Things are in a predictable state of chaos here at the Press Center at the AIDS2008 meeting. The wireless access is down, the keyboards only “speak” Spanish, and so forth. . .

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But in the session halls, things are ticking along energetically. This morning’s plenary was a mix of science, policy, and personal stories. Some highlights:

• Jaime Sepulveda, of the Gates Foundation, addressed supranational, global efforts against HIV/AIDS, dissecting what has worked, what has been insufficient, and what reforms are now needed.
  • He highlighted these accomplishments from what he called “an unprecedented global response” to the disease: UNAIDS, the first UN organisation devoted to a single disease; the Global Fund; PEPFAR, “the largest bilateral programme in history”; and the global alliance of people living with HIV/AIDS.
  • But deficits persist, in research and prevention especially. Existing research mechanisms are well adapted for new technologies and treatment, but are not adequate for the kinds of behavioral interventions needed. The private sector has conquered marketing, for example, and that kind of expertise is needed to combat HIV. And not enough resources are being invested in prevention and in delivery of proven prevention methods, like male circumcision, integrated family planning services, and scaling up of combination prevention and combination therapy. “More and better prevention” must be our common goal.

• Alex Coutinho, from the Infectious Diseases Institute, Kampala, Uganda, said what is needed is “leadership, leadership, and more leadership”.
  • He highlighted Tanzania, Rwanda, Cambodia, and Mexico as countries that have demonstrated leadership and results. Ethiopia also has been able to establish more than 260 treatment sites, even in remote areas of the country. Villages in rural Uganda are now doing home-based testing, with one area alone reaching more than 400 000 people.
  • “Even the best orphans and vulnerable children programmes cannot replace parents”, he said. The best solution is to keep parents alive and healthy.
  • A number of community-based programmes have achieved good results–campaigns to stop violence against women; programmes to scale up services for sex workers; and support groups for HIV-positive people that dedicated to fighting stigma.

A session that followed sounded fascinating: “Is religion a barrier to HIV prevention?” Unfortunately, a lot of other people must have thought it would be intriguing as well. Dozens of people, including me, were turned away because the room was full to overflowing. Info to come, I hope.

Faith McLellan

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