Dr. Pedro Cahn leaves the presidency of the International AIDS Society in the hands of another Argentine Credit: Courtesy of the IAS

Dialogues
"There Are Seven Million People Who Lack AIDS Treatment
By Marcela Valente*

Three million people today receive treatment against AIDS. It was what the World Health Organization proposed for 2005, and we are achieving it with difficulty in 2008, but meanwhile there are seven million who lack treatment, says Argentina's Pedro Cahn, co-chair of the 17th International AIDS Conference.

BUENOS AIRES, Aug 4 (Tierramérica).- A greater commitment to universal access to anti-HIV therapies and to the defense of health workers in impoverished countries are two achievements noted by Argentine physician Pedro Cahn as president of the scientific society that organized the 17th International AIDS Conference.

"But it isn't a personal effort, it's a collective endeavor," Cahn is quick to clarify. He is the first from a developing country to head the International AIDS Society (IAS).

Cahn spoke with Tierramérica as he was packing his suitcases in Buenos Aires for the trip to Mexico City, where he led the AIDS conference that started Aug. 3, and is handing over the IAS presidency to a fellow Argentine, Julio Montaner, who directs the Center for Excellence in HIV/AIDS in the Canadian province of British Columbia.

In 2010, the leadership of the IAS will go to African physician Elly Katabira, of Uganda's Makerere University, "an achievement to which I can say I strongly contributed," says Cahn.

In the line of fire since the HIV/AIDS epidemic erupted, Cahn's name has been closely associated with the fight against the disease in his country, and around the world since 2006 when he took the reins of the IAS, an independent association of more than 12,000 professionals in 183 countries, founded 20 years ago to prevent, monitor and treat AIDS (acquired immune-deficiency syndrome).

Cahn continues to serve as the chief of infectious diseases at the Hospital Fernández in Buenos Aires, and president of the Fundación Huésped, which works to improve medical services and create an appropriate community environment for people with HIV (human immuno-deficiency virus), which is the precursor to AIDS.

TIERRAMÉRICA: Why is the 17th Conference on AIDS, to take place in Mexico City, so important?

PEDRO CAHN: It is the first time that this event is being held in a Latin American country, and it comes at a moment when universal access to treatment is being somewhat ignored.

-- What did you achieve during your term at the head of the IAS?

-- Above all, I must say that it is not a personal effort, but rather the result of a collective endeavor. We achieved in great part to demonstrate that the IAS is more committed to two important issues: universal access to treatment and the rights of health workers in Africa, Asia and Latin America.

-- What challenges do those workers face?

-- They suffer poor working conditions and low wages. Then, paradoxically, the countries that provide financial assistance to fight the epidemic in the poorest countries lure them away to work for them. There is a true brain drain from the South to the North. This is a problem that we exposed publically in all forums. It is essential to improve the conditions so they don't leave, because we need them.

-- What were the results of efforts towards greater access to antirretroviral treatments to fight AIDS?

-- The IAS participated actively with UNAIDS (Joint United Nations Program on HIV/AIDS) and the WHO (World Health Organization) to analyze how to quickly improve access to medication. In 2004, 10 percent of people who should have been receiving treatment did so, and in 2006 it rose to 25 percent. Now we are at 31 percent.

-- That sounds like progress.

-- It could be considered good news, but it isn't. There are some 10 million people who need AIDS treatment in the world -- the vast majority in poor countries. We reached three million people. That was what the WHO proposed for 2005, and we are working hard to achieve it in 2008. But the bad news is that we are missing another seven million people. In Brazil alone, to give a Latin American example, 190,000 people rely on very expensive treatment that they couldn't afford without the commitment of the government.

-- What is needed in order to advance more quickly?

-- More resources, political will, more leadership in the actions. Greater awareness that this isn't about numbers, but about people who die from a disease that nobody should die from anymore. We still have some 7,000 people who contract AIDS each day, which is to say that we are running faster and faster but we are farther and farther away from the goal.

-- Has there been medical progress in the last few years?

-- For now, there are no vaccines, nor has there been development in the area of microbicides. We don't yet have an effective prevention tool for women that isn't the condom. Yes, the value of male circumcision has been confirmed and the effectiveness of any strategy that combines prevention with treatment. Because the greater the access to treatment, the more people achieve an undetectable viral load, and they more they reduce the possibility of transmitting the virus to others.

-- And in the area of AIDS among children?

-- There were advances in the pharmaceuticals developed for children, but the only acceptable achievement on this point would be eliminating mother-to-child infection. This is why there must be better primary medical attention to pregnant women, otherwise it will all fail.

* Marcela Valente is an IPS correspondent