Slower progress likely in search for HIV cure : Liz Hunt reflects on the pluses and minuses of the Aids conference in Amsterdam this week

THERE were more than 900 speakers at 165 sessions covering the basic science of HIV, the clinical care of patients, the epidemiology and social impact of the Aids pandemic.

There were 11,000 delegates who negotiated their way through nearly 5,000 scientific papers, talks and presentations. There were protests, sit-ins and 'die-ins'. And there was Hollywood too. Liz Taylor as founder of AmFar, the American Foundation for Aids Research; and Francis Ford Coppola, the film director, researching a new film - working title: The Cure.

A cure is why they all came. But Mr Coppola is likely to be more successful in his quest.

As the conference closed yesterday, the inescapable conclusion was that, despite the most intensive clinical research ever devoted to one disease, progress will now be slow and painstaking.

Rapid advances in the first decade of Aids - of finding the virus and developing a test, of new drugs to slow the onset of Aids and better drugs to treat related infections - will be followed by a 'consolidation' phase, according to Anthony Pinching, Professor of Immunology at St Bartholomew's Hospital, London. 'And we're in for a hard, long haul.'

But there was some good news. Large-scale trials of some candidate vaccines, which may protect healthy people from HIV, are likely to begin by 1995. And progress is reported for therapeutic vaccines too - vaccines for HIV-positive people, which may boost their immune system.

Drug therapy against the virus and the infections it causes remains the best way of prolonging life, and there are hundreds of trials of new drugs.

But one issue overshadowed all. The occurrence of an Aids-like illness in patients without HIV, and the claim by a Californian doctor that he has found a new virus which may be the cause.

Aids experts were sceptical and said that it was a preliminary report only, but journalists pursued the story relentlessly. Under the spotlight, the World Health Organisation has called an urgent meeting to discuss the cases. The 'new' virus was dubbed MTV - the media-transformed virus.

Away from the impromptu press briefings, social issues - and particularly the role of women - were a central theme of the conference. Dr Michael Merson, of WHO's global programme on Aids, said that HIV 'thrived' on poverty and discrimination.

Women, as wives, lovers and mothers, have a key role in education prevention. 'Empowering' women, particularly in the Third World, so that they could talk with their partners about safer sex was vital. Developing protection for women - such as the female condom - was also a priority.

And then there was Africa. The sheer scale of the Aids epidemic, with a quarter of the adult population infected in some areas, is difficult to comprehend. A second epidemic has taken hold too, and tuberculosis is making people with Aids die faster while it spreads to those who do not have HIV.

The numbers affected are staggering, but it is the personal stories which have the greatest impact. The 76-year-old man who is caring for eight grandchildren left orphans by Aids, or the elder sisters who must care for younger children because their parents are dead or dying. The conference offered little in the way of hope to these people.

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