Universal access to treatment, progress in scientific understanding of the human immunodeficiency virus (HIV) and the importance of human rights in responding to the disease highlighted the 18th International AIDS Conference.
Nearly 20,000 attendees from 193 countries included scientists; health care providers; political, community and business leaders; government, nongovernmental and multilateral organization representatives; and people living with HIV/AIDS. They met in Vienna July 18–23 for the annual gathering. Nearly 250 sessions covered science, community and leadership.
“International governments say we face a crisis of resources, but that is simply not true. The challenge is not finding money but changing priorities,” AIDS 2010 Chairman Dr. Julio Montaner, president of the International AIDS Society, said on the final day of the conference. “When there is a Wall Street emergency or an energy crisis, billions upon billions of dollars are quickly mobilized. People’s health deserves a similar financial response and much higher priority.”
Also on the last day, President Obama and Secretary of State Hillary Rodham Clinton sent video messages to attendees in Vienna.
“Ending this pandemic won’t be easy and it won’t happen overnight. But thanks to you we’ve come a long way and the United States is committed to continuing that progress,” said Obama, who on July 13 released a National HIV/AIDS Strategy that seeks to reduce the number of new infections in high-risk groups and increase access to care in the United States.
“Together we have mounted one of the greatest public health responses in history,” Clinton said. “Through your tireless efforts we have begun to halt and reverse the epidemic, and millions of lives have been saved.”
The United States, working through the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria, is the largest contributor to global AIDS programs.
In 2008, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 33.4 million people were living with HIV, up from 29 million in 2001. New HIV infections are believed to have peaked in the late 1990s and declined between 2001 and 2008, from 3.2 million to 2.7 million, even though there were more than 7,400 new HIV infections a day in 2008.
Most new infections are transmitted heterosexually, but risk factors vary. In some countries, men who have sex with men, injecting drug users and sex workers are at high risk for HIV infection.
By July 26, nearly 14,000 people had signed the Vienna Declaration. This official declaration of the conference seeks to improve community health and safety by calling for more rational and scientifically sound drug policies to strengthen HIV prevention among people who use drugs. Conference organizers characterized as a “disconnect” the gap between current knowledge and access to HIV prevention and treatment services for those who use injected drugs in Eastern Europe and Central Asia.
“Though injecting practices fuel the region’s epidemic, access to scientifically sound strategies, including needle and syringe exchange programs and opioid substitution therapy, are scarce and even illegal in many locations, including Russia,” according to the official conference press release
Scientists around the world reported progress in several areas. A microbicide gel containing an anti-retroviral drug was shown to be modestly effective in reducing the risk of infection by the HIV virus in a clinical trial of women volunteers in Durban, South Africa. Another trial already in progress and others that will be conducted to improve the product’s effectiveness could move the product toward availability within several years, scientists said.
Several research laboratories, including that of Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the U.S. National Institutes of Health, reported findings about the earliest stages of HIV infection. HIV targets CD4 cells, a type of white blood cell.
“[Fauci’s] lab has identified a specific type of CD4 cell that’s especially vulnerable to the first infection, and then several other groups today talked about similar findings of that first cell and what it looks like,” Jon Cohen, a reporter for Science magazine who is providing coverage of the meeting for the Kaiser Family Foundation, said in a July 22 interview.
“They all found slightly different things and some overlapped, but the basic idea could really influence future development of vaccines” and possibly a cure, he said.
“If it’s the first cell that gets infected, what if a vaccine could make an immune response that’s targeted to protecting that cell? And the cure idea is simply, if that cell is particularly vulnerable, there’s going to be more HIV in it, what if you could wipe out those cells?” Such basic research could take many years to yield a new vaccine or drug.
Principal investigators of a clinical trial called the Cambodian Early Versus Late Introduction of Antiretroviral Drugs (CAMELIA) announced that it is possible to extend the survival of untreated HIV-infected adults with very weak immune systems and newly diagnosed tuberculosis (TB) by starting anti-HIV therapy two weeks after beginning TB treatment, rather than waiting the standard eight weeks.
The study, co-funded by NIAID and the French National Agency for Research on AIDS and Viral Hepatitis, was launched in January 2006 at five sites in Cambodia, a country with a high prevalence of TB and HIV.