TORONTO, ONTARIO – Today is my last day at the XVI International AIDS Conference. In case you’ve been worried that you’ve been missing anything about FDA, I’ve kept tabs while I’ve been gone and so far, no speeches, no testimony and no press releases have gone out. It is August in Washington and most people are gone.
But here in Toronto, I sat listening to a talk today by the distinguished Kevin De Cock, Director of the WHO Department of HIV/AIDS whose presentation was entitled "From ’3×5′ to Universal Access". For those not familiar, 3X5 was the global effort aimed at getting 3 million people in developing nations antiviral therapy by the end of 2005. It failed, but it nevertheless got the ball rolling.
Dr. De Cock’s talk was both inspired and inspiring. It made clear how very important expanded access to therapy is, not only for the individuals involved, but as a matter of global public health, and that expanded access can likely reduce expanded infection.
But one poignant moment for me came when he mentioned that this was not only the 25th anniversary of the epidemic, but the 10th anniversary of HAART which stands for Highly Active Anti-Retroviral Therapy. I remembered sitting in another auditorium a continent away and seeing the astonishing slides about the impact of protease inhibitors and remember that it was the first time in years I had felt anything akin to hope. At that moment in 1996 in Vancouver, my hope had re-kindled. It’s been going strong ever since.
The XVI International AIDS Conference has fanned the flames of that hope. I wish there were words to convey how bleak life was before HAART. How many phone calls conveyed the deaths of dead friends. How one stopped going to funerals because there were too many. How one looked at Africa and could only feel stark fear for what was about to happen.
I don’t mean to minimize the significant challenges that lay ahead. But this conference has shed light on tremendous progress made through all of the many global efforts to finally get drug moving into the developing world where disease burden is so high. A majority of those infected are still not getting what they need. But when I look back to 25 years ago, and the utter age of darkness in which we sat, and even 10 years ago, when there were no effective therapies, if I think of the world ten years from now, I can imagine a significantly better place.
And it is due to the heroic efforts of activists, of governments and policy leaders. And, in the United States, the Food and Drug Administration, which enacted reforms to speed life saving drugs to market and the pharmaceutical companies and the university and government researchers who in a breathtakingly short period of time learned about the human immune system and brought compounds from theory into the bodies of hundreds of thousands of people with HIV who, had they not received the, would be dead.