Tuesday, April 1 – Daily Summary

  • What’s ahead

    • Day Two of the Treatment as Prevention Workshop will begin with presentations from representatives of the WHO, NIH, NIDA, ANRS, and UNAIDS.
    • The second session will look at country-based Treatment as Prevention initiatives. The afternoon will begin with the first abstract-driven session of the workshop, followed by a session examining challenges and opportunities with Treatment as Prevention
    • For details on session times and presenters, please click here.
    • Follow along with the Treatment as Prevention Workshop live stream and on Twitter @BCCfE and #TasP2014.

    Dr. Luiz Loures, Deputy Executive Director of UNAIDS

    Towards new HIV treatment targets

    This year’s International HIV Treatment as Prevention Workshop began with an opening roundtable session that gathered high-level delegates from across the globe. The goal of the panel: to bring together the key national decision-makers and pivotal international partners to explore the importance of new HIV treatment targets.

    The session, a political segment co-hosted by UNAIDS and the BC Centre for Excellence in HIV/AIDS, comprised representatives from the three key groups influencing HIV strategy: politicians, scientists, and community.

    The critical need to bring these groups together would emerge as the key theme of the Workshop’s opening day.

    Progress through equality

    Dr. Luiz Loures, Deputy Executive Director of UNAIDS, began the session with a keynote address tracing the history of the HIV epidemic while pointing the way toward achieving an AIDS-free generation.

    Dr. Loures recounted visiting Vancouver in 1996 for the International AIDS Society conference, and how the response to HIV treatment has grown in strength. In order to continue to build on the success that has followed, Dr. Loures argued, political will, science, and community organization must be consolidated. Most critically, he said, progress needs to be equitable.

    Vulnerable populations such as women, children, and men who have sex with men remain at-risk as a result of ongoing discrimination in many countries. “They are not being left behind by choice; they are being left behind by all of us,” he said.

    He called for renewed partnerships with communities to maximize resources, improve the efficiency of treatment scale-up, and end discrimination. “We risk not moving forward in part because health systems are saturated. They must move closer to communities to improve outcomes.”

    Where this has been done, he said, there has been less discrimination, more HIV testing, and better health outcomes.

    Setting new targets

    A video message from Dr. Mark Dybul, Executive Director of the Global Fund to Fight AIDS, Tuberculosis & Malaria, established the necessity to set clear treatment and prevention targets.

    “We should be setting one goal, and one goal only: to end HIV as an epidemic,” he said.

    Dr. Dybul spoke to the need to move away from generalized targets and instead focus treatment and prevention efforts on key affected populations: the people most marginalized and made vulnerable as a result of societal determinants. “We have to bring the epidemic under control within all of these affected populations,” he said. “If we don’t, we will continue to leave people behind.”

    The primary goal, Dr. Dybul asserted, should be a world free from HIV as a public health threat—in every sub-region, in every sub-geography, and in every key affected population.

    “We will defeat this epidemic.”

    Consolidating efforts

    Pamela Martin, a former broadcast journalist and current liaison to the Premier of British Columbia, moderated the roundtable discussion. The panel brought together global decision-makers: Hon. Terry Lake, Minister of Health, British Columbia; Hon. Clarice Modeste-Curwen, Minister of Health, Grenada; Dr. Christine Nabiryo, The AIDS Support Organization; Nikos Dedes, Positive Voice; Dr. Julio Montaner, Director, BC Centre for Excellence in HIV/AIDS; and Dr. Loures.

    Minister Modeste-Curwen shared the Caribbean experience and the need to invest in fighting the epidemic, acknowledging the financial support of organizations including the Global Fund. Upon initial investment it was no longer a problem of cost; instead, she said, “the question became: can we afford not to treat?”

    Pointing to the success of British Columbia’s treatment as prevention strategy, Minister Lake called for fellow politicians to follow the evidence and not the ideology. “Look at the evidence and the economics,” he advised, in reference to the cost-benefits of treatment expansion.

    Mr. Dedes argued for the need to ensure community involvement to end stigma and discrimination, and condemned those countries, like Russia and Uganda, for ignoring human rights and furthering risk of HIV transmission. Dr. Nabiryo, who is from Uganda, spoke to the need to invest more resources to strengthen and utilize our communities.

    According to Dr. Montaner, we are at a critical time where finally there is a voice of consensus emerging—that treatment is highly effective at stopping HIV transmission. He argued for being more efficient by simplifying who to treat and when.

    While each panelist provided their unique perspectives on the fight against HIV and AIDS, all agreed on the need to bring scientists, politicians, and affected communities together to strategize and implement HIV treatment as prevention.

    Perhaps the key point of agreement, however, which was repeated often throughout the evening, was removing stigma and discrimination—and engaging and giving voice to communities—is the only way forward to ending the HIV epidemic.