July 24th, 2016

Really Rapid Review — AIDS 2016, Durban

aids2016 logo vertThe International AIDS Conference returned this year to Durban, South Africa, where it was famously first held in 2000. At that time the HIV epidemic was exploding in South Africa; funding for HIV treatment was essentially non-existent, and there was ongoing HIV denialism quite openly from some very influential figures in the South African government (including the President). Globally, fewer than 1 million people were receiving antiretroviral therapy, hardly any of them in Africa.

Encouragingly, according to this UNAIDS report, the number being treated today is 17 million — with, incidentally, the largest number in South Africa. Yes, this 17 million is only half the number who need treatment, but this is still extraordinary progress. HIV-related deaths started steadily declining in 2005, a trend one can hope will continue.

OK, on to a Really Rapid Review™ of the conference. It’s organized by prevention, treatment, complications, and whatever else happened to have caught my eye; I welcome suggestions for what I’ve missed (undoubtedly something important) in the comments section.

A few non-scientific words about being back in Durban after 16 years:

  1. Underrated beachfront. There’s plenty of activity during the day, with the surfers out between 6-7AM and the walkers, joggers, bikers, skateboarders, rollerbladers, and general observers appearing just a bit later to experience the beautiful sunrise. All day long a walk on the beachfront promenade was an ideal way to clear the brain of “conference head.”
  2. Great, affordable food. Not surprisingly, there is a pervasive Indian influence, as Durban has one of the largest Indian populations in the world outside of India. (If you get a bunny chow, be reassured it has nothing to do with rabbits.) And don’t skip the Pinotage and Chenin Blanc (I didn’t). Unfortunately, unlike my experience 2 years ago in Melbourne, the coffee is terrible.
  3. Pride. Every person I met from Durban was both extremely kind and extraordinarily proud of their city; all knew the history of the city well, and were eager to talk about it. I sensed a bit of both envy and disapproval of both Cape Town and Johannesburg.
  4. Uber rules. Cheap, reliable, and every bit (if not more) the “disruptive innovation” it is in the USA.
  5. Safety. It did seem as if the local advice about security was even stronger than the first time I visited. It was obvious stuff: don’t walk alone to the conference center, don’t carry your computer, don’t take out your cell phone on the street, and (repeatedly) never walk alone at night. Some of this, no doubt, is that the first time we were here it was pre-9/11. It’s a different world.

An ancillary benefit about going to this conference — the noise from a certain political convention was only a faint peep, or a footnote on a distant TV that happened to be turned to CNN!

4 Responses to “Really Rapid Review — AIDS 2016, Durban”

  1. Robert Cannon says:

    Drugs, drugs, more drugs – for treatment and prevention – great.
    What about overcoming impediments to diagnosis and treatment?
    What about overcoming stigma, ignorance, misinformation and changing attitudes and behaviors?
    Any successful programs applying interventions based on local psychology, sociology, and/or anthropology?

  2. Mehri McKellar says:

    Lots of exciting PrEP news indeed.Flying from the U.S. to Durban (and back) is not for the meek and mild-mannered however. Wow that was a long flight.

  3. Loretta S says:

    “If this isn’t an ID nerd’s factoid, I don’t know what is.” How about it also being an ID nerd’s groupie’s factoid? I will have to figure out how to drop that little fun fact into a lecture.

  4. Santiago Perez Patrigeon says:

    Thank you for the really rapid review! It was a pleasure to be there (even with a tremendous jet-lag).

    I would only add, that we had a wonderful pre-meeting symposium on Cure, co-chaired by Françoise Barré-Sinousi of course along with Steve Deeks and Sharon Lewin.

    Afterwards, during the meeting there were several sessions focused on the reservoir elimination or cure strategies. I would only call your attention on the project EPISTEM. The European project to investigate the potential cure of HIV by Stem Cell Transplantation (http://www.epistem-project.org). It was presented on the session “Targeting Reservoirs for Cure”. They report 3 patients with Stem-cell transplant (all 3 had a clinical condition that required transplant), one of them has no reservoir detected! The authors highlight the importance of a graft vs host disease (or as they called it the “Graft Vs Reservoir”) in order to eradicate the reservoir. Of course none of these patients have stopped therapy (yet).

    So let’s wait and see…

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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