Malaysian Airlines Flight MH17 was sadly at the centre of discussions as the AIDS 2014 Conference commenced in Melbourne on 20 July.
Several colleagues, including Dr Joep Lange, the former International AIDS Society President, were on the doomed flight. They will be missed deeply in the crowd of over 15,000 international delegates in Australia. Senior AIDS experts died in a region that needed them the most: Eastern Europe, where HIV infection is on the rise due to legal suppression and drug use issues.
The United Nations is setting a target to end AIDS by 2030. To achieve this, all those involved in the response have to step up the pace: this is the AIDS 2014 theme.
Like past AIDS conferences, the 2014 Melbourne event is a good opportunity to discuss successes and setbacks, and to rethink future goals. Scientifically-speaking, enormous success has been made on prevention, diagnosis and cure of the virus.
“Nearly 14 million people are now on treatment globally, that is a great, collective achievement,” says Michel Sidibe the UNAIDS executive director.
Medical science is making new and exciting progress. An HIV vaccine, early diagnosis and treatment, preventing infection, limiting HIV reservoir and replication, novel therapy and eliminating cells capable of producing HIV are the most promising medical development to look out for in the near future.
But antiretroviral coverage still needs to expand in many countries and regions and there have also been setbacks on the science front. The ‘Mississippi baby’ is a case which has questioned progress as a viral rebound took place in a baby after 27 months of no signs of HIV, followed by 18 months treatment after birth.
Political and social contexts
The political situations and legal environments around the world are also an important factor in determining the future of HIV. “Fifteen countries of the world account for 75 per cent of new infections and mortality,” says Sidibe.
There is a need for global advocacy to hold governments accountable for decriminalising HIV and making antiretroviral treatment more accessible.
A Global Commission on HIV and Law and the Melbourne Declaration are welcome steps, to be discussed further in Melbourne. These aim to make legal systems accountable for decriminalisation and ensure equity in diagnosis and treatment.
Role of civil society
The role of civil society needs to be discussed with greater focus. In a session hosted by UNAIDS on South-South Collaboration at AIDS 2014, experts from India and South Africa presented the impressive progress both countries have made on the disease. The two countries have a large number of people living with HIV and together constitute a major portion of global HIV burden.
“Civil society in South Africa has been instrumental in our response to HIV. Some 2.4 million people are on treatment and our PMTCT [prevention of mother to child transmission] rates have gone down by 80 to 90 per cent,” said Dr Fareed Abdullah from the National AIDS Control Programme of South Africa.
Meanwhile, India has reduced mortality by over 35 per cent and partnerships with civil society have been largely responsible in achieving this, according to a senior government officer from India.
End AIDS by 2030
At the conference’s opening ceremony, an inspiring Indonesian young woman spoke about how HIV cannot be fought by science alone. It needs people’s support and global solidarity. The roles of people and civil society must continue to develop and the efforts need to percolate deeper into society.
Significant successes can be impacted by minor setbacks. It is like running faster in the last moments of a marathon. It is time to run faster to catch up with the new infections, the roadblock to the end of AIDS.
*Dr. Prakash Tyagi, Executive Director, GRAVIS. He has written this for the Key Correspondents network which focuses on marginalized groups affected by HIV, to report the health and human rights stories that matter to them. The network is supported by the International HIV/AIDS Alliance< http://www.aidsalliance.org/