How far has the world progressed in the fight against HIV/AIDS? How about each individual country? No doubt great strides have been made against this massive killer in scientific, social, and clinical areas, resulting in an increased life expectancy and an enhanced quality of life for those infected. Furthermore, great strides have been made in terms of prevention, education, and medicine as well. But a great deal must be done still, as the epidemic is on the rise, especially in less prosperous regions of the world where access to preventive, diagnostic, and therapeutic HIV/AIDS resources is completely unavailable [1].

The XV International AIDS Conference set out to address these and other issues on communal, national, and global levels. The universal theme of the conference, “Access for All,” emphasized the need for unity and recognized the great diversity of all those involved. The conference took place at the IMPACT Exhibition and Convention Center in Bangkok, Thailand, from July 11 th to July 16 th [1]. Seventeen thousand delegates from 160 countries attended [1]. Sponsors included the International AIDS Society (IAS), the Thai Ministry of Public Health, UNAIDS (Joint United Nations Programme on HIV/AIDS), TNP+ (Thai Network of People Living with HIV/AIDS), and TNGA, an umbrella Thai NGO (non-governmental organization) [1].

Thailand is a widely HIV/AIDS affected nation which in the last few years has fought to have affordable antiretroviral medication accessible to all of its one million HIV and AIDS patients [2]. With a history of grassroots NGO movements, Thailand is a favorable country to draw its communities, and many communities worldwide, to such a conference. The conference, as well as its venue, was committed to include all individuals and groups; a cultural program was instated to invite artists as well as different artistic groups involved with HIV/AIDS awareness and outreach to express their feelings and concerns as “being part of a solution in living and fighting with HIV/AIDS.” [2]

The Silabha ART and Cultural Program included art and AIDS history exhibitions, fashion shows, and performances of music and poetry in the artists’ own languages. These shows and displays contributed to the overall internationality, while helping unite all those present by acknowledging the mutuality of their pain [3]. A cultural parade culminated this portion of the program by presenting a variety of cultural costumes along with banners voicing HIV/AIDS issues [4].

Women’s rights were a great concern at this International AIDS Conference as women are currently almost one half of the 40 million individuals infected with HIV. Another alarming trend is the increasing rate of infection among the 15 to 24 year old age group, constituting one-third of all those infected [1].

United Nations Population Fund (UNPF) executive director Thoraya Obaid noted these disturbing patterns. She urged political and social leaders to revert back to the statutes of the 1994 International Conference on Population and Development (ICPD). She stated that global leaders had vowed to “ensure universal access to education and sexual and reproductive health by 2015.” [5]

Since such “universal access” has not been implemented, Ms. Obaid stated that in cases involving women and girls: “to make [HIV/AIDS] prevention work…we must promote and protect their human rights. We must work within cultures to challenge the social norms that contribute to the lower status of women and girls and that condone violence against them.” [6] Ms. Obaid, as a figurehead for UNPF, along with representatives from other organizations such as UNAIDS and UNIFEM, released “Women and HIV/AIDS: Confronting the Crisis,” which illustrates the necessity for programs that include gender inequality issues [6].

Another matter of importance during the conference was the lack of antiretroviral treatments for all HIV/AIDS patients. Sonia Ghandi, leader of the Congress Party of India, informed the conference that while India has increased subsidizing and testing of generic antiretroviral medications and has increased safety measures, much more needs to be done. She hopes that India will soon attain the efficacy it had when smallpox was eradicated there decades before [6]. On a global scale, the number of patients on antiretrovirals has doubled in “developing countries,” but only 7% of all those afflicted have access in those nations [7].

The development of preventive measures and scientific research for cures was covered during the conference, although some media believed that the XV International AIDS Conference had a greater political slant compared to previous conferences. While the research in HIV treatment has progressed since the previous conference, results are still inconclusive and pending. Although the number of HIV vaccines has risen from 7 to 22, the final solutions appear to be close to a decade away. Microbicides, an array of products that could aid in preventing sexual HIV transmission, will most likely have an approved future in the next five to seven years [8].

Antiretroviral treatment is the only form of medication for HIV patients at this time. A part of the conference was committed to reviewing the research findings on protease inhibitors (PI), a common antiretroviral drug. PIs have been proven to cause certain side effects, most notably lipodystrophy. Lipodystrophy is an abnormal alteration of body fat composition. A usual loss of fat occurs at the peripheral area, such as the face, arms, legs, etc., accompanied by an accumulation of central fat [8].

Studies presented at the conference included four studies using PIs that demonstrated lipodystrophy. Clinical testing of PIs also showed another side effect in patients: the rise in LDL (bad cholesterol) and decrease in HDL (good cholesterol). Treatment with recombinant human growth hormone (rhGH), a fat catabolist, showed promise as a prospective medication for PI lipodystrophy removal, but its high cost makes it largely unavailable at this time [9].

Unfortunately, treatments that alleviate the effects of certain HIV medications are not even a possibility for most individuals affected with HIV/AIDS. The standing problem is the lack of funding for antiretroviral drugs in most countries of the world today. In a great number of underdeveloped countries, the devastating effects of HIV/AIDS have been compounded by malaria and tuberculosis, resulting in about 6 million deaths annually [9]. For these reasons, “governments, civil society, the private sector, and affected communities” have united to form the Global Fund to Fight AIDS, Tuberculosis, and Malaria, a financial organization that works with local and national leaders and experts on many levels [11].

This fund collaborated with the 2004 International AIDS Conference to bring together the public and private institutions and organizations for this common cause. Nelson Mandela, former South African president, lead the conference closing ceremonies with an appeal to all countries and organizations to contribute to this fund [7]. He stated that, “We need to build the private-public partnership that is the vision of the Global Fund.” [7] The Bill and Melinda Gates Foundation donated 50 million dollars to the Global Fund that night. Mandela emphasized, however, that, “It is going to take much more than the resources of the Gates Foundation to achieve the scale-up required to fund the fight against AIDS, TB, and Malaria.” [11]

The struggle against HIV/AIDS has seen many impressive contributions and much progress in the past few decades, but much remains to be accomplished. Jim Keats, the World Health Organization leader for upscaling worldwide treatment, lamented the six million AIDS-related deaths since the XIV International AIDS Conference: “By these measures of human life, the ones that really matter, we have failed and we failed miserably to do enough in the precious time that has passed since Barcelona” [2]. With many initiatives realized and planned out at this conference, however, the outlook for the upcoming XVI International may be more optimistic.