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4 years later, Canada still trying to 'turn the corner' on AIDS

July 18, 2010 - "It's time to deliver."

That was the slogan of the 16th International AIDS conference held in Toronto in 2006, an event that drew more than 20,000 scientists, activists, ex-presidents, rock stars and billionaires, and reinvigorated the global battle against AIDS.

The world is radically different four years later: back then George W. Bush was president, few outside of Alaska had heard of Sarah Palin, Facebook was just for university students and tweeting was something birds did, not computer users.

Since the conference - touted as a turning point in the fight against the epidemic - the Joint United Nations Programme on HIV/AIDS estimates that 8 million people have died of AIDS, and more than 11 million more have become infected. At the same time, the U.N. says the rate of new infections worldwide has declined annually and that a vaccine is closer than ever.

"We haven't turned the corner yet," says Richard Elliot, executive director of the Canadian HIV/AIDS Legal Network. ". . . In certain places, it (the virus) is growing up quite dramatically."

Dr. Mark Wainberg, co-chair of the Toronto conference and director of the McGill AIDS Centre, agrees this is not the time to let up.

"We're going run the risk of backsliding (on progress since 2006) unless we commit to prevention programs in a much more serious way than we managed to until now."

Ahead of the latest AIDS conference beginning Sunday in Vienna, the Star examines the pledges and proclamations of the Toronto conference to see what progress has, or hasn't, been made.

Getting generic drugs to poor nations

Then: Federal Health Minister Tony Clement, now Industry Minister, vowed to immediately review Canada's Access to Medicines Regime, created to send cheap generic drugs to poor nations to fight HIV/AIDS. The act was originally passed under Paul Martin in 2004, but not a single pill had been exported.

Now: A review of the legislation was tabled in December 2007, six months late. Only one country, Rwanda, has made it through the red tape to receive drugs.

Male circumcision

Then: New evidence emerged at the conference about male circumcision helping prevent HIV/AIDS. The World Health Organization was waiting for the results of two studies in Africa before deciding whether to recommend circumcision to combat AIDS.

Now: The identification of two human antibodies potentially key in stopping the spread of HIV in early July is sure to be a hot topic at this year's conference. Scientists say the finding could lead to a vaccine being available within years, rather than decades.


Then: Vaginal microbicides were touted in Toronto by speakers like Bill Gates and Bill Clinton as one of the best hopes to give African women some control over their sexual safety. A microbicide is a gel or cream applied prior to sex that could stop the transmission of HIV.

Now: Microbicides have largely been a disappointment. In January 2007, a Phase 3 study of a Toronto company's anti-viral gel was stopped because it found women using the gel had a higher rate of HIV infection.

However, Wainberg, says the results of a new clinical trial for a microbicide known as "CAPRISA 004 Tenofovir Gel" will be announced Tuesday in Vienna. Wainberg expects the clinical results of the microbicide, which is the first to use an antiretroviral in its gel, will be a success.

Political blunders

Then: Prime Minster Stephen Harper was literally missing in action for the Toronto conference, instead touring Canada's north. Wainberg, addressing the conference as co-chair on opening night, proclaimed "Mr. Harper, you have made a mistake that puts you on the wrong side of history."

As well, an international uproar was caused when South Africa's Health Minister Dr. Manto Tshabalala-Msimang had a booth at the conference that promoted lemon juice, garlic and beetroot as effective ways to battle HIV, reflecting her country's controversial stance against antiretroviral drugs.

Now: Tshabalala-Msimang died in late 2009 from liver complications. With Jacob Zuma becoming president of South Africa earlier that year, "there's been a 180-degree change in (AIDS) policy in the country," says Wainberg.

As for Harper, he has remained relatively quiet on the HIV/AIDS front, using the G8 summit in Canada last month to focus on maternal health.

AIDS funding

Then: The Bill and Melinda Gates Foundation announced a $500 million donation to the Global Fund to Fight AIDS, Tuberculosis and Malaria days before the conference opened. On the national front, a major funding announcement by the Conservative government at the conference was derailed at the last minute because the climate had become "too politicized."

Now: The Conservative government eventually pledged $120 million in December 2006 for two dozen global projects, including $20 million over two years to the International AIDS Vaccine Initiative and $15 million to the International Partnership for Microbicides.

The microbicides partnership said it put Canadian government grants into developing vaginal gels, but the progress has been slow.

In February 2007, the government pledged $110 million with the Bill and Melinda Gates Foundation to develop a Canadian centre to manufacture promising AIDS vaccines for clinical trials.

It was quietly announced in February of this year that the government was scrapping plans for the manufacturing centre. The Public Health Agency of Canada was not able to provide information to the Star on where the funds for the project would be redirected, if at all, though its website said the government remains "committed to the previously announced funding levels over 5 years."


"Reproduced with permission - Torstar Syndication Services"

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