Author: Julio Montaner (IAS President)
01 November 2009
It was an honor to serve as International Conference Chair of the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009) held in July in Cape Town.
A comprehensive impact report examining the potential impact of new research presented is available here. I was particularly impressed by research that illustrated how investments in HIV have contributed to improved access to health services for women, expanded health systems capacity, and reductions in infant mortality and incidence of TB and malaria.
The results are not surprising to those of us engaged in this work. Ten years ago, there was less than US$1 billion available per year for HIV programmes globally. Today $14 billion is available. These investments have generated substantial returns in addressing the HIV epidemic. In particular, four million people who would otherwise be dead are now on HIV treatment and alive. Data suggest that the number of new HIV infections may have peaked, due in part to successful prevention efforts. In addition, new evidence presented at IAS 2009 suggests that large-scale treatment programmes not only save the lives of individual patients, but also curb the epidemic by reducing viral loads and thereby reducing infectiousness.
Evidence presented at the conference also suggests that HIV programme scale-up can bolster health care infrastructure overall. As a result of investments in HIV, clinics and hospitals are being refurbished; laboratory and diagnostic capacities are being strengthened; additional cadres of health workers are being mobilized; and morale among health care workers is greatly lifted. The findings echoed those presented at a two-day IAS pre-conference meeting on health systems strengthening sponsored by the Rockefeller Foundation and the World Bank.
The scale-up of antiretroviral therapy over the past five years has also served as a “pressure relief valve” for many poor countries with high HIV seroprevalence. Previously, hospital beds and clinics in resource-poor settings were overwhelmed by AIDS patients requiring extensive management for opportunistic infections and end-of-life care. Doctors and nurses were overworked and de-motivated. AIDS care displaced other health issues from many health systems. Recent investments in HIV and the resulting declines in morbidity and mortality have freed up resources for use on other health priorities.
Our main task ahead is to maintain the momentum generated by these investments. With 2010 on the horizon, the IAS will continue to serve as a global leader in advocating for universal access to HIV prevention, care and treatment.
For those of you unable attend IAS 2009, I encourage you to view key sessions online at www.ias2009.org.