Thirty Years On: Why We Need a Cure for HIV Now More Than Ever Before
Opinion Piece by Dr Elly Katabira, International AIDS Society (IAS) President
June 03, 2011 - Thirty years ago this month, health agencies in the US began monitoring unusual
clusters of diseases that would later be identified as the first cases of AIDS. A year later, a young medical officer
working at a Health Center documented and reported to the Ministry of Health the first cases of AIDS in Uganda found
on the shores of Lake Victoria in the Rakai district.
Over the past three decades, I have worked extensively in the field of care and support for people living
with HIV, watching the story of AIDS unfold in my own country and around the world. I have witnessed some of the devastating
consequences of silence and stigma, as well as the incredible results that translating scientific evidence into action can produce.
Today, HIV experts are in agreement that "prevention", "treatment" and "care" are the three pillars to
successfully responding to the HIV epidemic. Lessons learnt, and in particular the compelling new evidence that HIV treatment is
also HIV prevention and that expanding antiretroviral therapy (ART) coverage has preventative benefits for the entire community,
also show us that these three pillars must not be approached separately, but as three interconnected efforts.
Here at the International AIDS Society (IAS) however, we are convinced that the three pillar approach to
ending the HIV epidemic is incomplete and, to mark this historic month, the IAS is calling for the addition of a fourth
pillar -- "cure" -- to the international response to the HIV epidemic.
Under no circumstances should the inclusion of "cure" into the global response direct funding away from treatment, prevention and
care programmes. The IAS will continue to advocate for increased funding across each of these pillars. The IAS does believe
however, that it is imperative that donors, governments and the AIDS community make a viable economic investment in HIV
cure research, and right now.
Globally, there are currently 33.3 million people living with HIV. Although significant progress has been made towards scaling up access
to antiretroviral treatment, the increase in new infections in certain regions, a decrease in funding, and the fact that under new WHO
guidelines HIV patients should be starting their treatment regimens much earlier, means that universal access targets are way off
track. As new infections continue to outstrip numbers on treatment by 2 to 1 in resource-limited settings, the scale of unmet
need can only increase.
Furthermore, while ART has greatly improved the quality of life of people living with HIV and reduced AIDS-related mortality rates, the
virus remains persistent in certain cells even in patients being successfully treated. In turn, patients have no option but to undertake
life-long treatment to keep the virus under control. Life-long adherence to these drugs remains both costly and tiring for the patient,
while side-effects associated with ART usage can be severe. Lastly, resistance to treatment can occur for a number of reasons.
Funding research to develop a functionalor sterilizing cure for HIV which could offer people living with the virus
an alternative to the burden of a difficult life-long ARV regimen is therefore not only important for the health and human rights of
people living with HIV, it is in our collective economic interest.
Professor Françoise Barré-Sinoussi, co-discoverer of HIV, Nobel Laureate and IAS President-elect, is currently guiding
the development of a global scientific strategy, Towards
an HIV Cure . This strategy aims at building a global consensus on the state of the art research in the field of HIV
reservoirs and defining scientific priorities that must be addressed to tackle HIV persistence in patients undergoing treatment,
the key hurdle impeding any alternative to long-term therapy.
Thirty years after the first cases of AIDS, if we are ever to envisage the remission of the disease in infected
individuals, or even the eradication of the virus, then we must invest in and aggressively pursue an HIV cure.
Dr Elly Katabira is President of the International AIDS Society, the world's leading independent association of HIV
www.iasociety.org | www.ias2011.org
 Functional cure some HIV genetic material remains in the body, but the patient's immune defense fully controls any viral rebound, allowing
patients to be free of antiretroviral treatment
 Sterilizing cure no HIV genetic material can be found in the body, HIV infection is eradicated
About the IAS
The International AIDS Society (IAS) is the world's leading independent association of HIV professionals, with over 16,000 members
from more than 196 countries working at all levels of the global response to AIDS. Our members include researchers from all
disciplines, clinicians, public health and community practitioners on the frontlines of the epidemic, as well as policy
and programme planners. The IAS is the custodian of the biennial International AIDS Conference and lead organizer of
the IAS Conference on HIV Pathogenesis, Treatment and Prevention, which will be held in Rome, Italy in July 2011.
www.iasociety.org | www.ias2011.org
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