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

How to Safeguard Your Mobile Privacy

As the digital world becomes more mobile, so too do concerns about eroding privacy and increased hacking More

'Desert Dancer' Chronicles Iranian Underground Dance Troupe

Film by Richard Raymond is based on true story of Afshin Ghaffarian and his friends More

Obesity Poses Complex Problem

Professor warns of obesity’s worldwide health impact More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Rolling Thunder Run Reveals Changed Attitudes Towards Vietnam Wari
X
Katherine Gypson
May 25, 2015 1:32 AM
For many US war veterans, the Memorial Day holiday is an opportunity to look back at a divisive conflict in the nation’s history and to remember those who did not make it home.
Video

Video Rolling Thunder Run Reveals Changed Attitudes Towards Vietnam War

For many US war veterans, the Memorial Day holiday is an opportunity to look back at a divisive conflict in the nation’s history and to remember those who did not make it home.
Video

Video Female American Soldiers: Healing Through Filmmaking

According to the United States Defense Department, there are more than 200-thousand women serving in the U.S. Armed Forces.  Like their male counterparts, females have experiences that can be very traumatic.  VOA's Bernard Shusman tells us about a program that is helping some American women in the military heal through filmmaking.
Video

Video Iowa Family's Sacrifice Shaped US Military Service for Generations

Few places in America have experienced war like Waterloo. This small town in the Midwest state of Iowa became famous during World War II not for what it accomplished, but what it lost. As VOA’s Kane Farabaugh reports, the legacy of one family’s sacrifice is still a reminder today of the real cost of war for all families on the homefront.
Video

Video On Film: How Dance Defies Iran's Political Oppression

'Desert Dancer' by filmmaker Richard Raymond is based on the true story of a group of young Iranians, who form an underground dance troupe in the Islamic Republic of Iran. This is the latest in a genre of films that focus on dance as a form of freedom of expression against political oppression and social injustice. VOA’s Penelope Poulou has more.
Video

Video Turkey's Ruling Party Trying to Lure Voters in Opposition Stronghold

Turkey’s AK (Justice and Development) Party is seeking a fourth successive general election victory, with the goal of securing two-thirds of the seats in Parliament to rewrite the constitution and change the country's parliamentary system into a presidential one. To achieve that, the party will need to win seats in opposition strongholds like the western city of Izmir. Dorian Jones reports.
Video

Video Millions Flock to Ethiopia Polls

Millions of Ethiopians cast their votes Sunday in the first national election since the 2012 death of longtime leader Meles Zenawi. Mr. Meles' party, the Ethiopian People's Revolutionary Democratic Front, is almost certain of victory again. VOA's Anita Powell reports from Addis Ababa.
Video

Video Scientists Testing Space Propulsion by Light

Can the sun - the heart of our solar system - power a spacecraft to the edge of our solar system? The answer may come from a just-launched small satellite designed to test the efficiency of solar sail propulsion. Once deployed, its large sail will catch the so-called solar wind and slowly reach what scientists hope to be substantial speed. VOA’s George Putic reports.
Video

Video FIFA Trains Somali Referees

As stability returns to the once lawless nation of Somalia, the world football governing body, FIFA, is helping to rebuild the country’s sport sector by training referees as well as its young footballers. Abdulaziz Billow has more from Mogadishu.
Video

Video With US Child Obesity Rates on the Rise, Program Promotes Health Eating

In its fifth year, FoodCorps puts more than 180 young Americans into 500 schools across the United States, where they focus on teaching students about nutrition, engaging them with hands-on activities, and improving their access to healthy foods whether in the cafeteria or the greater community. Aru Pande has more.
Video

Video Virginia Neighborhood Draws People to Nostalgic Main Street

In the U.S., people used to grow up in small towns with a main street lined by family-owned shops and restaurants. Today, however, many main streets are worn down and empty because shoppers have been lured away by shopping malls. But in the Del Ray neighborhood of Alexandria, Virginia, main street is thriving. VOA’s Deborah Block reports it has a nostalgic feel with its small restaurants and unique stores.

VOA Blogs