Signal of hope

It was a serious Bill Clinton who, at the conclusion of the 19th International AIDS Conference in Washington, reminded participants that even though a lot had been achieved since the discovery of the immunodeficiency disease, there was still more to do.

Fifty-six percent of people infected worldwide with HIV are now being treated. But, Clinton said, in Central and Eastern Europe barely a third were being treated for the disease, and "in the Middle East and North Africa not even 25 percent" were able to receive health care for their condition.

Clinton also stressed the importance of combating prejudice: "All of us can't be blind to the fact that no matter how much we come together and cheer each other and see the evidence, that we still have to fight the stigma wherever we find it."

That even applies to the host nation, the US, Holger Wicht, spokesperson for the German AIDS Service Organization, said in an interview with DW. Travel bans placed on people infected with AIDS were lifted in 2009, but prostitutes and drug addicts are still denied visas, preventing them from attending the conference.

There were repeated protests during the six-day summit. "We are in a country where freedom is praised," Wicht said, "but sometimes people who choose a different sexuality than the majority, or even drugs, are treated very repressively." Germany has set an example in this area, he said: German AIDS prevention emphasizes human rights and excludes no one.

The global goal agreed upon at the conference is ambitious. By 2015 the number of new infections should be halved, each patient should have access to treatment and mother-to-child transmission will be unheard of. Theoretically this is possible, as the steps needed are known, but only if politicians are willing to take action.

The former US president said he learned this on his recent trip to Africa, where he visited Uganda, Mozambique, South Africa and Rwanda. "There I met with program managers who don't know where the money will come from."

Achieving more with less money

Clinton's foundation has been collecting for AIDS relief, but money now is scarce. This year the Global Fund had to stop financially supporting the fight against AIDS, malaria and tuberculosis because of a complete lack of finances. For the first time, Clinton said, the majority of the money isn't coming from international coffers, but from the affected countries themselves.

Clinton said he agreed with the experts in Washington that with limited resources and funding from international organizations it is not always justifiable to pay consultants as much for one day of work as three people could be paid in a year. Efficiency, he said, is the key word.

French President Francois Hollande said in his speech at the beginning of the conference that France would implement an international financial transaction tax from August 1, with proceeds benefiting AIDS charities.

Signal of hope

Despite a tight budget, the mood at the conference was positive. Wicht said that while there was no new medical breakthrough, the Washington conference provided a "signal of hope." "We say we can achieve a cure, it is realistic, even when we don't know if it will be in five or 15 years or even longer." This, he said, is important politically, because it is also linked a cure to the demand for better support for research. Germany, for one, must make more funding available, Wicht said.

Dr. Anthony Harries from the International Union Against Tuberculosis and Lung Disease in Paris presented a key finding to the conference, "If we can use anti-retroviral treatment earlier for treatment and prevention, we can do a lot to try to turn around this epidemic." Secondary diseases as a result of AIDS, such as tuberculosis, a common cause of death in sub-Saharan Africa, could be reduced significantly with the early use of drugs, he said.

Keeping patients in therapy

Yogan Pillay, Deputy Director of the South African Department of Health, was impressed with the development of the scientific knowledge surrounding HIV/AIDS: "I wish they would slow down a little bit. My major concern when I go back home is what do I do with all these things, how do I implement them, because if you don't implement them they are not as useful as we would like to think." He also learned about the importance of keeping patients in therapy, as it is the only way to effectively keep the virus in check.

For now there is no cure in sight for the immunodeficiency illness even if there are promising approaches. An effective vaccine has not yet been invented. Another problem is that the increasing resistance of HIV makes newer anti-retroviral medicines necessary that cost much more than earlier versions of the drug.

Cheaper generic versions of the older drugs exist that are produced in places like India and distributed throughout African countries. These typically cost $150 (122 euros) per patient per year, said Oliver Moldenhauer from Doctors Without Borders, while the new generation of drugs, protected by a patent, can cost $2,500 a year for one patient.

Doctors Without Borders is calling for pharmaceutical companies to allow drugs to be produced generically, as well as for the removal of international patent protection in countries where pharmaceutical companies are uncooperative: "International patent law allows countries to force licensing if necessary," Moldenhauer said. Recently India implemented this for the first time, providing access to treatment for eight million people.

Overall, organizers were happy with the conference. Nearly 24,000 delegates from 183 countries came to Washington for six days to discuss issues of therapies, finance and how to advance the search for a cure, a vaccine, and draw attention to the disease that affects 34 million people worldwide. The next conference will be held in Melbourne in 2014 - with the hope that all those affected by HIV and AIDS can be included. That's because there is no travel ban placed on prostitutes and intravenous drug addicts in Australia.

Author: Christina Bergmann / jlw
Editor: Simon Bone