By Julio Montaner, Director, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Providence Healthcare and Past-President, International AIDS Society
We must make this conference the moment when the global AIDS community joins together to call for universal endorsement and funding for Treatment as Prevention.
For over a decade, the BC Centre for Excellence in HIV/AIDS has generated convincing evidence of the value of Treatment as Prevention. This has been boosted with the recently announced results of the NIH sponsored HPTN 052 study, which showed a 96% reduction in HIV transmission among sero-discordant heterosexual couples when HIV treatment was initiated immediate in the seropositive member of the couple. Taken together the available evidence is compelling and definitive: immediate access to highly active antiretroviral therapy (HAART) by people living with HIV prevents HIV/AIDS related morbidity and mortality as well as HIV transmission. This impressive triple benefit of HAART makes it the most effective intervention in the field of HIV/AIDS today.
As my colleague Dr. Elly Katabira, President of the IAS and International Chair of the IAS 2011 has noted, “Treatment as Prevention is one of the most important and promising additions to the range of prevention strategies available to us today.” UNAIDS and the World Health Organization embraced the Treatment as Prevention model within the Treatment 2.0 initiative, announced last year as a central pillar of the global strategy to respond to HIV.
With the weight of the scientific evidence now in hand and the need for swift action to save millions of lives, today I published a commentary in The Lancet calling on the international community to support an immediate and expanded roll out of HAART under the Treatment as Prevention strategy. As I concluded in the commentary, “The evidence is in: Treatment is Prevention. Indeed, treatment dramatically prevents morbidity, mortality and transmission. This is the case in vertical, sexual and IDU settings. The challenge remains: to optimize the impact of this valuable intervention. Failure to move forward is not an option.”
I am encouraged that the international community recently renewed its pledge to universal access in New York. To deliver 15 million HIV-infected people on HAART by 2015, as per the June 2011 United Nations pledge, will require approximately $24 billion per year. However – considering the G8 alone recently pledged $40 billion for the “Arab Spring” – the amount is fully affordable.
I urge every one of you attending IAS 2011 and all of you following from afar to join with me in this urgent call to action. Our collective voice must go out from Rome to political and public health leaders the world over. As people committed to relieving the suffering of HIV/AIDS, we have an ethical obligation to act and to act swiftly.