International AIDS Conference Sounds the Alarm

The colossal hard-won progress in the global fight against AIDS might be lost to defunding and unequal access to care, warned various speakers in the first day of the International AIDS Conference.

The 21st edition of the event began on Monday, in Durban, South Africa. Some 18 000 people are expected to attend the week-long convention, including politicians, researchers, popular personalities and people living with HIV.

UN Secretary-General Ban Ki-Moon opened the event by calling on the international community to keep going forward “rapidly and decisively” to reach the objective of ending the AÌDS epidemic by 2030.

Fifteen years of globally coordinated efforts have produced tremendous results in the fight against HIV. The number of deaths caused by AIDS dropped from around 2.4 million in 2005 to 1.1 million in 2015, according to the UN. The rate of HIV infection has also decreased by 38% since 2000.

This has been achieved by huge prevention campaigns – namely to promote protected sexual relations and normalize HIV testing- and exceptional scientific progress. Thanks to constantly evolving treatments, HIV went from being a painful death sentence to a perfectly treatable condition. In 2000, only one million people had access to treatment. Now, it’s nearly 15 million.

“But this progress should not hide the reality,” warned the French organization AIDES. Less than half of the 37 million of people living with HIV in 2015 are being treated. Many other actors in the fight against AIDS called attention to the grave inequalities hiding under the encouraging numbers.

According to UNICEF, AIDS is still the leading cause of death for 10 to 19 year olds in Africa. In the last fifteen years, the raw number of AIDS-related deaths more than tripled in North Africa and the Middle-East. Doctors Without Borders urged the leaders attending the convention to implement a plan of action for improving access to treatment in West and Central Africa, where less than 30% of people with HIV are being treated.

As the first world’s attention slowly ebbed away, so did the funding. Thirteen of the fourteen biggest contributors to the Global Fund to Fight AIDS reduced their donations this year according to the executive director of Onusida, Michel Sidibé.

Do You Know What AIDS Is?

People infected with HIV are seropositive. Not all of them have AIDS. HIV is a virus transmitted by certain body fluids including blood. AIDS stands for Auto-Immune Deficiency Syndrome: the condition that arises as a consequence. Thanks to treatments like tritherapy, seropositive people can now live their entire life without ever developing AIDS.

The HIV virus induces over-activation of certain immune cells called lymphocytes T CD4+, which leads to their destruction. The primary role of the T CD4+ is to activate larger immune response to fight off infections. A seropositive person whose number of T cells drops below a critical threshold has AIDS.

Many conspiracy theories have been spread about the origins of the virus, from “patient zero” being a Canadian flight attendant who single-handedly started the epidemic to the virus being engineered in a lab experiment gone wrong. The most evidence-backed theory, however, is that people first contracted the virus in the 1930s in Congo by eating chimpanzee bush meat.

What’s Next?

New strategies like the “test and treat” approach in South Africa and preventive treatment PrEP, will be discussed in the following days. Innovative treatments are continuing to progress everyday.

Just this week, two researchers from Montreal made a major discovery for the long term treatment of the disease. Drs Nicolas Chomont and Rémi Fromentin from the research center of Centre Hospitalier de l’Université de Montréal (CRCHUM) have found a way to uncover the favourite hiding spots of the virus inside the body during tritherapy.

Tritherapy is an efficient treatment to stop the progression of an HIV viral infection towards AIDS, but the virus known to find hiding spots. These are specific cells, like Lymphocytes T CD4+.  Only one in a million of TCD+ lymphocytes can be used as a hiding spot.

Chomont’s research team has found three cellular markers shared by the hiding spots. In other words, they have identified three distinctive characteristics of the cells housing HIV during triterapy. It could be an important step in the search for a cure.

It’s the second time that the International AIDS Conference is hosted in Durban. The first time was in 2000 when Nelson Mandela had delivered a vibrant plea for universal access to the newly developped antiretroviral treatments. Let’s hope that he might be heard better this time around.

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