New Phase in AIDS Battle Prompts Strategic Rethink

The global portrait of AIDS greeting some 20,000 attendees at the 18th International AIDS Conference next week in Vienna is more optimistic than it has been in years.

"One day, we will have to turn our minds on how to wipe out the virus," said Jean-Francois Delfraissy, director of France's National Agency for AIDS Research.

Among the successes to be chronicled at the conference is the impact of highly active antiretroviral (ARV) therapy, both as a treatment tool and a prevention strategy.

Looking ahead, researchers are encouraged by reports of circumcision's ability to reduce female-to-male HIV transmission, as well as laboratory reports of advancements in the development of vaccines and microbicide gels.

"We really are at an important crossroads," said Gottfried Hirnschall, the new director of HIV/AIDS at the World Health Organization.

More sobering are statistics on the current size of the global epidemic. About 33.4 million people have the virus, and an additional 2.7 million people are infected each year.

The availability of lifesaving HIV therapy is uneven across the world. A recent analysis in the journal Science calculates that efforts to make the drugs available to all in need are facing a shortfall of $11.3 billion.

In addition, ARVs' ability to help AIDS patients live longer has quelled some of the urgency surrounding the disease. "The success of ARVs made it so people think HIV is no longer there," said Julio Montaner, director of the British Columbia Center for Excellence in HIV/AIDS in Vancouver, Canada.

The conference will highlight Eastern Europe, where the HIV epidemic is being fueled, in particular, by injection drug use. On the agenda for discussion are policies that criminalize the use of injection drugs and potential responses such as needle-exchange programs.

The conference website is www.aids2010.org.

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