After IAC -- The Conversation Continues

The nineteenth International AIDS Conference (IAC) sounded a note of hope: we have the medical tools we need to end AIDS, if not HIV. But are we able to put them to use in an imperfect world?

Three days after IAC closed, former IAS President Julio Montaner wrote, "It is now more certain than ever that we have the tools, medicines and expertise to stop this epidemic. However, without the political will to expand antiretroviral treatment to everyone in need, the audacious goals set before us in Washington last week will never be met and infection may spiral out of control once again." Montaner's home Province of British Columbia has committed to offering immediate treatment to every British Columbian who tests positive. The Province is now launching a social media campaign encouraging every British Columbian who has ever been sexually active to get tested. Montaner accepts that 99 percent of test results will be negative, but the reward will be what he calls "the golden 1 percent."

Harvard researchers reviewing health outcomes of the landmark HPTN 052 trial found that starting treatment as soon as possible after diagnosis does more than dramatically reduce the risk of transmission. It also leads to fewer HIV-related adverse health events for individuals, and reduced long-term health care costs for communities and governments.

Other voices are less optimistic. Eminent medical reporter Lawrence Altman wrote in The New York Times, "Bill Gates, whose foundation is spending billions on developing AIDS preventions, expressed skepticism that the world could soon end the AIDS epidemic by any conventional definition. 'Unfortunately, we do not have the tools, and we need lots of new tools,' with a vaccine the ultimate preventive one, Mr. Gates told the conference."

No one said it was going to be easy. But now at least some of us think it's possible.