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  5th IAS Conference on HIV Pathogenesis, Treatment and Prevention
July 19th-22nd 2009
Capetown, South Africa
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IAS Opening Session - Recession Impact
  from Jules: the highlight of the opening session was for me the feeling portayed by the African young woman with HIV who spoke as a community representative. She effectively warmed hearts by eloquently expressing HAART's success, the need for access to second and third line therapies at reasonable costs, and her concerns the global recession will impact AIDS programs in Africa. I understand the minister from S Africa who spoke last night did not discuss the country's denialism history. Stephen Lewis discussed the need for activism on these issues. Without denying the needs in this and other developing countries how can one defend a lack of adequate funding for greatly impacted patient needs in the USA. Women and men of color, particularly African-Americans, and more specifically African-American women in the USA have access to HAART but there are so many services that should be beefed up. Overcrowded HIV clinics in big inner city hospitals in the USA do not adequately provide the services and care these needy patient populations need to be successful. Our ADAP programs and State funding for HIV is being harshly cut over the course of this year as some cuts like in California have already been clear but others remain to emerge over the future months. HCV screening and testing gets no funding in the USA. The HIV aging population, in their 50s and 60s are increaingly experiencing frailty, increased risk for bone disease and fracture, cognitive impairment, and cancers. Premature comorbidities and consequent deaths have been reported in DAD & EuroSida, as well as association with inflammation in SMART. Much of this is due to a lack of attention paid to research and education to key specific aging issues like studying senesence & immune activation; education for doctors, providers and patients about these issues. This major issue is the elephant in the room and gets marginalized compared to its proportionate importance, why? Politics and money are at the root.

Recession, broken promises posing health disaster: AIDS experts

Geoffrey York
Cape Town, South Africa - From Monday's Globe and Mail
Last updated on Sunday, Jul. 19, 2009 09:09PM EDT


At one of their most politically charged conferences ever, AIDS scientists are warning of a looming health catastrophe because of the global recession and the "criminal" silence of world leaders on their faltering HIV-AIDS promises.

Thousands of people are dying unnecessarily of AIDS every day because of a growing gap between what science demands and what politicians deliver, Canadian scientist Julio Montaner told the conference.

Even as wealthy countries are providing full access to AIDS medicine for their own citizens, up to 12 million people in poorer countries are unable to get the life-saving medicine they desperately need, Dr. Montaner told the International AIDS Society Sunday night.

Dr. Montaner, the society's president, is director of the B.C. Centre for Excellence in HIV/AIDS. He and his fellow organizers, who have mounted one of the most political conferences the AIDS society has ever held, are furious that the G8 ignored the HIV-AIDS issue at its annual summit this month. The G8 leaders made no mention of the issue in their final communique - just four years after pledging at the 2005 Gleneagles summit to fight for universal access to AIDS treatment by 2010.

"The silence of the G8 leaders is not just pathetic, it is criminal," Dr. Montaner told a news conference at the opening of the AIDS-society conference, which is convened every two years and is being held this year in Cape Town.

"We will not shut up on this issue," he said. "It will be a dominant issue this week [at the conference]. We will not be silent."

Because of the global economic slump, some of the biggest donors to HIV-AIDS treatment programs are seeing their budgets slashed, while others fear for their very survival, he said.

The global recession "represents an immediate threat to the progress we have witnessed over the last decade," he said. "A retrenchment now would be catastrophic. ... We know what needs to be done, yet implementation flounders, costing thousands of lives each day."

Cutting back on HIV-AIDS treatment programs during the recession will mean billions or even trillions of dollars in additional costs over the long term, especially because of growing scientific evidence that anti-retroviral medicine for AIDS patients can be crucial in preventing the transmission of the AIDS virus, Dr. Montaner said.

His scathing criticism of world leaders was echoed by other scientists at the conference. Françoise Barre-Sinoussi, a French scientist who played a key role in identifying the AIDS virus in 1983 and later won the Nobel Prize for medicine, said the world is facing a health disaster if governments abandon their pledge to fight for universal access to AIDS treatment.

"Governing bodies and world leaders will be responsible for this disaster if they don't uphold their commitments," she told the conference. "HIV is not in recession."

In another highly political gesture, the conference gave a prominent keynote position to Canadian AIDS campaigner Stephen Lewis, co-director of AIDS Free World and a former United Nations special envoy on HIV-AIDS in Africa.

Though not a scientist himself, Mr. Lewis was invited to tell the conference how scientists can be activists. His speech last night was a blistering assault on politicians who find excuses to cut AIDS funding, and a plea to scientists to get involved in the political struggle.

"When the G8 won't renew its 2005 commitment to universal access, when the G8 cynically uses the financial crisis to threaten cutbacks to AIDS funding ... then it's time for science to speak with one powerful voice of accusation," Mr. Lewis said.

"You spend every day of your working lives to make life possible, and the power brokers devalue your work with the fraudulent plea of destitution," he told the scientists. "Don't let them get away with it."

In an interview, Mr. Lewis said the politicization of AIDS scientists is a sign of the times. "I think they're feeling very anxious about the circumstances today," he said. "Things have started to slip away. To lose that momentum now would be a disaster."

In another symbol of the new mood of political activism, Dr. Montaner and other conference organizers joined hundreds of AIDS activists in a street rally in downtown Cape Town last night just before the conference opened. The activists cheered when Dr. Montaner denounced the G8 leaders as "delinquent" in their promises.

Meanwhile, the independent group, Doctors Without Borders, warned that disruptions in the supply of AIDS medicine are threatening the lives of HIV patients in at least six African countries.

"Funding gaps and supply-management problems have led to the delay, suspension or risk of suspension of the supply of life-saving HIV drugs," said the group, also known as Medecins Sans Frontières.

Waiting lists for AIDS medicine are growing longer every day in South Africa, while the supply of the medicine in several regions of Malawi and other countries is running dangerously low, the group said.