International AIDS Society (IAS) Conference – Day 3

During today’s plenary session we heard HIV experts from Australia, the Ivory Coast and Belgium.  Susan Kippax (Australia) talked about the social barriers to effective HIV prevention.  She argued that any prevention plan will require people to change their social practices.  Additionally, she presented the case that people’s behavior cannot be separated from their social, cultural and political structure and the biomedical pieces of prevention planning cannot be separated from the non-biomedical ones.  As such, Kippax voiced the requirement that social scientists be part of the discussion when creating HIV prevention plans and policy.

Serge Eholie (Ivory Coast) made a presentation outlining the challenges of antiretroviral therapy (ART) in developing countries.  It has been 10 years since the first antiretroviral therapy initiatives were launched in developing countries.  Recent data estimates that 6 million people have started ART with 4.5 million of them living in sub-Saharan Africa resulting in a significant decrease in the HIV mortality rate. Eholie stated that while there has been significant progress using ART in developing countries, there is still a challenge with sustained funding, a need to start treatment earlier to avoid the high mortality rate during the first year after ART initiation, and the need to train health care workers, physicians and countries on implementing the new 2010 WHO guidelines for HIV treatment.  Eholie also addressed the challenges of treatment side effects, the issue of patient retention, the increasing number of first line treatment failures, the high cost of second line treatment, socio-political instability, and natural disasters.

During Peter Piot’s (Belgium) presentation on the topic “AIDS: The Need For A Long Term Response,” Peter pointed out that the global response to the AIDS epidemic has been framed as an emergency because of the huge mortality and human suffering caused by it.  However, the ultimate long duration of the crisis has never been addressed; consequently, long term planning has never been carried out.

Despite the decline in funding and interest in the AIDS crisis, UN member states recently adopted a new declaration subtitled “Intensifying Our Efforts To Eliminate HIV/AIDS”.  This declaration contains ambitious goals for the next five years.  Projections from AIDS 2031 and UNAIDS estimate that over the next two decades, there will be 1 million-1.5 million new HIV infections and one million deaths annually. The resources required to curb infection rates and treat new infections are well in excess of currently available funds.  These facts together along with the longer life expectancy of people living with HIV provided a compelling argument for a long term view on AIDS response.

I spent a large portion of the afternoon saturating my brain with the more than 1,300 poster presentations on display during the conference.  Topics covered included treatment, prevention, mechanisms of transmission, health program implementation, health program monitoring and evaluation, and vaccines to name a few.  So much information…

Don’t forget to check out our Day 1 and Day 2 coverage.

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