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“Community engagement makes science better and learning outcomes better. We learned that from HIV.”
“Since the discovery of the vaccine against COVID-19, we are closer than ever to an effective HIV vaccine and even on the way to a cure,” said Dr. Jean-Pierre Routy, co-chair of the 24th International AIDS Conference. Photo by Alan McInnis/Montreal Gazette
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Say “pandemic” and most people think COVID-19. Yet HIV, which takes a life every minute, remains the deadliest pandemic of our time.
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According to the United Nations Joint Program on HIV/AIDS (UNAIDS), approximately 79 million people have become infected with HIV, the virus that causes AIDS. There is still no vaccine or cure, although 28 million of the 38 million people living with HIV today are on life-saving antiretroviral therapy, which keeps them healthy by reducing the amount of virus in their bodies and preventing transmission. That means 10 million people are not.
HIV infections are increasing in many countries, and progress against new infections is slowing in others. More than four decades after AIDS was first reported in 1981, “we live in a world where HIV is the forgotten epidemic,” said the program describing the opening session of the world’s largest international meeting focused on HIV/AIDS, 24th International AIDS Conference. The five-day meet begins in Montreal on Friday.
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This first session of AIDS 2022, as the conference is known, will explore the “growing apathy” about HIV and consider “why and how the world needs to re-engage and follow the science” if the virus is to be defeated.
AIDS 2022, Montreal’s biggest conference this year, will have a hybrid format: it will bring 7,200 delegates in person to the Palais des congrès — masks required — and another 800 will participate virtually through an interactive platform. COVID-19 meant that the 2020 edition of the biennial conference was entirely virtual.
As HIV researchers and scientists focused on developing vaccines and treatments for COVID-19, the speed with which they understood the coronavirus was directly related to their HIV research, said Dr. Marina Klein, a professor in the university’s department of medicine McGill, director of research at McGill University Health Center’s Chronic Viral Disease Service and conference speaker.
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And the HIV research community “will bring lessons from the work on COVID-19 back to the HIV field,” she said. “This could have particular benefits for the development of an HIV vaccine, which has so far, despite decades of research, been elusive.”
Human clinical trials began this year for an experimental HIV vaccine developed by Moderna and the International AIDS Vaccine Initiative. It uses the same mRNA technology as Moderna’s successful COVID-19 vaccine to build an immune response.
“Following the discovery of the COVID-19 vaccine, we are closer than ever to an effective HIV vaccine and even on our way to a cure,” said AIDS 2022 Co-Chair Dr. Jean-Pierre Routy, Clinical Director of the Chronic Viral Illness Office at the MUHC, Louis Lowenstein Chair in Hematology and Oncology and Senior Scientist at the MUHC Research Institute and Professor of Medicine at McGill. “If it works for one disease, it should work for another.”
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But it’s important to shift the focus to HIV, said Rutty, who is also co-director of the Immunotherapy and Vaccines Core of the Canadian HIV Trials Network at the Canadian Institutes of Health Research (CIHR).
As resources were diverted to deal with the COVID-19 pandemic, HIV testing and treatment rates declined, access to treatment and prevention services was limited, and health personnel and community organizations supporting people living with HIV were depleted. said Klein, national co-director of the CIHR Canadian HIV Trials Network. Without a concerted effort to scale up interventions, and quickly, “we are quite concerned that the progress that has been made will be significantly affected,” she said.
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In 1989, when the international AIDS meeting was in Montreal for the first time, protesters from community and activist groups took the stage and disrupted the opening ceremony. This mobilization “initiated a transformation of the relationship between medicine and society,” said Montreal Pride executive director Simon Gamache. “Patients’ voices can no longer be ignored by scientists.”
That meeting provided the impetus for “engaging the community, people living with HIV, as a partner in the fight,” Ruthie said, and now the conference is a “true partnership” between science and the community.
A one-day pre-conference on Thursday will bring together scientists and people living with HIV at the Institut de Recherches cliniques de Montréal.
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In a prelude to Montreal Pride, which begins Aug. 1 and overlaps with AIDS 2022, the festival will feature cultural events including Rapture, a choreographed piece designed to honor people who have died of AIDS. The work “combines commemoration, pain and resilience and aims to remind us of the remarkable progress of recent decades,” Gamache said.
“One of the big lessons from HIV is the importance of community engagement and participation,” said Dr. Kathryn Hankins, professor of public and population health at McGill, co-chair of the Canadian Task Force on Immunity to COVID-19 and a conference participant . “It’s not just an addendum to science. It makes science better when there is co-creation of studies and co-supervision of studies.”
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In 2004, two pre-exposure HIV prevention trials in sex workers in Cambodia and Cameroon were halted because of inadequate community engagement, “and we realized that this would affect all prevention trials,” said Hankins, who was UNAIDS’ chief scientific adviser. in Geneva from 2002 to 2012.
She called a meeting and invited representatives of ACT UP, an international grassroots political group working to end the AIDS pandemic, and what emerged was the need for community guidance.
Community engagement has spread to other conditions, including breast cancer, “with survivors being engaged and participating in conferences. I think people realized that community engagement makes science better and learning outcomes better,” Hankins said. “We learned that from HIV.”
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Among the speakers at the AIDS 2022 conference will be Dr. Theresa Tam, Chief Public Health Officer of Canada. Photo by BLAIR GABLE/Reuters
While the COVID-19 pandemic has significantly hampered efforts to address HIV, it has also led to innovation, she said. There has been a shift to telemedicine in HIV management and concerns about taking antiretroviral drugs have been addressed.
In a session organized by Global Affairs Canada, participants will consider the international community’s efforts to respond to HIV/AIDS and the relevant lessons for the fight against COVID-19 and future pandemics.
Speakers will include Bob Rae, Canadian Ambassador to the United Nations; Dr. Theresa Tam, Chief Public Health Officer of Canada; UNAIDS Executive Director Winnie Byanyima and Matshidiso Moeti, World Health Organization Regional Director for Africa. The session will include video remarks by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to US President Joe Biden.
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AIDS 2022 programming has been kept flexible to accommodate last-minute additions reflecting current issues, Ruthie said. One is a session on monkeypox public health management featuring Dr. Geneviève Bergeron of the Montreal Department of Public Health. The monkeypox virus is spread through close skin-to-skin contact, and most confirmed cases are among men who have sex with men.
Public health officials announced in June that Montreal was the epicenter of the monkeypox outbreak in North America. By mid-July, nearly 10,000 men in Montreal and their health care providers had received the smallpox vaccine, which is effective against monkeypox, and the vaccination campaign was extended to tourists.
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“The good news in Montreal is that the cases have slowed down,” Rutty said.
But on Saturday the WHO, which has received reports of more than 16,000 cases of monkeypox in 75 countries, declared monkeypox a “public health emergency of international concern”.
A session on the needs of refugees and others with HIV during armed conflicts such as the war in Ukraine was also added to the agenda. It will address, among other things, the difficulty of maintaining the supply of HIV drugs in bombarded areas. Dr. Andrew…
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