AIDS 2014

AIDS 2014 20th International AIDS Conference issues call to ‘step up the pace’


The 20th International AIDS Conference (AIDS 2014)) was held in Melbourne, Australia from 20-25 July. The opening day started with a tribute to the lost colleagues who died aboard fight MH 17 which was shot down over Ukraine en route to the conference.

A one minute global moment of remembrance was held in their honour with eleven former, present and future Presidents of the International AIDS Society onstage together with representatives from those organizations who lost colleagues, the World Health Organization, AIDS Fonds, Stop AIDS Now, The Female Health Company, the Amsterdam Institute for Global Health and Development and members of the Dutch HIV research community.

Some 12,000 participants from all over the world gathered in Melbourne for AIDS 2014. Under the theme ‘Stepping up the Pace’, during the five days of the conference delegates discussed the latest research developments and heard about the status of the epidemic from world renowned experts.

During the Opening Sessions speakers discussed the encouraging data related to access treatment and reducing new HIV infections, but reminded the audience that HIV is far from being defeated and that stigma and discrimination towards Key Affected Population pose a major barrier to the end of the epidemic.

“The tremendous scale-up of HIV programmes has, for so many people transformed HIV from a death sentence into a chronically manageable disease,” Professor Françoise Barré-Sinoussi, AIDS 2014 International Chair, President of the International AIDS Society (IAS) and Director of the Regulation of Retroviral Infections Unit at the Institut Pasteur in Paris told delegates.

“One-third of people living with HIV, who need treatment now have access to it. “Nevertheless, these remarkable achievements are still not enough, 22 million people still do not have access to treatment. The official AIDS 2014 theme reminds us that we need to step up the pace and redouble our efforts.

Too many countries are still struggling to address their HIV epidemic with their most vulnerable people consistently being left behind.” UNAIDS Executive Director Michel Sidibé said that efforts to increase access to antiretroviral therapy are working. In 2013, an additional 2.3 million people gained access to the life-saving medicines.

This brings the global number of people accessing ART to nearly 13 million by the end of 2013. Based on recent scale-up, UNAIDS estimates that as of July 2014 as many as 14 million people were accessing ART.

“If we accelerate a scale-up of all HIV services by 2020, we will be on track to end the epidemic by 2030,” said Sidibé. “If not, we risk significantly increasing the time it would take, adding a decade, if not more.” AIDS 2014 Melbourne Declaration Speakers also referred to the AIDS 2014 Melbourne Declaration reaffirming the importance of non-discrimination for an effective response to HIV and, more in general, to public health programmes.

The enforcement of discriminatory, stigmatizing, criminalizing and harmful laws leads to policies and practices that increase vulnerability to HIV. These laws, policies, and practices incite extreme violence towards marginalized populations, reinforce stigma and undermine HIV programmes, and as such are significant steps backward for social justice, equality, human rights and access to health care.

AIDS 2014 Melbourne Declaration

Highlights from the conference Sir Bob Geldof told delegates that the “preposterous reluctance” of governments to fund HIV programs in developing countries is “disgraceful”, especially as the journey to the end of the HIV epidemic is “in the last mile”.

The renowned anti-poverty campaigner made the comments at the conference in Melbourne as he reflected on the impact of HIV on developing nations. Geldof said that the HIV epidemic in low income countries is “inextricably linked” to poverty, and he strongly criticized wealthy nations for reneging on foreign aid commitments.

Former US President Bill Clinton told delegates that finding more economically efficient ways to respond to HIV is vital to saving lives and preventing the spread of the virus Clinton said meeting global HIV prevention and support targets is possible within the “existing funding envelope”, but only if resources are used more effectively.

“The development of super-efficient systems can help us achieve the 90 / 90 /90 goals,” Clinton said, referring to the UNAIDS 2020 targets of 90% of people with HIV knowing their status, 90% of people with HIV receiving antiretroviral treatment and 90% of people on treatment having an undetectable viral load.

He said one of the biggest challenges is delivering care to patients in a better way in rural and remote areas. He added that ending mother to child transmission of HIV, and supporting children with HIV is another challenge – as well as a tremendous opportunity for sustaining progress in the response to HIV.

“Almost 50% of all new paediatric infections occur during the breastfeeding period. So keeping these women in care until the end of the breastfeeding period is the single most important thing we can do to achieve an AIDS-free generation.” Prof. Sharon Lewin, the Australian cochair of AIDS 2014, said the focus of efforts for an HIV cure was currently on developing treatments leading to remission.

She said the latest research and findings were significant in that “they have shown us that we can wake up the virus reservoir and make enough of the virus to leave the cell, making it visible to an immune response”.

WHO guidelines for care of key populations

In the run up to the conference, the World Health Organisation, issued a statement saying failure to provide adequate HIV services for key groups – men who have sex with men, people in prison, people who inject drugs, sex workers and transgender people – threatens global progress on the HIV response. These people are most at risk of HIV infection yet are least likely to have access to HIV prevention, testing and treatment services. In many countries they are left out of national HIV plans, and discriminatory laws and policies are major barriers to access. WHO released Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. The guidelines outline steps for countries to reduce new HIV infections and increase access to HIV testing, treatment and care for these five ‘key populations’. They include a comprehensive range of clinical recommendations but, for these to be effective, WHO also recommends countries need to remove the legal and social barriers that prevent many people from accessing services. “None of these people live in isolation,” said Dr Gottfried Hirnschall, Director of the HIV Department at WHO. “Sex workers and their clients have husbands, wives and partners. Some inject drugs. Many have children. Failure to provide services to the people who are at greatest risk of HIV jeopardizes further progress against the global epidemic and threatens the health and wellbeing of individuals, their families and the broader community.” Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations

 Date of upload: 16th Sep 2014


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