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From Paris, With Hope

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I'm here in Paris a few days out from the symposium being held at the Institut Pasteur to mark the 30th anniversary of the discovery of HIV. There's a sense of expectation amongst all of us I think - catching up with colleagues from all ends of the globe to celebrate just where we've come in three decades and where we might be headed is going to make for some fascinating conversation over the next few days!

I do not think we can underestimate the degree to which science has so significantly shifted the direction of an epidemic - HIV science has provided lessons for all of us working in the field but also for many of those working in other branches of medicine. As many of my colleagues will undoubtedly reiterate over the coming days, the role of HIV science in responding to the HIV/AIDS epidemic has also changed forever the way in which we deal with global health.

No, we do not have a vaccine - yet. And no, we do not have a cure - yet. But look at the massive achievement in getting people on antiretroviral treatment across the globe, the millions of lives saved. HIV science, has, in a relatively short timeframe, transformed what was once a death sentence into a chronically manageable disease.

In those terribly black early days of the epidemic scientists were working on how to prevent infection and soon we came up with condoms and clean needles that on reflection were so vital in stopping a major pandemic in its tracks in parts of the western world.

But soon the epidemic became an emergency in Africa and other parts of the developing world, growing exponentially and taking so many lives. And then at a memorable International AIDS Conference in Vancouver in 1996, scientists announced the first triple course therapy drugs and forever changed the course of the epidemic.

In 2011 scientists came up with another game breaker - early diagnosis and treatment could prevent transmission by up to 96% when the viral load is undetectable and no STIs are present. We now had at our disposal an extraordinarily powerful new tool to approach the epidemic. Yet like all science, Treatment as Prevention will only prove to be effective on the ground if scientists, community, leadership and health personnel work together.

It was not the science alone that transformed AIDS. It was the unique and inspiring collaboration between researchers, leaders, health professionals, communities and activists that created the pressure to produce generic drugs to lower their cost, to distribute condoms, clean needles and methadone. The inclusion of the key affected populations such as men who have sex with men, sex workers, transgender people, or injecting drug users, among others, in decision making at all levels of governance, has defined the global response to HIV/AIDS and become the model for dealing with other global diseases too.

Let us not forget either that so many of these good people descending on Paris this week were not just scientists but at the same time, activists too. I can think of no better example of the activist scientist than Professor Françoise Barré-Sinoussi, an inspiration to so many of us. It is fitting, I think, that on the occasion of such a significant anniversary, Françoise's organisation the Institut Pasteur and its symposium partners, the US National Institutes of Health, ANRS and Sidaction have chosen to look forward and Imagine the Future. I'll let you know what that may look like later this week!

À bientôt!

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