Following are the main outcomes of the 18th International AIDS Conference, which took place in Vienna from July 18-23:
Hailed as the best news in years, a vaginal gel containing an anti-HIV drug, tested on South African volunteers over 30 months, provided protection of 39 percent against the AIDS virus. There were no side effects nor viral resistance.
Caution must be sounded. Further test work is needed. Some experts doubt whether the gel, in its current formula, is protective enough to warrant being released to the public. But hopes are high that a powerful weapon will emerge to shield women against HIV, of especial importance in sub-Saharan Africa.
NEW MONEY PROBLEMS
After several years as a receding issue, the "funding gap" for fighting AIDS flared once more as donor countries tightened their belts in response to the recession.
After six successive years of big increases, funds for fighting the pandemic in poor countries fell back in 2009 to 7.6 billion dollars, leaving a gap of 7.7 billion dollars. For 2010, there is currently a funding gap of 11.3 billion. Campaigners are pushing for a "Robin Hood" micro-tax on financial transactions to meet a relentlessly rising bill for AIDS drugs.
There were no big announcements about new drugs to treat HIV. But encouraging evidence emerged about the effectiveness of existing drugs, especially in their ability to reduce virus levels to almost zero levels. When this happens, someone with HIV is far less likely to hand on the virus to another person. As a result, antiretrovirals are fast emerging as a policy tool to prevent the spread of HIV, and not just treat it.
Acknowledging data about the better safety and effectiveness, the World Health Organisation (WHO) unveiled new guidelines for treatment, recommending that patients get the therapy at an earlier stage of infection. Doing so boosts their chances of survival and avoiding chronic sickness.
A CURE FOR AIDS?
Scientists led by French Nobel laureate Francois Barre-Sinoussi ended a years-long taboo by launching a debate about whether HIV can be wiped out. After being repressed by drugs, HIV retreats to boltholes in the body, from where it rebounds if the treatment is stopped.
The goal is to see whether these "reservoirs" for the virus can be eradicated. But even if this is achievable, it lies many years away. Arduous, fundamental research will be needed to understand the immune system, identify the hiding places, find ways of flushing out the lingering virus and then destroy it.
Complex social problems are emerging as the war on AIDS nears the end of its third decade. Among them is how to treat and provide for the growing numbers of people who are growing old with HIV. Before antiretrovirals, they would have died.
Helping this rising tide of survivors will pose huge social, medical and financial challenges. HIV, and drugs taken to suppress it, are linked with a long list of peripheral sicknesses, including cancer, heart, liver and kidney diseases and diabetes. Many people with HIV have no network of support, fear stigma and discrimination, and have only meagre savings for their old age.