDS vaccine or functional cure. Scientists are also exploring ways to “wake up” HIV cells and kill them. As discovered in the late 1990s, HIV has a way of getting deep into the immune system itself — into what are known as resting memory T-cells — and going to sleep there. Hidden away, it effectively avoids drugs and the body’s own immune response. “Once it goes to sleep in a cell it can stay there forever, which is really the main reason why we can’t cure HIV with current drugs,” says Lewin. Her team in Melbourne and another group in the United States are about to start the first human trials using a drug called SAHA or vorinostat, made by Merck and currently used in cancer treatment, which has shown promise in being able to wake up dormant HIV. As scientists begin to talk up a cure, the old question of whether that’s the right goal has re-emerged. Seth Berkley, a medical epidemiologist and head of the U.S.-based International AIDS Vaccine Initiative (IAVI) is concerned. An HIV-positive person holds a placard during a programme organized to mark World AIDS Day in Kathmandu December 1, 2010. To match Special Report AIDS/ REUTERS/Deepa Shrestha “From a science point of view, it’s a fabulous thing to do. It’s a great target and a lot of science will be learned. But from a public health point of view, the primary thing you need to do is stop the flow of new infections,” says Berkley. “We need a prevention revolution. That is absolutely critical.”   Vuyiseka Dubula agrees. The South African activist finds talk of a cure for HIV distracting, almost disconcerting. “This research might not yield results soon, and even when it does, access to that cure is still going to be a big issue,” she says. “So in the meantime, while we don’t have the answer on whether HIV can be cured or not, we need to save lives.”
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Special Report: An end to AIDS?.


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The government said in a friend of the court brief filed on Friday that glyphosate, the weed killer’s active ingredient, is not a carcinogen and as a result a warning on the label was not required as California state law demands. The backing by the EPA and Justice Department comes days after Bayer asked a U.S. federal appeals court to throw out a $25 million judgment it was ordered to pay Edwin Hardeman. Bayer had denied its Roundup weed killer causes cancer. In April, the EPA reaffirmed that glyphosate does not cause cancer. Farmers spray glyphosate, the most widely used herbicide in U.S. agriculture, on fields of soybeans and other crops that are genetically engineered to resist it. Roundup is also used by consumers on lawns, golf courses and elsewhere. Hardeman’s lawyers previously accused Roundup maker Monsanto, which Bayer acquired last year in a $63 billion deal, of having failed to warn consumers about the herbicide’s cancer risk. Bayer stock has lost about 23% in value since the first Roundup verdict for plaintiffs in August 2018. Bayer argued it would be impossible to comply with the Hardeman verdict, a lawsuit brought under state law, because any warning label would be in conflict with guidance from a federal agency. The EPA and Justice Department agreed in their Friday filing. “It is unlawful for manufacturers and sellers to make claims on their labels that differ from what EPA approves,” the U.S. government said.
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More Breast Cancer Patients Should Consider Radiation, New Guidelines Say


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“You want to get clean so bad. You know something’s killing you and you can’t stop,” said the 33-year-old who used heroin for 10 years. This spring was different. While in a jail work-release program, she took a medication called buprenorphine. It quieted a voice in her brain that told her to keep using. When she got out of jail, she headed for an Olympia clinic where a doctor is working to spread a philosophy called “medication first.” The surprising approach scraps requirements for counseling, abstinence or even a commitment to recovery. Instead, it starts with fast access to prescribed medicine that prevents withdrawal sickness. After patients start feeling better, they choose their next steps. In St. Louis, Seattle and San Francisco, people with opioid addictions can start medication on their first day of treatment. Early research suggests the approach can change lives. But it will be a tough sell elsewhere: Nearly two-thirds of U.S. treatment centers don’t offer anti-addiction drugs and there’s resistance to easy access. Within two weeks of walking into the Olympia clinic, Cline had a job at a millwork shop. Now, nine months later, she has received a promotion and a raise, rebuilt relationships, found a room in a sober house and is proud to display a chain of “Clean & Serene” key fobs she earned from Narcotics Anonymous. She takes buprenorphine twice daily. “I’ve got my life back,” she said. The opioid crisis now kills more Americans than car crashes and is estimated to cost more than $500 billion a year. The epidemic is driving new treatment strategies for the 2 million Americans addicted to opioids. Bupe, as it’s known, isn’t new. Approved to treat opioid addiction in 2002, it blocks the effect of other opioids and eases withdrawal. It’s an opioid, but an imperfect fit for the brain’s receptors, so its effect is mild and it doesn’t cause a high. It also lowers the danger of overdose and raises the likelihood a person will stay in treatment. But finding a prescriber without a waiting list is difficult. Guidelines say bupe should be used alongside counseling, which some doctors don’t feel equipped to provide. Success stories have convinced some experts that buprenorphine should be available in homeless camps, syringe exchanges and anywhere people use drugs. “This is an obvious thing to do,” said University of Washington researcher Caleb Banta-Green. STABILIZING INFLUENCE OR FALSE PROMISE? Martyn is a 57-year-old former heroin user who goes by one name. He was living in a Seattle homeless camp known as the Jungle, running errands for drug dealers. “Toward the end, you’re not trying to get high anymore,” he said. “You’re just trying to not be sick.” He got his first bupe prescription at Neighborcare Health, a free downtown clinic. Once stabilized, he found a spot in a sober home with help from a caseworker. “Now I’ve got a little room in a house I share with seven other guys.” On bupe, Martyn said, “I don’t get that high feeling. And that’s OK.” Critics worry medication-first clinics will add to the flood of opioids on the street. The tactic could also lead to a false understanding of addiction, said Atlanta-based counselor Samson Teklemariam, who directs training for NAADAC, the Association for Addiction Professionals. “You’re promising the public a cure,” Teklemariam said. “There’s not a pill that you can take to alleviate symptoms of true addiction.” In Missouri, some treatment programs had shunned buprenorphine, particularly long-term, in favor of abstinence-based counseling and support groups. Some didn’t have doctors or nurses who could prescribe it. Some believed medications were a crutch that prevented true recovery. In 2017, with overdose deaths rising, Missouri tied federal grant money to a medication-first philosophy. Programs would get money only if they started clients on meds rapidly and if they dropped rules about medication time limits and attending counseling. The result? Medication treatment increased and more patients stayed in treatment longer, said Rachel Winograd of University of Missouri-St. Louis who studied the implementation. There’s pushback in Missouri from those who see the idea as at odds with “full and thriving recovery,” Winograd said. “The state is saying, we can do both.” MEASURING EFFECTIVENESS Research is beginning on the idea. In New York, 250 drug users will be enrolled at syringe exchanges. Some will be randomly assigned to get same-day bupe prescriptions and others will get standard care. “If the older treatment philosophies were working, we wouldn’t have the problems we’re having today,” said Dr. Aaron Fox, who is leading the study. In Washington state, health officials are encouraging jails and drug courts to embrace bupe. Many are changing their policies. Not everyone approves. In Skagit County, Prosecuting Attorney Rich Weyrich calls bupe “low-grade heroin.” He bristles at requirements tying drug court money to medication assisted treatment. “There are lots of things happening in the big cities that I don’t agree with,” Weyrich said. Sixty miles away in Seattle, King County Prosecutor Dan Satterberg has tried to convince other prosecutors of bupe’s value. His sister, Shelley, used heroin for years. In 2015, after starting treatment with bupe, she got clean. “I saw firsthand the difference it made in her life,” Satterberg said. “We became a family.” Years of drug use had worn down Shelley’s health. She died in March 2018 of an infection at age 51. Bupe should be “as easy to get as heroin,” Satterberg said. To those in law enforcement who worry about it trading on the street, he said: “At least they’re not buying fentanyl and supporting the Mexican cartels. At least they’re not going to overdose. And they might find out buprenorphine actually makes them feel better.” A pilot study in Seattle treated 147 patients in one year, most of them homeless. The program reached capacity within three months and kept people in treatment at rates similar to other programs. That drew financial support from a foundation, resulting in four new sites. They are expected to serve 1,250 patients over two years. To treat one patient for one year at the Olympia Bupe Clinic costs $3,000 in public money, said its medical director, Dr. Lucinda Grande. She said the money will prevent steeper hospital costs down the road. A ‘GODSEND’ On a recent evening, Grande spent more than three hours helping people start or maintain treatment with bupe. She met with patients in a cluster of donated furniture, a floral-pattern sofa and chairs. Two new patients wanted to start bupe for the first time. Former patient Jamie Cline proudly told Grande of recent accomplishments at her workplace. “You’re getting used to being successful,” Grande observed, smiling with encouragement. Later, pharmacist Brad Livingstone arrived. At the front desk, he opened a clear plastic bin with 14 pill bottles inside. He called out a name. Jon Combes, 36, of Lacey, Washington, stepped up to get his pills, a “godsend” that has helped him sleep. “They don’t care what your past is,” Combes said of the clinic’s staff. “They just want to get your future going.” Combes had been coming to the clinic for three weeks. He took home a 12-day supply of medication. That evening, 31 people picked up medications. Young men with tattoos and ballcaps. A middle-aged woman with stylish hair and smart clothes. A man in a wheelchair. A woman with a school-age child. Some nights there are as many as 45 picking up meds. Cline scrolled through her phone to find photos of herself when she was in the depths of heroin addiction. The pictures remind her of where she’s been, a time she does not want to forget. “I’m always going to be an addict,” she said. “I’ve got to be very careful where I step.” ___ The Associated Press Health and Science Department receives support  from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
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Walk-in clinics for opioid addiction offer meds first, fast.