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Dr Alvaro Bermejo

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The Greatest Show on Earth?

Posted: 27/07/2012 00:00

Every two years the International AIDS Conference rolls around and every two years I always start the week by referring to it as a bit of a jamboree. This year we've heard how Elton John believes that he should be dead from AIDS by now alongside his friend Freddie Mercury. And we've heard all about Sharon Stone's "mismatched outfit, a hodgepodge of clashing colours" (The Daily Mail), also referred to by one US outlet as a classy knee-length cherry red dress. Wyclef Jean performed at the Keep The Promise march and Alicia Keys mingled with the great and the good.

The conference is the world's largest gathering of experts, activists, people living with HIV and policy makers. Some 20,000 people who, just like me, have a point to get across in the tumult of symposiums, receptions, satellite sessions, plenary talks, round table debates and meetings.

It can be hard to shout loud enough when you're up against ground-breaking scientific achievements that will always - and rightfully - capture the headlines. Keeping up with them all during the course of the week can be overwhelming to say the least. There was news of a study taking place in Africa on a vaginal ring that will act as an HIV blocker. A new TB combination cocktail, PA-824, which is expected to be able to work in tandem with HIV therapy. New treatment options for HIV-positive children and adolescents. Not to mention all the chattering that goes on around finding a cure, a vaccine to end the AIDS epidemic once and for all.

All of which goes to show that our thirst for knowledge in the long struggle to beat the disease is neither diminished nor vanquished. The sheer scale of the optimism, humanity and solidarity on display in Washington this week is enough to re-energise and refocus even a hardened old veteran like myself.

Of course, not everything in the garden is rosy. Bill Gates warned that far too many people are still dying of AIDS. "We don't have the tools to end the epidemic", he stressed. Meanwhile, a Lancet report published this week highlighted that drug-resistant HIV has been increasing in parts of sub-Saharan Africa over the last decade. Additionally, the World Health Organisation announced that new HIV infections are spiralling in Eastern Europe and Central Asia, largely due to most at risk groups such as people who inject drugs not having access to prevention and treatment services.

Working in this field has certainly been one long rollercoaster ride, more often than not a case of two steps forward one step back. It was heartening though to hear of the US government's commitment to developing a blueprint for an AIDS-free generation by World Aids Day this December. The detail remains to be seen but for me this week there's one area that wasn't talked about quite enough in all the excitement over biomedical advances and that's the importance of investing in communities themselves - those carrying the greatest HIV burden - if we are really to break the back of the epidemic.

Delivering accessible and affordable quality health services for all those who need them is impossible without community mobilisation. If we strengthen community-based structures, integrate them into health systems and support links with other development sectors, we can make significant inroads into reducing HIV infections and create sustainable health and social care systems for the HIV and AIDS response.

Without communities and human rights, there is no such thing as an effective HIV response. In order to attain universal access to treatment, prevention and care, their frontline position must universally be acknowledged.

There, that was the point that I wanted to get across this week. And now I've done it. Not such a jamboree after all!

 

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