From killer to chronic, epidemic to eliminated: stopping the spread of HIV+AIDS through effective, sustained treatment
Just two decades ago, an HIV diagnosis brought with it stigma and suffering and eventually, death. End of story. But not any more, thanks in large part to ongoing work pioneered in the 1990s and continuing to this day at the BC Centre for Excellence in HIV/AIDS
April 15, 2015 - Dr. Julio Montaner is the determined and much-decorated
head of UBC's Division of AIDS and the BC Centre for Excellence in HIV/AIDS (BC-CfE), a
UBC-affiliated centre based at Providence Health Care's St. Paul's Hospital.
Dr. Montaner was the principal investigator of an international 1996 study that showed a
cocktail combination of drugs to be the most effective way to prevent HIV turning into AIDS. Known
as HAART, or “highly active anti-retroviral therapies,” the cocktail has essentially turned
HIV/AIDS from a catastrophic diagnosis into something manageable with consistent,
sustained lifelong treatment. This means people living with HIV can now lead
healthy, normal lives, have children and plan for a future.
HAART was just the first step however in a battle that continues to this day in Canada
and around the world.That is why Montaner developed a program he calls “Treatment as Prevention®,” or
Many UBC researchers at the BC-CfE have supported Montaner in his work towards eliminating the
spread of HIV and other related diseases, including Drs. Evan Wood, Thomas Kerr and
On a global scale, TasP® has been adopted by the United Nations as its standard of care for HIV
and AIDS. By expanding testing and access to anti-retrovirals following a diagnosis, people
living with HIV can receive effective, sustained treatment that improves their health and
longevity, while dramatically reducing the likelihood that they will spread the disease.
So far, TasP® has been implemented to great success in BC. Between 1994 and 2013, the number of
new AIDS cases in BC decreased from 696 to 84 – a drop of 88 per cent. It has also been embraced by
China, Brazil, Spain, France, major U.S. cities, and Queensland, Australia – among many others.
That is not to say the battle against HIV and AIDS has yet been won—there are still many barriers to
accessing sustained treatment for some living the disease—but the principles of TasP® are
strengthening the global fight against it.
The UNAIDS 90-90-90 program aims to ensure 90 per cent of people infected with HIV are tested; 90
percent of those diagnosed are on sustained antiretroviral treatment; and 90 per cent of those on
treatment have undetectable viral loads. The goal: to virtually eliminate progression to AIDS,
premature death and HIV transmission by 2020.
By 2030, the worldwide HIV/AIDS pandemic could be transformed into a low-level sporadic endemic.
“We turned what was a crazy idea into a sound public policy,” says Montaner.
As the leader of both the BC-CfE and the Division of AIDS at UBC, a former head of the International
AIDS Society and a special advisor to the United Nations, Montaner wears many hats. They all have one
thing in common: to eliminate HIV and AIDS, no matter what it takes.
Reproduced with permission - "University of British Columbia"