Working toward IAS 2012

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Key experts from the administration and civil society Thursday discussed results from the 18th International AIDS Conference in Vienna, and provided a look ahead to the 2012 meeting in Washington, D.C. The forum was co-hosted by the Kaiser Family Foundation (KFF) and the Center for International and Strategic Studies, and aimed to examine U.S. and global AIDS strategies post-Vienna.

Panel participant Deborah von Zinkernagel, Principal Deputy at the Office of the U.S. Global AIDS Coordinator (OGAC), summarized some of the most important developments of the Vienna conference and discussed some of OGAC’s approach to current concerns around treatment shortages.

In the last year PEPFAR has put an additional 800,000 people on HIV/AIDS treatment, von Zinkernagel said.  The administration has recently moved aggressively to address treatment shortages in Uganda, which was welcomed by activists in the US and Africa. She added that the administration has had discussions with the Global Fund about how to harmonize their activities in each country to reduce the chance of bottlenecks.

When asked about the President’s recent statement that seemed to counterpoise treatment and prevention and to what extent the administration viewed treatment as an essential part of combination prevention, von Zinkernagel responded with a clear endorsement of the concept. She also noted some of the more promising recent studies of the impact of treatment for prevention for discordant couples. One of the other panelists – Chris Beyrer, MD of Johns Hopkins University – said that Vienna would be remembered as the conference where science ended the divide between treatment and prevention, including for injecting drug users.

Von Zinkernagel discussed the importance of the CAMELIA study, which showed the benefits of early treatment for people with HIV and tuberculosis.  She was then asked about the recent criticism from Doctors Without Borders that PEPFAR is encouraging countries to provide earlier treatment only to the sickest patients, despite the cost savings (due to less hospitalization) from enrolling patients at an earlier stage in disease progression. 

Early initiation posed challenges at the programmatic level, von Zingernagel said, since patients are coming to PEPFAR clinics with an average CD4 count of 138.  She added that PEPFAR was moving forward with early treatment enrollment for some patients, such as the sickest patients, pregnant women, and people with TB-HIV co-infection. Country level decisions and sharing the burden also play a huge role in advancing, she said.

Other panelists at the forum included Jeff Crowley, Director of the White House Office of National AIDS Policy, and Phill Wilson, President of the Black AIDS Institute. Both emphasized the importance of having the next IAS meeting in Washington, D.C. At its core, we see IAS as a scientific meeting, Crowley said, and even though the meeting will be held in the backyard of the National Institutes of Health, the premiere AIDS research institution in the United States, the meeting will also present an opportunity for broader participation of scientists from a range of federal agencies.

A  full video of the forum is available on the Kaiser Family Foundation website.

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