Bay Area Reporter - August 8, 2002
Michael Lauro, Survive AIDS Writers Pool

It is impossible for one lone AIDS activist to cover all of the seven separate tracks of the conference (basic sciences, clinical science/care, epidemiology, prevention "science," social sciences, interventions/program implementation, & advocacy/public policy), review all the daily poster abstracts for these seven tracks, and attend the plenary sessions and overlapping oral presentations held each day. Given that, this modest article will in no way attempt a conference highlights theme. The words which follow are merely one individual's highlights, including some admittedly cursory observations of the themes that most interested him.

Nighttime Opening Ceremonies

Thankfully, I skipped these to sort through the conference program materials, two volumes of abstracts, and plan for my next day's schedule. The following morning Barcelona's major daily newspapers all carried an enormous above-the-fold photo of thousands of opening ceremony conference participants holding lighted candles in the air at the Palau St. Jordi. I'm not sure if "Ode to Joy" was cued in the background, but certainly that would have been an appropriate accompaniment. On Monday, as the first full day of the conference breaks, I am satisfied that I'm one-for-one in time management.

Monday's Plenary Session

The large hall was nearly filled as the first of four speakers, Irene Fernandez, a human rights activist and director of an NGO serving women and migrant workers in Malaysia shared her guiding slogans such as "nothing for us without us" and "it s a noisy world¡it s unhealthy to speak in whispers." She was followed by Bernard Schwartlander of the World Health Organization whose lecture was entitled: "The HIV Epidemic: What is it Doing? Where is it Going?" He referred to WHO global estimates of 40 million infected (11.8 m youth), 4 to 5 m new infections each year, and 3 million dead this year alone.

Schwartlander gloomily reviewed the impact of the epidemic in Africa, especially places like South Africa with the largest number of people infected by HIV in the world and where the number of children orphaned by AIDS now stands at 700,000 and is estimated to hit 2 million at the end of the decade. Some areas of Southern Africa are already seeing one-in-four children orphaned by AIDS. HIV infection rates in some areas near 20% of the region's population. In clinics in South Africa, 25% of pregnant women present with HIV, in places in Botswana that number rises to 40%.

Next came Bob Siliciano, Professor of Medicine & Molecular Biology at Johns Hopkins University School of Medicine who gave a good HIV 101 lecture and ended his talk, based on current knowledge, with these words: "HIV is intrinsically incurable with antiretroviral therapy alone." That current knowledge was derived in no small way from Siliciano's own work. In 1995, Dr. Siliciano's lab showed that latently infected CD4 T-cells were present in patients with HIV infection despite prolonged ART. This led to a repudiation of the complete eradication theory proffered by David Ho, a former Time magazine man-of-the-year from the Aaron Diamond Institute in New York.

According to conference materials, Siliciano's work "has lead to a rethinking of current treatment strategies." The final repudiating nail in Ho's hit it hard-hit it early strategy came only weeks ago as CDC guidelines to defer treatment initiation were revised downwards from the prior 350 CD4 benchmark to the newer and lower 200 standard. In subsequent presentations during the conference, some speakers even suggested that patients who went on drugs based on the older recommendation when their CD4's dipped below 350 but whose levels still remain above the new and revised 200 standard, might consider discontinuing them for now.

Finally, Milly Katana rose to speak. A PWA from Uganda, Katana s work bespeaks a knowledgeable and veteran activist on the frontline of the epidemic: Lobbying and Advocacy Officer of the Health Rights Action Group in Uganda, Project Manager for the Network of People Living with HIV/AIDS in Uganda, board member of the Global Network of People Living with HIV and a developing country board member to the Global Fund to Fight AIDS, Tuberculosis & Malaria. Katana has mobilized resources for healthcare delivery in this devastated area of the world, designed training programs for people living with HIV, helped combat HIV/AIDS stigma and discrimination in her country, implemented Ugandan prevention campaigns in institutions and schools, the police, army, and in prisons. Her conference bio states: "Today, Milly is engaged in the international campaign for access to treatment in the wake of an intensifying epidemic which badly needed a change in focus from prevention alone to addressing the care needs for those affected and infected by HIV/AIDS..."

Before Katana uttered a word and barely one hour into this first substantive part of the conference, the audience made for the door en masse. Katana was scheduled to speak for only 25 minutes but that seemed to matter little to these fine individuals. With all the rhetoric about the global AIDS crisis and with these participants supposedly the right target audience, you would have thought they would have foregone their espresso break before the conference presentations began in earnest to hear the wisdom this fine woman brought.

I suppose holding all those candles the night before was just too exhausting for these dedicated folks fighting the good fight.
020808
BR020801

Always watch for outdated information. This article first appeared in 2002. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2002. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .