To achieve universal access to HIV prevention and treatment, the scientific and public health community must respond quickly to developments on the ground to narrow the gap between discovery and intervention.
Dr Charlie Gilks, head of treatment, prevention and scale up at the World Health Organization's (WHO) HIV/AIDS Department, stressed the need to "learn by doing" at the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, a biennial scientific meeting, in Rio de Jeneiro, Brazil. Gilks stressed that the scientific community must be committed to applying the results of scientific studies quickly to AIDS programmes while they are being implemented.
The goal of achieving as close as possible to universal access to HIV treatment by 2010 was recently endorsed by G8 leaders in Gleneagles, Scotland at their annual meeting. Achieving this goal will require a significant new investment of resources and effort in research, says Gilks, who cited new formulations of HIV drugs for children and simpler tests to diagnose and monitor patients as major research priorities for scaling up treatment in resource-limited settings.
"The list of research questions is long," said Gilks. "But if we are going to achieve universal access, we will need to invest in applied research and move new products and approaches quickly into the field."
Gilks remains confident that the scientific community can meet this challenge, and that prospects for rewarding scientific work in the field of HIV/AIDS have never been better. "We have the knowledge to answer many of these questions", he said. "In fact, I would argue that in no other field are the opportunities to translate evidence into action so great, as they currently are in HIV/AIDS. Not only can researchers have direct impact on policy and practice, they can reduce inequities by helping to make scientific advances available more quickly to the millions of people who need treatment”.
The Rio conference brings together leading AIDS researchers, activists and policy makers to discuss recent advances in HIV/AIDS research and ways of translating research findings into practice.
The WHO and UNAIDS strategy to ensure treatment for three million people living with HIV/AIDS in low- and middle-income countries by the end of 2005 (the "3 by 5" ) has been a major catalyst for mobilizing support and action and was an important first step towards the goal of universal access. Access to antiretroviral treatment in developing countries has expanded significantly. Since the initiative started in 2003, the number of countries establishing national treatment targets has risen from four to 40, and the number of countries that have developed national plans to scale up antiretroviral treatment now numbers 34, up from only three. In the last 12 months, more than 50 countries have doubled the number of people who are on treatment. The recent G8 endorsement of achieving as close as possible to universal access to treatment by 2010 is seen as a major boost to continuing this effort.
Gilks emphasized the importance of research on HIV prevention in addition to more effective ways to deliver treatment. "While we work to keep people alive and healthy with the tools we have now, we also need to ensure that future generations will have access to better prevention technologies," said Gilks, referring to the importance of vaccine and microbicide research.