Simultaneous Conferences Last Week: Lisbon, Paris, and Kuala Lumpur
Three major AIDS conferences took place on the same dates in late October:
7th European Conference on Clinical Aspects and Treatment of HIV-Infection, October 23-27, Lisbon, Portugal;
XIIth Cent Gardes meeting, October 25-27, in Marnes-La-Coquette, France; and
5th International Conference on AIDS in Asia and the Pacific, October 23-27, in Kuala Lumpur, Malaysia (which this writer attended).
Lisbon
The Lisbon conference has the most immediately important clinical information. Excellent summaries are available on the Web--see especially:
http://www.medscape.com/hiv-aidshome (registration may be required, but it's free)
http://www.hivandhepatitis.com (in the "Internet Conference Reports" section)
Paris
Cent Gardes, a basic science meeting which occurs every two years, is by invitation only; this year it focused particularly on vaccines, and included reports of antiretrovirals as well. Daily summaries and interviews, as well as other information, are available at:
http://www.centgardes.org (click "Enter Here" for the English version)
Kuala Lumpur
The International Conference on AIDS in Asia and the Pacific is an Asian regional meeting which covers all aspects of AIDS. It takes place every two years; the previous one was in Manila, the next will be in Melbourne. This year there was relatively little new treatment information, because of the competing conferences in Portugal and France.
Over 3,000 people attended; slightly over one third were from Malaysia, and almost all the others were from elsewhere in Asia.
The issues we most noticed at Kuala Lumpur were:
Access to treatment. Unlike U.S. and European conferences, most of those who attended this meeting, and most of the speakers on the stage, cannot get modern antiretroviral treatment no matter what their viral load, CD4, and clinical condition, due to the prices of the drugs. Few get three-drug antiretroviral combinations; some get two drugs; many, (probably most) get none. People know the treatments exist and are angry that they cannot obtain them--making treatment access a central issue at this conference.
Emphasis on building partnerships between government, business, the nonprofit sector, and others. However, the denial and other political problems around AIDS are generally as severe in Asia as elsewhere.
As at other AIDS conferences, a focus on confidentiality, human rights, and protection of persons with HIV as a critical component of controlling the epidemic.
The Web site for the Fifth International Congress on AIDS in Asia and the Pacific--The Next Millennium: Taking Stock and Moving Forward, is at (website no longer available).
Malaysian Prime Minister Mahathir on Drug Prices, Compulsory Licensing
Prime Minister Mahathir of Malaysia gave the opening address of the conference, including the following section on drug pricing:
"Access to care and treatment--
"The high cost of HIV drugs means that most people in developing countries just cannot afford them. But this high cost need not be so if developing countries can get together and challenge the pharmaceutical companies to reduce the prices or allow compulsory licensing of lifesaving drugs. Compulsory licensing is allowed under the WTO but it is sad to see certain powerful countries aligning themselves with giant pharmaceutical companies to deny developing countries the right to produce cheaper drugs to save the lives of their people. Profit is taking precedent over peoples' lives.
"Access to care means not just access to the most sophisticated antiretroviral drugs but also to drugs to treat opportunistic infections. This is possible for many countries. Even if they can't afford the protease inhibitors.
"We accept that pharmaceutical companies expend a lot of money on research and need to recoup in order to continue their research. But they should not try to recoup from the sufferings of the poor. The governments of the rich should bear most of the cost of such research. We understand that some countries are never as prosperous as they are now. Surely they can spare some of their wealth to reduce the burden of the poor people in poor countries."
