IAS: `Game changers' must be widely adopted

'The old dichotomies no longer exist'

Researchers and clinicians are achieving game-changing results that are revolutionizing HIV prevention, care and treatment, Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) said recently in Rome at the IAS 2011 conference.

Outlining an ambitious agenda of "Zero new HIV Infections, Zero discrimination, and Zero AIDS-related deaths," Sidibé said such lofty goals are very much on the table.

"These tools are not so far from our reach," he said. "The old dichotomies between prevention and treatment no longer exist, as the science to support each is increasingly converging. We can expect further decreases in HIV stigma and discrimination as passionate advocates and activists, and in particular, people living with HIV, raise their voices and take charge of their health."

The scientific community has provided true breakthroughs this past year, he noted.

"Results from clinical trials have vastly widened our prevention tool-box, including oral pre-exposure prophylaxis and vaginal microbicides that reduce the risk of HIV transmission," he said. "Most recently, the extraordinary results of HPTN052, in which antiretrovirals used by people living with HIV dramatically reduced the risk of HIV transmission to their HIV-negative partners, give us further hope that we will continue to see reductions in the number of new HIV infections."

The Joint United Nations Programme on HIV/AIDS (UNAIDS) is working closely with scientific and community partners to understand how the results from this groundbreaking study can most effectively be implemented, and to advocate for this implementation, while at the same time ensuring that the rights of people living with HIV are protected, Sidibé said.

Already last year, UNAIDS, WHO and other global and local partners began exploring ways of effectively expanding access to antiretroviral treatment and launched the Treatment 2.0 initiative. Treatment 2.0 is a "radically simplified treatment platform" that will also produce benefits in preventing HIV transmission, he said. The five pillars of Treatment 2.0 are optimized drug regimens, point of care and other simplified lab technologies, cost reductions, service delivery modifications and community mobilization.

At a recent United Nations high level meeting on AIDS, countries set forth bold new targets in a new and robust Political Declaration on HIV. Unanimously adopted at the meeting, the declaration calls on UN Member States to redouble efforts to achieve universal access by 2015.

The declaration is also commendable for recognizing key populations at higher risk of HIV infection, including men who have sex with men, people who inject drugs and sex workers. This is the first time a United Nations declaration has recognized these key populations and will be instrumental in reaching groups most at risk of exposure to HIV with services and new technological and scientific advances, he said.

"In these extraordinary times it is incumbent upon us to continue to advocate for the resources that we need to implement these game-changers, while at the same time ensuring that funding for the next generation of game-changing science is maintained," Sidibé said. "With commitment, perseverance and vision, every day brings us one step closer to achieving our collective goals and lead us to a world without HIV."