International AIDS Conference: largely compromised goals

An experimental vaccine against the AIDS virus, tested in South Africa in November 2016. MUJAHID SAFODIEN / AFP

Text by: Simon Rozé Follow

The 23rd conference of the international society on AIDS (IAS) brings together from Monday, July 6, thousands of researchers, politicians, activists, to take stock of the progress of the epidemic and scientific advances.

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The biggest rally to fight the AIDS epidemic will be held for a week starting Monday, July 6. The cities of Oakland and San Francisco, emblematic places in the fight against HIV, were to host this conference. It will ultimately be virtual, a coronavirus crisis requires.

The fight against AIDS during the Covid-19 era

This year, the Covid-19 pandemic was also invited to the program. This is evident worldwide; the fight against HIV has clearly suffered from the Covid-19 epidemic. Whether it is overwhelmed health systems or funding redirected to this new emergency, several studies should therefore be presented to measure the extent of the phenomenon, particularly in terms of breakdown and difficulties accessing treatment. 

The Covid-19 pandemic and the confinements it caused could even have represented an increased risk of contamination, particularly among key populations. Sex workers, prisoners, drug users, LGBTI + communities are already the most stigmatized and the hardest hit by the HIV epidemic, a phenomenon that has undoubtedly been exacerbated in recent months. Without waiting for the precise figures to be revealed during this conference, we can already say that Covid-19 has worsened the HIV epidemic situation.

90-90-90

The UN aims to see the end of AIDS in 2030. To achieve this, an intermediate goal has been set: 90-90-90 . This means that 90% of sick people must know that they are sick, 90% of those screened must have access to medication and finally 90% of these must have an undetectable viral load, i.e. properly followed treatment that works and no longer makes them contagious. Treatment thus also acts as prevention.

This intermediate goal of 90-90-90 has been set for this year. The final figures will be communicated by UNAIDS at the opening of the conference, but we already know that they will not be reached. Bad news, especially since the impact of the Covid-19 should not yet be taken into account and could further distance this goal.

While progress is being made globally in terms of prevention or treatment, several elements limit their scope. Key populations therefore always remain the primary target of the virus. Because of the stigmatization they undergo, in particular by certain political powers, they too often remain outside the care pathways and prevention programs.

And as often, the second limiting element is funding. Screening in the field, offering treatments and carrying out viral load measurements as close as possible to the communities requires infrastructures and means which are not sufficient today. However, the Global AIDS Fund was replenished last year. 

The goal of ending HIV in 2030 compromised

This body responsible for financing part of the fight against the epidemic has seen its funds bailed out by the international community to the tune of 14 billion dollars for the period 2020-2022, a minimum necessary despite the disruptions due to Covid-19. This IAS virtual conference should therefore be an opportunity to review everything and discuss health policy and funding. Even if the objective of ending the epidemic in 2030 already appears to be compromised, efforts are necessary to maintain hope for achieving it. 

Finally, the 23rd IAS conference is also scientific. Unless there is a surprise, unfortunately we should not expect a miracle from the laboratories. Indeed, all the tools to see the end of HIV already exist. Preventive measures such as PreP or treatments are very effective today. They can certainly be improved, but the important thing now is that they are sent to the field. A vaccine could make a difference, but it is still far from available.

►Read: AIDS, the story of an epidemic, in an infographic

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  • Health and Medicine
  • AIDS
  • Coronavirus

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