HIV is not in recession

Such was the refrain at opening session of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. After cultural entertainment and a welcome to Cape Town from the Deputy President of the Republic of South Africa (so is that like the Vice President), a young South African HIV positive woman poignantly described the dangers of the global community backing away from the current levels of funding for HIV prevention, treatment, and care (not to mention the G8 pledge from 2005 to provide universal access for all who require anti-retroviral treatment by 2010). The consequences of reduced support for treatment are very real; first, effective treatment reduces the amount of virus circulating, thus someone who is being successfully treated for HIV is much less likely to infect others. Second, any treatment interruptions quickly lead to resistant virus. The first line treatment regimen is fairly inexpensive here in sub-Saharan Africa (never mind that the choice of drug combination is based entirely on cost, not efficacy or safety, but that's a subject for another day). However, once a patient develops resistance to the first line regimen they must be switched to the second line regimen, which is roughly 100 times more expensive. Therefore, in the long run, cutting budgets for treatment now will cost more money and more lives in the long run. The Nobel Laureate Francoise Barre-Sinoussi ended her scientific talk with a slide with this refrain, and Stephen Lewis, the former special envoy to the UN on HIV/AIDS gave a motivational talk to the scientific community to urge us to take a larger role in activism. His argument is that as scientists we can and should use the weight of our science to promote public health. Sometimes just publishing in medical and academic journals isn't enough; he used the example of global climate scientists arguing for attention to climate change policy as evidenced by a recent full page ad in the New York Times. He recalled the push from the AIDS scientists following the International AIDS Conference in Toronto in 2006 against the Minister of Health of South Africa whose blatant ignorance of the science behind HIV/AIDS was leading to the tragic deaths and senseless spread of HIV among thousands of South Africans. I feel very proud to be working in a field that has such committed and passionate individuals, from the counselors, nurses, and community workers on the ground up to the leaders.