Women's Prevention Revolution demonstration. Photo©IAS/Steve Forrest/Workers' Photo
Rome is packed with tourists at this time of year. In a city littered with so many spectacular
ruins and imposing monuments, you hear loud exclamations all around you.
The scale of the problem
You might have thought you
would hear more exclaiming in response to some of the statistics presented at the
Auditorium Parco della Musica, where the International AIDS Society’s
conference is entering its final day. The truth is most of us here have heard
them all before and often. We’ve probably become numb to their shocking nature
or perhaps the scale is just so great we struggle to comprehend the human
Here are some statistics that may cause you to exclaim and help
explain the buzz here around prevention.
- In 2009, across
the globe, 7000 new HIV infections were registered every single day.
- That’s not far
off the number of people who were diagnosed in the UK during the whole of that same
- Since the HIV pandemic
years ago), over 25 million people have died with AIDS-related illnesses.
- 33 million people
are living with HIV today.
HIV is one of the most destructive diseases humankind has ever faced. It
has had profound social, economic and public health consequences.
HIV clearly has to be a priority in our world.
A sense of optimism
The great news from IAS 2011
is that the armoury for our fight against the virus is fuller than ever. There
are now so many potential weapons at our disposal – to combat HIV and to
prevent its transmission – it isn’t surprising there is a palpable sense of optimism
and excitement here.
Now, in addition to the prevention methods that we’ve practised since
the earliest days of the epidemic, including condoms,
we are learning more and foreseeing the potential impact of microbicides, circumcision
programmes and – a host of acronyms – TasP (treatment
as prevention), PEP (post-exposure
prophylaxis), PMTCT (prevention
of mother-to-child transmission), and PrEP (pre-exposure
prophylaxis). You can find out more about prevention
tools in NAM’s
recently launched online resource Preventing
conference has been described as a watershed in the global AIDS response. But,
as Michel Sidibé, UNAIDS’s Executive Director, cautioned as the event began,
“We have to remember that history will judge us not by our scientific
breakthroughs, but how we apply them.”
Judge us by our actions
The key challenge now is how to scale-up the breakthroughs we have been
hearing about over the last three days, to bring them to the millions of people
who need them across the world – and how to fund them.
And money, in these times of austerity, is going to be a major issue.
Numerous speakers at the conference have called for the advances in science to
be matched by advances in funding. There have been countless calls on
governments and donors to pledge to continue and increase commitment to HIV and
AIDS across all programme areas, now that the evidence shows so convincingly
their potential impact.
I hope the powers that be are listening in London. In its 2010 report, the UK’s Health Protection Agency drew attention to
the continuing high levels of transmission among gay men in the UK and stressed
the need for “ongoing prevention efforts tailored to all ages within this group”.
Just a few months later, NHS commissioners in London cut funding for community-delivered HIV
prevention services by 20%. And, as I write this, it is still unclear how or
whether treatment information services, which enable people with HIV to become
involved in their treatment and care, leading to improved adherence (critical
if treatment as prevention is to work), are to be commissioned across the capital.
Is a historian somewhere taking some notes?