AIDS 2022, the 24th International AIDS Conference, will take place in Montreal, Canada, as well as virtually, from 29 July to 2 August. AIDS 2022 will call on the world to come together to re-engage and follow the science. It will define future research agendas, shift latest evidence to action, and chart a new consensus on overcoming the HIV epidemic as a threat to public health and individual well-being.
We caught up with Adeeba Kamarulzaman, IAS President and International Co-Chair of AIDS 2022, to learn more about the global response to HIV and her hopes for the conference.
It has been more than 40 years since AIDS was first reported. Looking back, what do you see as some of the most important milestones in the history of the global HIV response? And what challenges remain?
One of the most impactful milestones that immediately comes to mind is the discovery of effective treatment in the late 1990s, which dramatically changed the landscape of the epidemic. I trained as an Infectious Diseases physician years ago when there was no treatment,When antiretroviral therapy (ART) was introduced, you’d see people magically get better in front of your eyes. ART brought people back from the brink of death.
Then, four studies confirmed that the same treatment reduces transmission: someone living with HIV, who is on treatment and virally suppressed cannot transmit the virus to a sexual partner. From the data, the U=U (undetectable equals untransmittable) campaign was launched and has been instrumental in helping reduce stigma and increase early adoption of treatment, two barriers that still have to be addressed.
That the same pills are also used for pre-exposure prophylaxis (PrEP) – preventing transmission before you have been exposed – is pretty revolutionary. Using medication for treatment and prevention has given a lot of hope that we can bring an end to AIDS.
Another big milestone is the creation of very large funding mechanisms that enable many countries that have not been able to provide treatment to millions of people through domestic funding. Among them are WHO’s initial 3 by 5 program, the Global Fund, the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Gates Foundation. We know that even though ART has been shown to be extremely effective, it doesn’t work if you don’t get it into the hands of people.
Having said that, I was just in a meeting with UNAIDS, reviewing the data from the Asia-Pacific region, and the majority of countries in my region still see late presenters: 50% or more of people who present for the first time with a diagnosis of HIV are doing so at a late stage.
The challenges are multifactorial. The newer generation may not be so afraid or aware of HIV. Underlying socio-environmental issues and legal and policy barriers persist in deepening stigma and discrimination. Criminalization of sex work and gay and trans people and people who use drugs leads to stigma that prevents people from coming forward for diagnosis and linkage to care. So, while we’ve made progress, there are still significant barriers to overcome.
What do you hope participants in AIDS 2022 learn?
We have a smorgasbord of presentations and abstract submissions from all tracks this year. Some of the top headlines presented by colleagues all over the world will spotlight: the search for an HIV cure and vaccine; newer medication formulations like long-acting injectables for treatment and prevention; knowledge sharing around how to implement effective treatment; different delivery models; and client centredness.
While the theme is re-engage and follow the science, AIDS 2022 is more than just science. We hope that the participants will also be immersed in the culture of the HIV response – the humanity of it, our rights-based approach, our respect for diversity and gender, and everything we represent. Our hope is for participants to attend in person to experience the Global Village and the multitude of other fantastic activities that surround the scientific content.
The theme of AIDS 2022 is re-engage and follow the science. What does this theme mean to you? And what are your biggest hopes for the conference?
The science around HIV and AIDS through the years has been enormously transformative and has given us an array of tools for treatment and prevention. But a lot of the science in the conference is also dedicated to social and behavioural sciences and policy making. This year, “follow the science” is about how to deliver. And there is plenty of research focusing on those aspects.
In terms of hopes for the conference, we cannot deny that since the COVID-19 pandemic began, HIV and other diseases have taken a back seat because of the urgency and enormity of the pandemic. What I hope for AIDS 2022 is to re-engage and reignite the passion to bring an end to AIDS. We want to “re-engage” not just those who are already a part of it, but also use the global media coverage and high-level engagement we attract to bring to the attention of global leadership that the HIV epidemic is not over and we need to continue to invest in it in the whole array of HIV science including the search for an HIV cure and vaccine, politically and financially to truly bring an end to AIDS.
“The science around HIV and AIDS through the years has been enormously transformative and has given us an array of tools for both treatment and prevention. A lot of the science in the conference is also dedicated to social, behavioural and implementation sciences and policy making to further inform evidence into action.” – Adeeba Kamarulzaman, AIDS 2022 International Co-Chair