23 July 2012

Experts hope to turn the tide on Aids

Science has given the world "no excuse" to resist bold action against the spread of the 30-year Aids pandemic.


Science has given the world "no excuse" to resist bold action against the spread of the 30-year Aids pandemic, said a top US expert at the opening of the International AIDS Conference.

This year's meeting, themed "Turning the Tide Together," is the world's largest gathering on HIV/Aids and is expected to draw 25 000 people, including politicians, scientists, celebrities and activists to the US capital.

Experts and high-profile guests

High-profile guests at the six-day event include Secretary of State Hillary Clinton, former president Bill Clinton, former first lady Laura Bush, singer Elton John and actress Whoopi Goldberg.

President Barack Obama will not attend in person but will send a video message and will invite some attendees to the White House for talks, a top health official said.

Many experts have spoken of their optimism in the days leading up to the event. But Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the pace of progress must accelerate.

"The fact remains that right now, today, in the summer of 2012, 31 years after the first cases were reported, there is no excuse scientifically to say we cannot do it," Fauci said.

"What we need now is the political, organisational and individual will to implement what science has given us."

Fauci cited the UNAIDS report released last week that showed there were 2.5 million new infections worldwide in 2011, down from 2.7 million in the prior report.

"But that makes the slope look like that," he said, holding out a flat hand. "That is unacceptable."

Early treatment a must

Among the tools scientists have are trials that show treatment can reduce the risk of transmitting the virus to others, and antiretroviral drugs that, when taken by healthy people, can help reduce their risk of becoming infected.

"My message to policy makers around the entire world watching us in DC is this: invest in science, invest in the epidemic - you will save lives," said Diane Havlir, the co-chair of AIDS 2012 at an evening ceremony.

Also on opening day, an international group of scientists called for all adults who test positive for HIV to be treated with antiretroviral drugs immediately - rather than waiting for their immune systems to weaken.

The International Antiviral Society is the first global group to make such a call.

Other major groups, such as the World Health Organisation, currently urge treatment after the disease progresses to a certain point, or when the body's T-cell count, or CD4 count, reaches or falls below the level of 350 cells/mm3.

"These guidelines are aspirational," said Melanie Thompson, a doctor with the AIDS Research Consortium of Atlanta, urging increased testing and better care of those who test positive for HIV.

"The science should drive the allocation of resources and guidelines can play an important role in that respect."

Some 34 million people in the world are living with HIV, according to the latest UNAIDS report. However, about one in five people are not aware of their status and are most at risk of spreading the disease.

Eight million people in low and middle income countries are now on antiretroviral treatment, making up about half of those in the world who need it, the UNAIDS report said.

Investing towards a cure

Held every two years, the conference has returned to the United States for the first time since 1990, after being kept away by laws that barred people with HIV from travelling to the country. The US ban was formally lifted in 2009.

The hunt for a cure will be another hot topic. HIV co-discoverer and Nobel laureate Francoise Barre-Sinoussi announced a new roadmap for scientists in research toward a cure.

The only man who has achieved a functional cure of HIV through a bone marrow transplant, American Timothy Brown, also known as the "Berlin patient," will address the conference to publicise new efforts in this regard.

Funding, too, is at a critical juncture, with many nations boosting their domestic spending on the disease while international donations remain flat.

Total worldwide investment in HIV was $16.8 billion last year, an 11% rise from 2010, but still far short of the $22-24 billion needed by 2015, according to UNAIDS.

(Sapa, July 2012)

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HIV/Aids expert

Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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