This week's International AIDS Society (IAS) Conference, hosted in Vancouver for the first time in nearly two decades, marks yet another milestone. The gold standard in HIV treatment (highly active antiretroviral therapy or HAART) was first introduced at the 1996 Vancouver IAS Conference. This was a pivotal moment, when HIV infection became a chronic manageable condition.
The 2015 IAS Conference, attracting around 6,500 delegates from all over the world, comes on the heels of three major achievements. It was announced this week that the Millennium Development Goal (MDG) of 15 million people on antiretroviral therapy by 2015 has been met. This is the first MDG that has been met, and we have done so nearly nine months ahead of schedule. There was also the recent release of the TEMPRANO and START trials confirming that immediate antiretroviral treatment for HIV reduces disease progression by about a half. Finally, there was the announcement of the final results of the HPTN 052 trial showing that an HIV infected person who faithfully takes effective antiretroviral therapy is virtually not able to pass on the virus. Furthermore, research studies from Vancouver, San Francisco, KwaZulu-Natal and Rwanda conclusively showed the strategy works in rich and in resource-limited settings. In other words: treatment fully prevents disease progression to AIDS, premature death and secondarily HIV transmission, through every means, all the time and everywhere.
Treatment as Prevention (TasP), pioneered in B.C. with support from the provincial government and introduced to the world nearly a decade ago at the 2006 IAS Conference in Toronto, has gained the day.
The world has now come to agreement that we need to provide treatment as early as possible (regardless of CD4 cell count level) to those living with HIV. This is a time to shine a light on the gains made in B.C. -- the only Canadian province to implement TasP and the only one to see a consistent decline in new HIV cases (65 per cent since 1994). At this year's IAS Conference, delegates and leaders signed on to the Vancouver Consensus, calling for the provision of immediate treatment to those diagnosed with HIV.
In a historic moment, at the conference opening, I read a letter from the Vatican to the BC-CfE that honoured the lives saved through TasP -- giving "witness to the possibilities for beneficial outcomes when all sectors of society unite in common purpose." Pope Francis called for all those living with HIV to be reached by treatment and joined other prominent figures who have endorsed the game changing TasP strategy, such as former U.S. President Bill Clinton.
TasP has been adopted progressively by jurisdictions around the world, including France, Spain, Panama, Sierra Leone, Tanzania, major US cities and the state of Queensland in Australia -- to name a few. Brazil, a forerunner in implementing universal access to antiretroviral therapy over a decade ago, redoubled its commitment by embracing the proposed UN 90-90-90 target, which asks that by 2020 we should have at least 90 per cent of people living with HIV diagnosed globally, 90 per cent of them on antiretroviral therapy and 90 per cent of them virologically suppressed. Meeting the 90-90-90 target by 2020 will ensure that AIDS incidence, premature mortality and new HIV infections will decrease by 90 per cent by 2030 (from 2010 levels). Doing so would put us on a path to ending AIDS as a pandemic disease by 2030.
At this point in history, it is upon political leaders to either join a science-based movement to end AIDS or to be left behind. Despite our progress, every day about 5,600 people contract HIV. In 2014, 1.2 million people died of AIDS and nearly 22 million people living with the disease are currently not accessing treatment. In particular, many children living with HIV are not being reached by lifesaving therapy.
To reach an AIDS-free generation, we will need political leadership, which should translate into full financing of the 90-90-90 target. We have been told repeatedly global funding for HIV and AIDS has reached a plateau -- at a time when a ramp up will save millions of lives, prevent millions of new infections and save money. Indeed, research by the BC-CfE released at this year's IAS Conference found expanding TasP in B.C. would result in $66.5 million in savings in health care and societal costs.
Unfortunately, the Canadian federal government is missing in action. In December 2013, Canada pledged approximately $6 per Canadian per year to global AIDS funding, far less than the nearly $10 per Nordic citizen. Underwhelming investment is characteristic of a broader trend from Ottawa. HIV treatment coverage is lacking and uneven within this country's own borders. The criminalization of vulnerable, at-risk groups such as injection drug users and sex workers (through legislation such as C2 and C36) creates further stigma and barriers to treatment.
TasP and it's related 90-90-90 target are the unequivocal, evidence-based path to ending the AIDS pandemic, the biggest health challenge of the last generation. Applying the same principles to other infectious disease, like hepatitis C, and even socially communicable illnesses, such as addiction, could result in more robust and sustainable health care system.
As we close the 2015 IAS AIDS Conference in Vancouver, we call on the leaders of the world to join us to end the AIDS pandemic. The scientific evidence is all in, the UN 90-90-90 target is the only way forward. There is nowhere to hide. You are either with us or against us! We demand you deliver on the promise of an AIDS-free generation by fully embracing and funding the UN 90-90-90 target, domestically and internationally.MORE ON HUFFPOST:
Only one quarter of the 1.1 million people with HIV have their condition under control, where "under control" means the virus has been suppressed, according to a report released this summer by the Centers for Disease Control and Prevention. CORRECTION: The first sentence has been reworded to more accurately reflect the number of people with HIV.
Even though two men were, for a time, able to go off antiretrovirals because their HIV had been reduced to undetectable levels after receiving bone marrow transplants, the HIV eventually returned in the men, according to news reports. In 2012, the news of the men’s undetectable HIV levels made headlines. The men, who were both HIV positive and taking antiretroviral drugs, had received bone marrow transplants for Hodgkin’s lymphoma. They had received the transplants while they were also taking the antiretroviral medication. However, in late 2013, preliminary results showed that the HIV had returned. This slide has been updated to note more recent developments related to the procedure.
New HIV infection rates can be dramatically lowered by making antiretroviral drugs free, a study from Canadian researchers found. The Canadian Press reported on the study, conducted by B.C. Centre for Excellence in HIV-AIDS researchers, which showed that British Columbia -- a province that offers free access to antiretroviral therapy -- had the lowest rate of new HIV infections over a more-than-10-year period, compared with Ontairio and Quebec.
More than half of HIV-infected young people are unaware that they have the virus, according to a Centers for Disease Control and Prevention report. "Given everything we know about HIV and how to prevent it in 30 years of fighting the disease, it's just unacceptable that young people are becoming infected at such high rates," Reuters reported CDC Director Dr. Thomas Frieden saying. The report also showed that for young people, 72 percent of the new HIV infections were in men who have sex with men, while almost 50 percent were in young, African-American males, Reuters reported. These figures are based on 2010 data.
The number of people living with HIV has increased by 18 percent from 2001 to 2011, according to a report released this year from the United Nations Programme on AIDS. An estimated 34.2 million people around the world are living with HIV. The report also showed that deaths from AIDS have dropped, from 2.3 million in 2005-2006 to 1.7 million in 2011, Reuters reported.
According to the same United Nations report, costs for the cheapest UN-recommended antiretroviral therapy drugs have also decreased over the past 10 years, Reuters reported. A year's worth of the drugs used to cost $10,000 in 2000 for one person; now, it costs $100 a year.
The Food and Drug Administration this year officially approved the drug Truvada -- which has been used since 2004 as a treatment for HIV -- to be sold as a preventive measure for people who don't have the infection, but are at high risk for it. The FDA said that the pill should be considered for preventive use not only by gay or bisexual men who are at high risk for HIV, but also heterosexual men and women who may also face HIV risks, the Associated Press reported. Heterosexual men and women make up more than one-fourth of new cases of HIV, and "that's not a portion of the epidemic we want to ignore," the CDC's Dr. Dawn Smith, who was the lead author of the new recommendations, told the Associated Press. The FDA also approved a new drug this year, Stribild, to treat HIV, Reuters reported.
In findings published this year in the journal PLoS Pathogens, scientists from the University of California, Los Angeles found that it's possible to genetically engineer stem cells to attack living HIV-infected cells in mice. While the study was only for "proof-of-principle," it "lays the groundwork for the potential use of this type of an approach in combating HIV infection in infected individuals, in hopes of eradicating the virus from the body," study researcher Dr. Scott G. Kitchen, an assistant professor of medicine at UCLA, said in a statement.
People should be screened for HIV even if they're not at high risk of contracting the infection, according to draft recommendations released just last month by the U.S. Preventive Services Task Force. The recommendations would mean that everyone between the ages of 15 and 65 should be screened for HIV, even if they're not at high risk for it, Reuters reported. "The prior recommendations were for screening high-risk adults and adolescents," Dr. Douglas Owens, a member of the USPSTF task force and a Stanford University medical professor, told Reuters. "The current recommendation is for screening everyone, regardless of their risk."
All HIV patients should be treated immediately with antiretrovirals, according to new guidelines issued this year from a panel of the International Antiviral Society-USA, as reported by TIME. The recommendations are counter to previous guidelines, which said that antiretrovirals should only be used if the CD4 count -- a measure of immune cells in a person's body -- becomes less than 350 cells for every mm3 of blood.
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