24 July

Home thoughts from abroad

`Half way through the International AIDS Conference no one can be any doubt of the central theme - the end of AIDS could be in sight.  Buoyed by research showing how HIV treatments can be used to prevent HIV transmission, and by the launch of new HIV self testing kits, the conference has seen a range of speakers from Hillary Clinton & Sir Elton John, through to eminent professors and researchers, and onto community leaders proclaiming that we now have the tools to end AIDS.'

`Such optimism is welcome and inspiring, but the scientific breakthroughs are only the beginning.

Much of the research shows that treatment can be used to prevent transmission, but what it hasn't yet told us is how best to use this in day to day practice. Key questions remaining unanswered are who should be prioritised for prevention treatment and how do we best reach them, how should treatment be best combined with work to reduce sexual risk taking, and how do we ensure that people remain adherent to treatment? Beyond this lie the ethical & economic questions, such as in cash strapped health systems should funding priority be given to resourcing treatment for those of us infected, or for those who find it difficult to sustain condom use? In England, the restructuring of the NHS raises further questions still such as the case for Local Authorities to fund HIV drugs for prevention when the financial savings will accrue to the NHS.

All of these can be tackled, and if anywhere can do it it should be the UK, where thanks to the NHS, HIV treatment rates eclipse those of many other nations, especially the US. At the start of July THT launched its campaign to halt the spread of HIV in the UK. The conference has shown this is within our grasp. What it now needs is a concerted and coordinated effort from communities, health services and Govt to overcome the remaining questions, provide the necessary problem solving and resourcing, and deliver the leadership needed.'

Paul Ward 
Deputy Chief Executive