As the District of Columbia prepares to host the XIX International AIDS Conference, one of the key players told a media audience last week that she eagerly anticipates the death of the pandemic.
'"Turning the tide together' is the overarching theme marking the beginning of the end of the AIDS epidemic," said Dr. Diane V. Havlir, an HIV/AIDS specialist and practicing physician with San Francisco General Hospital and Trauma Unit.
Havlir – one of the authors and architects of the first World Health Organization's Global HIV treatment guidelines and U.S. conference co-chair – said this is a defining moment for all who have worked tirelessly to eradicate the pandemic. The biennial conference comes at a time when there have been tremendous strides made in strategies, treatment and ultimately a cure, she added.
"There is new data and treatment of great health benefit by starting the treatment early," she said during the July 11 press conference at the Kaiser Foundation in Northwest. "The question is, how do we combine the tools and break them out?"
It is the first time the District of Columbia is hosting the conference and it comes after President Barack Obama lifted the travel ban that prohibited those with HIV/AIDS from entering the United States. Havlir and other speakers said they are delighted that the conference is here and said they saw great significance in Washington being chosen to host the conference's 25,000 delegates, including activists, HIV professionals, community activists, politicians, global community leaders and people living with HIV and 2,000 media representatives.
Leading into the conference, any questions about the District's ability to handle a conference of this magnitude have been put to rest, Havlir said. The conference will highlight the blend of policy, resources and leadership that is being used to fight the disease and conferees will laud its successes such as the fact that no baby has been born HIV-positive in the city in three years.
Just prior to the press conference, the International AIDS Society and the University of California, San Francisco, issued a declaration calling for global support for an end to the AIDS epidemic.
Organizers have been encouraging concerned citizens, scientists, politicians and celebrities to sign the nine-point Washington, D.C. Declaration. Among the points are calls for: an increase in targeted new investments; evidence-based HIV prevention, treatment and care in accord with the human rights of those at greatest risk and in greatest need; an end to stigma, discrimination, legal sanctions, and human rights abuses against those living with and at risk of HIV; and mobilization and meaningful involvement of affected communities.
Former D.C. Mayor Sharon Pratt is the honorary co-chair of the conference. Former President Bill Clinton, Sir Elton John, Microsoft's Bill Gates, Secretary of Health and Human Services Kathleen Sebelius, House Minority Leader Nancy Pelosi (D), former U.S. Senator Dr. Bill Frist, Ambassador Eric Goosby, the U.S. Global AIDS Coordinator, and actress Whoopi Goldberg are among those scheduled to lecture, participate in forums and other aspects of the conference.
"This is a medical, high-level conference with [high level participation], community involvement and a combination of individuals from all over the world," Havlir said.
Havlir said implementation of treatment and other strategies, along with some very positive medical advances in HIV treatment and biomedical prevention recently means that the momentum has shifted in favor of decisively stamping out the disease.
She said new data and dialogue on PrEp will likely be an integral part of any treatment regime. PrEP is short for PreExposure Prophylaxis, and according to the Centers for Disease Control and Prevention [CDC], may be part of comprehensive HIV prevention services for those who are high-risk HIV-negative individuals. If they take antiretrovirals everyday, it will lower their chances of becoming infected if they're exposed to HIV. So far, PrEP has been very effective for men who have sex with men [MSM] and heterosexual men and women.
She suggested broader wrap-around services for those living with HIV/AIDS, increased screenings for diseases such as diabetes and hypertension and even greater focus on curbing the growth of the pandemic among populations such as African-American men who sleep with men, drug users, pregnant women and male and female sex workers.
"There are novel ways to treat HIV," Havlir explained. "There are new drugs and technologies, new TB drugs, all of which is extraordinarily exciting."
Chris Beyrer, a professor of epidemiology at Johns Hopkins University in Baltimore, concurred.
"Now we have tremendous new tool kits, a better understanding and new technologies," he said. "Implementation is very important. He credited the U.S. President's Emergency Plan for AIDS Relief [PEPFAR] and similar programs with facilitating the widespread treatment of those living with HIV and treatment prevention.
"Now we have all the pieces to say that we have an AIDS-free generation," he said. "We're facing a tough global economic climate, a decline in donor interest and a decline in media interest. A real concern is that we will not go the last mile."
International Conference Chair Dr. Elias Katabira agreed.
"In a scenario unthinkable a few years ago, we now have the knowledge to end AIDS in our lifetimes," he said. "Yet at this moment of extraordinary scientific progress and potential, the global response to AIDS faces crippling financial challenges that threaten past success and future progress."
Beyrer spoke of the need for a "reinvigorated response" and explained that some of the keys to that are expanding access to retrovirals, conducting more research, filling the need for more vaccines and a cure, and better drugs with fewer side effects.
"None of this will happen without mobilization, community engagement and protest," he said. "There has to be an enriched response."
Both Havlir and Beyrer said that the rising rates of infection of MSMs or gay or bisexual men is alarming and underscores the severity of the problem for MSMs in the United States, especially in minority communities.
Beyrer suggested a global response of prevention, treatment and cure. He described homophobia as a political and social construct, and said there is still much work to be done.
"It's a very real challenge," he said. "We're not going to turn the tide if any of these populations are excluded."