News / Africa

Changing the Course of the Epidemic

Dr. Julio Montaner, BC Center for Excellence in HIV/AIDS. (De Capua)
Dr. Julio Montaner, BC Center for Excellence in HIV/AIDS. (De Capua)
Joe DeCapua
A former president of the International AIDS Society says it will take a combination of scientific and human rights advances to end the epidemic. Dr. Julio Montaner made his comments at the 19th International AIDS Conference in Washington.

Montaner pioneered Treatment as Prevention at Canada’s BC Center for Excellence in HIV/AIDS. The method of using antiretroviral drugs not only to treat infected people, but to protect uninfected as well, is now an accepted practice.



But despite having a dramatic effect on the course of the epidemic, he said, Treatment as Prevention is not enough.

“I want to be perfectly clear. While we have been strong proponents of this since our landmark call for action in 2006 in The Lancet – and since then we’ve been reporting continuously on the improvements that we have seen with this strategy in British Columbia – I’m the first one to realize that if we are going to truly control this disease we’re going to need a cure and a vaccine. In the absence of those two, the ability of Treatment as Prevention to truly control the epidemic is a bit of a rhetorical excess if you want,” he said.

Montaner said achievements in science can only work if many people change what they believe, especially when it comes to such high risk groups as men who have sex with men, sex workers and intravenous drug users.

“Well, I think it’s bigotry. I think it’s stigma. It’s discrimination. One thing is when you’re ignorant because you don’t know – so you’re an honest ignorant – but the other thing is when your ignorance is based on your preconceived biases. In other words, you’re closing your eyes to the evidence. And I think what we have today is a much more perverse situation, which is we know how to go forward and we still are unwilling or unable to implement the necessary legal reforms, for example, to make things happen,” he said.

Montaner said British Columbia, where he works, continues to take the steps necessary to tackle HIV/AIDS on many levels. And it’s paying off.

“We are the only jurisdiction in Canada that has seen decreasing HIV rates. And the reason is because we have a focused, aggressive HIV program. We have a progressive leadership in the province and we have a committed population to actually do the right thing. We can do things that are illegal in other parts of the country,” he said.

One of the programs deals with commercial sex workers. While the provincial government has not legalized brothels, Montaner says, it “tolerates” them. Some brothels are actually located in publicly subsidized housing.  As a result, sex workers are less likely to be victims of violence and more likely to receive health and HIV prevention services.

“I don’t mean it literally, but I said, look, we could stop the research, we could stop writing guidelines, and we could just say let’s implement everything that we know that works with a liberal frame of mind and this world would be a totally different world when it comes to HIV and AIDS, of course, and many other things as well,” he said.

Montaner was chair of AIDS 2010 and helped write the Vienna Declaration. It called for a decriminalization of drug use, saying it should be treated as a health issue instead.

“The war on drugs,” Montaner said, “has been an abject failure. Nobody actually believes that that’s the way to go and yet we’re still criminalizing people for the possession of small amounts of drugs for personal use. I mean these people need public health. They don’t need prisons. If they were not infected with HIV to begin with they can get HIV in the prison. This is not working.”

In British Columbia, addicts are offered clean needles, which they are not permitted to share. And they are regularly tested and, if need be, treated for HIV. The program, called Insite, has been in operation for about eight years.

He also helped write the D.C. Declaration for AIDS 2012 in Washington.

“What the D.C. Declaration is basically asking for is that we, once and for all, accept that we have the tools to change the course of the epidemic in a dramatic fashion. If we implement the things that we know – the evidence-based solutions that we have demonstrated over so many years – we are going to see a turning point in the epidemic. Could we eliminate HIV? No, that’s not the point. The point is that we’re going to see the curves bending downwards in a very dramatic way,” he said.

Dr. Montaner is calling for a redoubling of investments into finding a vaccine and a cure for HIV. He says that should be “the legacy left for generations to come.”

You May Like

Lesotho Faces New Round of Violence, Political Crisis

Brutal killing of military officer has sent former leaders back into S. Africa where they're watching anxiously as regional officials head in to try to restore peace More

Video US Diplomat Expects Adoption of Srebrenica Anniversary Resolution

Samantha Power says there's broad consensus about killings in Bosnia's war, but Russia calls resolution 'divisive,' backs countermeasure at UN More

UN Report Exposes Widespread Boko Haram Atrocities

Damning report graphically details pattern of vicious, widespread atrocities committed by Islamist militants More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Family of American Marine Calls for Release From Iranian Prisoni
X
Heather Murdock
July 01, 2015 8:59 PM
As the crowd of journalists covering the Iran talks swells, so too do the opportunities for media coverage.  Hoping to catch the attention of high-level diplomats, the family of American-Iranian marine Amir Hekmati is in Vienna, pleading for his release from an Iranian prison after nearly 4 years.  VOA’s Heather Murdock reports from Vienna.
Video

Video Family of American Marine Calls for Release From Iranian Prison

As the crowd of journalists covering the Iran talks swells, so too do the opportunities for media coverage.  Hoping to catch the attention of high-level diplomats, the family of American-Iranian marine Amir Hekmati is in Vienna, pleading for his release from an Iranian prison after nearly 4 years.  VOA’s Heather Murdock reports from Vienna.
Video

Video UK Holds Terror Drill as MPs Mull Tunisia Response

After pledging a tough response to last Friday’s terror attack in Tunisia, which came just days before the 10th anniversary of the bomb attacks on London’s transport network, British security services are shifting their focus to overseas counter-terror operations. VOA's Henry Ridgwell has more.
Video

Video Obama on Cuba: This is What Change Looks Like

President Barack Obama says the United States will soon reopen its embassy in Cuba for the first time since 1961, ending a half-century of isolation. VOA White House correspondent Luis Ramirez reports.
Video

Video Hate Groups Spread Influence Via Internet

Hate groups of various kinds are using the Internet for propaganda and recruitment, and a Jewish human rights organization that monitors these groups, the Simon Wiesenthal Center, says their influence is growing. The messages are different, but the calls to hatred or violence are similar. VOA's Mike O’Sullivan reports.
Video

Video US Silica Sand Mining Surge Worries Illinois Residents, Businesses

Increased domestic U.S. oil and gas production, thanks to advances known as “fracking,” has created a boom for other industries supporting that extraction. Demand for silica sand, used in fracking, could triple over the next five years. In the Midwest state of Illinois, people living near the mines are worried about how increased silica sand mining will affect their businesses and their health. VOA’s Kane Farabaugh has more in this first of a series of reports.
Video

Video Blind Somali Journalist Defies Odds in Mogadishu

Despite improving security in the last few years, Somalia remains one of the most dangerous countries to be a journalist – even more so for someone who cannot see. Abdulaziz Billow has the story of journalist Abdifatah Hassan Kalgacal, who has been reporting from the Somali capital for the last decade despite being blind.
Video

Video Texas Defies Same-Sex Marriage Ruling

Texas state officials have criticized the US Supreme Court decision giving same-sex couples the right to marry nationwide. The attorney general of Texas says last week's decision did not overrule constitutional "rights of religious liberty," and therefore officials performing wedding services can refuse to perform them for same-sex couples if it is against their religious beliefs. Zlatica Hoke reports on the controversy.
Video

Video Rabbi Hits Road to Heal Jewish-Muslim Relations in France

France is on high alert after last week's terrorist attack near the city Lyon, just six months after deadly Paris shootings. The attack have added new tensions to relations between French Jews and Muslims. France’s Jewish and Muslim communities also share a common heritage, though, and as far as one French rabbi is concerned, they are destined to be friends. From the Paris suburb of La Courneuve, Lisa Bryant reports about Rabbi Michel Serfaty and his friendship bus.
Video

Video Saudi Leaks Expose ‘Checkbook Diplomacy’ In Battle With Iran

Saudi Arabia’s willingness to wield its oil money on the global diplomatic stage appears to have been laid bare, after the website WikiLeaks published tens of thousands of leaked cables from Riyadh’s Ministry of Foreign Affairs. VOA's Henry Ridgwell reports.
Video

Video Nubians in Kenya Face Land Challenges

East Africa's ethnic Nubians have a rich cultural history that dates back thousands of years, but in Kenya they are facing hardships, including the loss of lands they have lived on for generations. They say the government has reneged on its pledge to award them title deeds for the plots. VOA's Lenny Ruvaga reports.
Video

Video Military Experts Question New Russian Tank Capabilities

Russia has been showing off its new tank design – the Armata T-14. Designers claim it is 20 years ahead of current Western designs - and driving it feels like playing a computer game. But military analysts question those assertions, and warn the cost could be too heavy a burden for Russia’s struggling economy. Henry Ridgwell reports.
Video

Video In Kenya, Police Said to Shoot First, Ask Questions Later

An organization that documents torture and extrajudicial killings says Kenyan police were responsible for 1,252 shooting deaths in five cities, including Nairobi, between 2009 and 2014, representing 67 percent of all gun deaths in the areas reviewed. Gabe Joselow has more from Nairobi.

VOA Blogs