Episode 9 - 2009-2010: Keeping the promise
In 2009, the ﬁnancial and political support needed to deliver effective responses to stop the global HIV pandemic were lagging. As a result, the IAS redoubled its efforts to focus attention on the need to increase funding and political support for HIV and AIDS programmes globally.
The 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009), attended by more than 5,000 AIDS researchers, implementers and community leaders, was an important forum.. Held in Cape Town, South Africa, in July 2009, the conference showcased important new data on the impact of HIV treatment programmes on TB incidence and other health challenges in low and middle-income countries. It also introduced a new track on operations research to provide delegates with data to inform the design, implementation and delivery of HIV programmes in countries most affected by HIV.
Three landmark studies on antiretroviral treatment for pregnant women and prevention of vertical HIV transmission were presented at IAS 2009. These studies demonstrated that maternal triple-drug ART used throughout pregnancy and breastfeeding reduced vertical transmission to 1%. Results of several basic research studies provided the field with a better understanding of the elevated HIV infection risk among African women and results from the five year Development of Anti-Retroviral Therapy in Africa (DART) trial suggested that CD4+ count monitoring was cost-effective as a targeted – rather than routine – strategy. By the end of the conference South African health authorities indicated that they would consider providing ART to everyone co-infected with TB and HIV.
2010 was a pivotal year for the global health and development field, coinciding with the 2010 deadline world leaders had set for achieving universal access to HIV prevention, care and treatment to all in need. Yet universal access was not on track at all, and though there was evidence of substantial progress in terms of the number of people on treatment, as well as important declines in the rates of new infections in some countries, these achievements were clouded by a challenging economic climate and the news that, for the first time in years, donors were curtailing or flat-lining HIV funding. The IAS launched its Universal Access Now campaign in March 2010 to hold world leaders accountable to the universal access pledge and to ensure that HIV remained part of the global health agenda.
In July, the IAS convened the XVIII International AIDS Conference (AIDS 2010) in Vienna, Austria. The conference’s theme, Rights Here, Right Now stressed the critical connection between human rights and HIV. Conference organizers aimed to create a positive impact on the HIV/AIDS response globally, in Austria and the neighbouring region of Eastern Europe and Central Asia (EECA) in particular, as this region was experiencing one of the fastest-growing epidemics in the world, fuelled primarily by injecting drug use. Over 1,200 participants from the EECA region attended the conference. It was hoped that holding the conference in Vienna had provided momentum for necessary policy change in the EECA region.
Delegates were informed of important scientific advances, including the promising CAPRISA 004 trial, which found that using the 1% tenofovir gel before and after sex provided women with moderate protection against sexually transmitted HIV.
On the occasion of AIDS 2010, the IAS and partners issued the Vienna Declaration. The declaration, currently endorsed by more than 23,000 people, seeks to improve community health and safety by incorporating scientific evidence into illicit drug policies. The launch of the Vienna Declaration in June 2010 reinforced previous IAS drug policy work, challenging policies on illicit drugs, advocating for the human rights of people who use drugs and drawing attention to the stark reality that the criminalization of drug users does not help law enforcement, but simply undermines public health efforts by driving people who use drugs underground and away from prevention and care services.