New phase in AIDS battle prompts strategic rethink

AIDS experts gather in Vienna on Sunday for a six-day rally on the new options emerging in a war which after nearly three turbulent decades is entering a stable, promising phase.

Expected to draw more than 20,000 researchers, policymakers and grassroots workers, the International AIDS Conference is the 18th since acquired immune deficiency syndrome came to light in 1981.

For almost all this time, the conferences have been the theatre for frustration and sometimes anger. Doctors would reel off the latest setbacks in the quest to treat and prevent the AIDS virus, while activists pounded the drum for money and action by Big Pharma.

Today, though, the mood is brighter than ever. Indeed, many AIDS warriors are talking cautiously of a foe that is on the way to being contained and one day will be rolled back.

"One day, we will have to turn our minds on how to wipe out the virus," Jean-Francois Delfraissy, director of France's National Agency for AIDS Research (ANRS), said in an interview.

The optimism comes from the success of antiretroviral drugs, the "cocktail" of drugs that, like a boot pressed firmly on the throat of a killer, keeps HIV suppressed.

For millions, this medication has transformed the human immunodeficiency virus (HIV) from a death sentence to a chronic but manageable disease.

Even better, antiretrovirals are also emerging as a policy tool for prevention. Lowering viral levels to below perceptible levels massively reduces the risk of handing on the pathogen between sex partners or from a pregnant mother to her child.

There is also hugely encouraging news about male circumcision for preventing the spread of HIV to men, and even a few glimmers of hope from the lab, where scientists are toiling for a vaccine and virus-thwarting microbicide gel.

"We really are at an important crossroads," Gottfried Hirnschall, new director of HIV/AIDS at the UN's World Health Organisation (WHO), said in an interview.

"It's all coming together. We no longer have this treatment-versus-prevention conversation. The question now is about making the best of the resources we have, and in the most intelligent way."

Many terrible problems remain, Hirnschall cautioned.

More than 33 million people live with the virus and each year 2.7 million more cases of HIV occur. Stigma, ignorance and discrimination, in many places, are entrenched. Millions of poor, needy people have yet to clutch the drug lifeline.

To help them, a key question in Vienna is how to finetune the use of antiretrovirals and mesh them with low-cost medical support, using nurses or medical orderlies as substitutes for doctors.

Doctors may be advised to start prescribing anti-HIV drugs at an earlier stage of infection, a tactic that would save more lives and, say some, be a cost-saver too, as healthy people are more productive for longer.

Yet does the world have the will, at a time of belt-tightening, to foot the bill for treating people sooner?

This year, 25 billion dollars has to be mustered for fighting AIDS in poorer countries, according to a UNAIDS estimate. So far, there is a funding shortfall of 11.3 billion, according to an analysis published last week in the US journal Science.

That means a 2006 vow by UN members to provide "universal access" to HIV drugs, prevention, treatment and care by the end of 2010 is set to become one more headline-making political promise that fell flat.

"The success of ARVs (antiretrovirals) made it so people think HIV is no longer there," said Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS in Vancouver, Canada, and president of the International AIDS Society, which is organising the conference.

"Politicians basically react on a short-term agenda. Since HIV treatment became effective, people are not under the same pressure that they used to be."

The Vienna conference will also turn the spotlight on Eastern Europe, where the epidemic is being driven especially by intravenous drug users.

Russia and Ukraine, the two hotspots of infection, are under pressure to scrap policies that criminalise drug users and to encourage needle-exchange programmes and help to wean addicts of heroin by using methadone, a safer substitute for opiates.

VIPs attending include former US president Bill Clinton, Microsoft tycoon and philanthropist Bill Gates, rock star Annie Lennox and Hollywood actress Whoopi Goldberg.



Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Rumer was diagnosed with bipolarity, attention deficit hyperactivity disorder and post-traumatic stress disorder: 'I was convinced it was a misdiagnosis'
peopleHer debut album caused her post-traumatic stress - how will she cope as she releases her third record?
Arts and Entertainment
'New Tricks' star Dennis Waterman is departing from the show after he completes filming on two more episodes
tvOnly remaining original cast-member to leave long-running series
Life and Style
Couples have been having sex less in 2014, according to a new survey
Holly's review of Peterborough's Pizza Express quickly went viral on social media
Arts and Entertainment
musicBiographer Hunter Davies has collected nearly a hundred original manuscripts
A long jumper competes in the 80-to-84-year-old age division at the 2007 World Masters Championships
Life and Style
Walking tall: unlike some, Donatella Versace showed a strong and vibrant collection
fashionAlexander Fury on the staid Italian clothing industry
Arts and Entertainment
Gregory Porter learnt about his father’s voice at his funeral
Arts and Entertainment
tvHighs and lows of the cast's careers since 2004
Life and Style
Children at the Leytonstone branch of the Homeless Children's Aid and Adoption Society tuck into their harvest festival gifts, in October 1936
food + drinkThe harvest festival is back, but forget cans of tuna and packets of instant mash
Lewis Hamilton will start the Singapore Grand Prix from pole, with Nico Rosberg second and Daniel Ricciardo third
F1... for floodlit Singapore Grand Prix
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    KS1 Primary Teacher

    £100 - £150 per day: Randstad Education Leeds: Qualified KS1 Supply Teacher re...

    KS2 Teaching Supply Wakefield

    £140 - £160 per day: Randstad Education Leeds: Qualified KS2 Supply Teacher r...

    Year 1/2 Teacher

    £130 - £160 per day: Randstad Education Leeds: Qualified KS1 Teacher required,...

    Primary Teachers Needed for Supply in Wakefield

    £140 - £160 per annum: Randstad Education Leeds: Qualified KS1&2 Supply Te...

    Day In a Page

    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits
    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments
    These Iranian-controlled Shia militias used to specialise in killing American soldiers. Now they are fighting Isis, backed up by US airstrikes

    Widespread fear of Isis is producing strange bedfellows

    Iranian-controlled Shia militias that used to kill American soldiers are now fighting Isis, helped by US airstrikes
    Topshop goes part Athena poster, part last spring Prada

    Topshop goes part Athena poster, part last spring Prada

    Shoppers don't come to Topshop for the unique
    How to make a Lego masterpiece

    How to make a Lego masterpiece

    Toy breaks out of the nursery and heads for the gallery
    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Urbanites are cursed with an acronym pointing to Employed but No Disposable Income or Savings
    Paisley’s decision to make peace with IRA enemies might remind the Arabs of Sadat

    Ian Paisley’s decision to make peace with his IRA enemies

    His Save Ulster from Sodomy campaign would surely have been supported by many a Sunni imam