Dr. Pedro Cahn, former president of the International AIDS Society (IAS) and president of Fundacion Huesped in Argentina argued that the XVIII International AIDS Conference was not just one more conference. Not only did AIDS 2010 provide a space to express disappointment at broken promises, Cahn also considers it “one of the best conferences ever” in terms of scientific breakthrough.
The development of the new microbicide raised enthusiasm among those working in the AIDS response. What’s your opinion? What’s your perspective of the Conference from a scientific point of view?
From the scientific side this has been one of the best conferences ever, as there have been many advances in basic science. Progress has been made in understanding what is hindering the development of a vaccine and, of course, a large step was taken with regards to microbicide development. It is the first time that a microbicide proves to be effective. Of course this doesn’t mean that next week we’ll be able to find this microbicide in drugstores; wee need to improve the method. The main advantage is that this particular method is controlled by women without depending on their partner’s willingness to use a condom.
What advances have there been in terms of treatment?
With regards to treatment, this is not a time for new drugs but a time for improving treatment strategies, for improving using existing drugs, and for combining drugs in new ways. The paradigm of the three drugs as the best treatment option is almost at end. We see from some of the studies presented at the conference that equal results can be achieved by using two different sorts of drugs. This can lead to cost reduction; reduced exposure and reduced toxicity.
A lot has been said about generic drugs. In your opinion, what are the next steps?
We need to be clear: the only chance to access treatment is by using generic drugs. Just to clarify, ‘generic’ is a medicine whose patent has expired. We’re talking about copies. I think we should definitely find a solution that takes into account patients’ needs but does not jeopardise further research. Whether we like it or not, research on new drugs is controlled by the pharmaceutical industry. Thus, through the so-called ‘patent pool’, new drugs developed by the pharmaceutical industry could be produced by local manufacturers who would pay the pharmaceutical companies reasonable royalties. Of course, if the pharmaceutical companies sold the medicines at the usual price, they would obtain greater profits. But with this option they would definitely obtain a return paid that could avoid research blockades. This double sided situation must be taken into account. It is nonsense to wage war on drug manufacturers, health service providers and patients; the war is against the epidemic, against the virus. We need to find ways to move forward. In the meantime, generic drugs save millions of lives, so they can’t be stopped. There can be no higher interest than the interest of human life, in any field.
Which do you think were the most relevant social issues rose during the Conference?
During this Conference, both the organisers and the activists highlighted the gap between promises and achievements in terms of access to ARV treatment. To clarify, we are not asking for more specific funding. We are asking the G8 governments in particular to fulfil their commitment to invest the funds they have already promised. If they don’t, many people in several countries with an HIV positive diagnosis will be told that they have a treatable disease but there is no money to buy treatment. This is unacceptable, as was strongly expressed at the Conference.