Update from Melbourne - Aidan's Day 1

  • HIV Scotland team members George Valiotis and Aidan Collins have been sending updates about what they're seeing and hearing at the AIDS 2014 international conference in Melbourne. This update is from Aidan, giving an overview of the first day of the conference from his perspective.

Melbourne and AIDS 2014

"Having spent three months in Melbourne in 2000, seeing it now I’m struck by the transformation of the city. The population has boomed and the range of people and nationalities living here has diversified exponentially. The diversity of the population was commented upon during Sunday’s Opening Session and is clearly reflected in the cities culture (food, music, street performances etc.).

"This diversity also mirrors the diversity of the conference delegates; people from all across the world coming together to discuss ideas, share best practice and consider how we might ‘step up the pace’ together. It is this diversity that has made the sessions I have so far attended so rich, insightful, moving and genuinely thought provoking.

"Melbourne has fully embraced the event. People everywhere are sporting red ribbons, there are trams and helicopters with red ribbons painted on their sides, iconic skyscrapers across the city have lit up red, there are huge ‘AIDS 2014’ signs at the side of the main roads with no less than 150 cultural events taking place during the week."

MH17 crash

"The plane crash has impacted greatly on the conference and on Australia. In each main plenary session I have attended most – if not all – of the speakers have known someone who was lost and taken time to pay their respects. This really brings home how the global community on HIV and AIDS has suffered a huge loss. There are tributes in Melbourne where people have laid flowers, lit candles and written messages of condolence. Within the conference people have tied red ribbons to pay tribute to their friends and colleagues who were lost.

"Tony Abbot (Australian PM) was unable to attend the conference due to the events but recorded a message which was played during the opening session. Similarly, Ban Ki-moon sent a message highlighting the importance of solidarity and work to promote health and human rights.

"Despite the tragedy, there is a clear feeling and sense of determination that the best way to pay respect to those lost is to ensure that AIDS 2014 is as successful as possible – and that we come together to ‘step up the pace’ in relation to global and local efforts on HIV and AIDS."

Implementing Global Treatment Access

"On Sunday I attended the satellite event ‘Implementing Global Treatment Access’.

"There was a lot of discussion of treatment as prevention (TasP) and related studies. Speakers highlighted the very strong evidence that treatment as prevention works within heterosexual contexts, but that adherence has to be good. More and more data will come to light over the coming year on treatment as prevention in relation to men who have sex with men.

"Speakers also stressed the potential risks around communicating the facts about treatment as prevention, and that is shouldn’t been seen as an alternative to condom use.

"Gus Cairns from NAM spoke about creating a community statement on TasP – to give people living with HIV some control. The statement can be viewed at www.hivt4p.org and has been endorsed by 352 organisations so far.

"It was discussed how post-soviet and African countries don’t have the commitment of government. In some places people are still fighting to access treatment at all, with overstretched health budgets and competing priorities - TasP seems unrealistic in these contexts. It was very interesting to compare and consider global situation compared to that in Scotland. I was humbled to hear an activist from the Ukraine talk about successful campaigning to improve access to treatment – following pressure the President committed to providing treatment for all.

"Ultimately, the session concluded that treatment as prevention has a key part to play, but is far from a silver bullet."

Toward 2020

"The next session on Sunday for me was another satellite event, called ‘Toward 2020’.

"Discussion was started by Francoise Barre-Sinoussi who set out current challenges and priorities – testing, treatment and retention as well as preventing new infections. Stigma, discrimination and a lack of political willingness remain the key challenges. She also commented:

  • There is still no AIDS vaccine but there has been progress e.g. research with Macaques has shown promising results.
  • There is a lot of public expectation and motivation in relation to finding a cure. We need to ask what kind of cure we are looking for e.g. eradication (Berlin patient being only known example and still not over long term) or remission (a ‘functional cure’).
  • The 2 Boston patients and the Mississippi baby examples show that while there has been progress we do not yet have the right tools.
  • The future? Early therapy to prevent the transmission of HIV and for the health of people who have bene infected with HIV, direct acting latency drugs, immune based therapy, a therapeutic vaccination and gene therapy could all be possibilities.
  • We need to develop a global multidisciplinary strategy (including HIV and non HIV researchers).

"There was discussion of funding cuts for grass roots organisations across Africa and Asia. It was questioned how we can envision an AIDS free world when grass roots organisations are being cut down at their knees.

"There was discussion about human rights and their role in empowering people with HIV. It was agreed that realisation of human rights is key but that too many people are still denied their basic rights, including access to treatment.

"Louis Pizarro talked about the integration of services (giving UN definition of service integration and only speaking in relation to integrating different types of health service). From the patient perspective, he felt there was clear evidence that better integrated services could deliver clear benefits and that there should be a move towards a more individualised approach to service provision. Again, it is interesting to compare this to where we are at in Scotland – with integration and personalisation two key policy drivers.

"There was also discussion about the need for borderless strategies in Western Europe high risk groups i.e. MSM and migrants; the use of new technologies with apps like Grindr changing the dynamics; and discussion over barriers to testing and the need for the EU to do more to remove barriers to testing and facilitate collaboration in research with sustained funding."

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Follow HIV Scotland and CEO George Valiotis on Twitter for real-time updates, and read more of his updates and about HIV Scotland and AIDS 2014.