Rev Alan Bain reports from the 18^th World AIDS Conference in Vienna.

The 18^th World AIDS Conference in Vienna ended this week after a roller coaster of exciting medical news mingled with fears of budgetary cuts.

US President Obama addressed the conference through video and committed his administration to a new Global Health Initiative to “help other countries improve health care, save lives and increase life expectancy. We’ll double the number of babies born HIV free and provide direct support for 12 million people including 5 million children and orphans,” he promised.

Outspoken conference chair, Dr Julio Montaner, had earlier cautioned to the applause of 10,000 in the room, “We are at a cross roads. There must be no retreat on AIDS. Leaders of the G8 can find money to bale out greedy Wall Street bankers but when it comes to global health the purse is empty. This is not acceptable. G8 priorities have to change.” Dr Schmied, AIDS 2010 local co-chair also joined with advocates from around the world to make a united call for global leaders to replenish the Global Fund to fight AIDS, TB and Malaria at its upcoming meeting in October this year, cautioning world leaders to fulfil their commitment to universal access to AIDS drugs.

President Bill Clinton and Microsoft’s Bill Gates spoke of the inevitability of budget cuts and the need to target limited resources better. Bill Gates said “ This is our opportunity. We are at a turning point and we need to become more effective, matching our compassion with science and work to end AIDS.”

But it was the grass roots activists who were bearing the heat of the day. Dr Fi Mclachlen Head of the Christian based Mildmay Hospital in London spoke of the need for British churches to be more aware of the pandemic;“ We owe it to the many churches in the developing world to be alongside them at the cutting edge of AIDS care. Between 40-70% of health care in developing nations is delivered by Faith Based Organisations. Even in London, we see an increase of patients, as the HIV rate rises to 83,000 infections throughout the UK. We could do so much more with more resources.”

Dr Emmanuel, Country Director of Mildmay Uganda, added, “ I treat 22,000 patients and our five year, US government grant, comes to an end this year. We don’t know if it will be approved again. We still only treat 40% of those infected in Uganda and our burden has increased not decreased. I have a further 500 people waiting for ARV treatment and I am left choosing who will live and who will die.”

A pilot study commissioned by the Ecumenical Advocacy Alliance (EAA), a network of churches working together around issues of HIV and AIDS, confirmed that faith-based organizations are experiencing shifts in funding that are reducing their capacity to provide HIV treatment. Meanwhile, EAA used the Vienna conference to launch an opportunity for religious leaders to pledge a personal commitment “to work tirelessly to end all stigmatizing attitudes and actions” that might discriminate against HIV-positive people in faith communities.

Important new scientific progress buoyed up the conference, with the announcement of the ground breaking results of a new CAPRISA microbicide vaginal gel which can be controlled by vulnerable women independent of her partner and is proven to significantly reduce risk of the HIV virus. Michael Sidibe, UNAIDS Executive Director welcomed the news; “This will help us break the trajectory of the AIDS epidemic. We are giving hope to women. For the first time they can control HIV prevention.”

Dr Montaner announced further startling scientific news. “There is growing evidence that ARV treatment drastically reduces HIV transmission. 90% reductions in transmission are reported by the Lancet . So, by treating more people we prevent more HIV transmission. It now makes sound economic, as well as medical sense, for world leaders to fund universal access.”

The race to find a cure for HIV engaged a packed and excited plenary session as Australian Professor Sharon Lewin, eloquently described how HAART (Highly Active ARV Therapy) has revolutionized HIV care, prolonging life expectancy of patients. Life long therapy is needed to control HIV largely due to an early established, “reservoir of latently infected cells.” Research is concentrating on this “reservoir” to eradicate or control the “dormant,” but poised to emerge virus. Professor Lewin pointed out that if a cure is not found the world will bear the unsustainable burden of 50 million people requiring treatment over the next 20 years.

“Rights here, Right now” was the conference theme with the centrepiece the “Vienna Declaration” demanding the decriminalisation of illicit drug users. “Billions of dollars are wasted on the “war on drugs” approach to drug control that manifestly does not achieve its aims, instead, contributing to the problem”. HIV rates among drug users reach up to 70% in the Russian Federation and the Ukraine, areas that have the highest rate of HIV increase in the world.

Fifteen thousand delegates took to the streets of Vienna to affirm the Declaration, with Britain’s good will ambassador for AIDS, singer/ songwriter Annie Lennox performing at a live concert in downtown Vienna. Working with Nelson Mandela changed Annie’s views on AIDS, she said, when he described the pandemic as, “a genocide on humanity.”

Desmond Tutu delivered a final video message; “Doom and gloom have been the order of the day as the global recession has spread a blanket of hardship across the world. HIV and its prevention is a basic human right. At this moment of great promise the international community has yet to live up to its promise of universal access. Now is the time to invest resources into it.”

There is no doubt that the global AIDS pandemic is at “tipping point”. Under funding the Global Fund could cause an additional 10 million AIDS related deaths. Equally true, greater efficiency in the use of resources and more support given to key scientific research, are prerequisites, if the global pandemic is to be finally consigned to history.

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