Little by little, but probably too slowly to save millions of people, the world seems to be getting its act together for confronting the Aids peril.
The 14th International Aids Conference which ended in Barcelona on Friday had only bleak news from the battlefield in a war now in its third decade.
Acquired immune deficiency syndrome is set to rampage across Eastern Europe and Asia after devastating sub-Saharan Africa, reaping a potential global harvest of nearly 90-million lives by 2020, the six-day forum heard.
Scientists bleakly confirmed that any cure remains way over the horizon.
They added that evidence is emerging of resistance to antiretrovirals, the only available drugs that can prevent people with the human immunodeficiency virus (HIV) from getting Aids.
And they cautioned that any protective vaccine, even one just partially effective, could be several years away at least.
But there is also a positive side to the story. The piecemeal tactics of the past, the pitiful underfunding and official indifference are now bit by bit yielding to a coordinated strategy, financial help and leadership.
The biggest change is in politics, thanks to a watershed conference in Durban two years ago and the UN’s special session of the general assembly in 2001 that set a deadline for countries to identify what they would commit to the Aids campaign and how much.
That has driven Aids — once marginalised by bigots as ”the gay plague” — to the top of the mainstream political agenda and helped set up a financial vehicle, the Global Fund, to channel money into the war effort.
True, the cash is still far short of what is needed. The UN has set a target of an additional $10-billion a year by 2005, from all sources, to combat the pandemic in the poorest countries.
So far, the commitments are less than a third of that, says UNAids’ executive director, Peter Piot.
Things are changing, too, in the controversial business of drug access. The pricing wall that denied antiretrovirals to tens of millions of infected Africans is crumbling fast.
Prodded by Aids activists, worried by the threat of losing markets to generic copies of their products from Brazil, India and Thailand, ”Big Pharma” is slashing prices of anti-retroviral drugs to the Third World.
A two-tier pricing structure is rapidly emerging, with rich nations paying top dollar, providing the vital profit motive for pharmaceutical research, and poorest nations getting the precious tablets at cost or for free.
Increasingly now, the worry among groups on the front line is less the cost of drugs than the need to build up supply lines and medical infrastructure so that the treatments can be properly administered.
In the labs, meanwhile, scientists are working desperately on a new array of potential weapons.
The successes include a new category of drugs called fusion inhibitors, which attack the virus from a different angle.
Unlike antiretrovirals, which disrupt the virus’ replication after it has entered a cell, these molecules block the virus at the point of entry, preventing it from crossing the cell membrane.
The first drug in this category has thrown a lifeline to volunteers whose immune systems were almost wrecked by HIV. Its makers are seeking US and European approval to market it. And there is plenty of mileage in antiretrovirals, too.
Knowledge is rapidly building up about how they can be used more effectively and more sparingly and improved to ease side effects.
And the resistance problem may not be as bad as feared. Robert Siliciano of the Johns Hopkins School of Medicine in Baltimore, Maryland, said that, among patients who had used the famous ”cocktail” of several antiretrovirals but not had any previous treatment, there was no sign of virus mutation.
”In principle this makes it possible to offer everyone with HIV infection the chance for a normal life,” he said. ”This will require the development of drug regimens that are convenient, affordable and non-toxic.”
Vaccines — until just recently the most sadly neglected part of the Aids war — are at last showing momentum. The ”Holy Grail” of an antibody vaccine to destroy the viral intruder may be found in the human genome — some hope.
But locating this molecule of dreams, testing it and — if all goes well — distributing it, is an agonisingly long process.
So, today, the message from the Aids battlefront is the one that has now prevailed, wearingly, for more than two decades. Keep up the fight. Do not expect miracles. And use a condom. – Sapa-AFP