Organisers expand scope of 2002 AIDS meeting

[Guest guest]

Organisers expand scope of 2002 AIDS meeting

In an effort to close what they feel is a serious gap between AIDS

scientists and people working on the ground in the fight against the

worldwide HIV epidemic, organisers of this summer's XIV International

AIDS Conference have reformatted the meeting to give greater

prominence to prevention, implementation, and policy. The biannual

conferences have become perhaps the most influential meetings in the

area, and the July 7-12 meeting, which will be held in Barcelona,

Spain, is expected to draw more than 15 000 scientists, clinicians,

activists, and journalists from around the world.

Past conferences have placed a heavy emphasis on biomedical research,

while prevention and field-based programmes have tended to receive

much less attention, says Jordi Casabona, director of the Centre for

Epidemiological HIV/AIDS Studies (Catalan Health Department,

Barcelona) who with Gatell of the Infectious Disease Unit,

Hospital Clínic de Barcelona, will co-chair the Barcelona conference.

This was understandable, Casabona says, because at the time AIDS was

a new disease and little was known about the causal virus. But as the

epidemic has grown and evolved, it has become increasingly clear that

a purely " biomedical " approach will not be enough. " In Western

countries, for example, the focus of AIDS research has been primarily

on drug treatments " , he says. " We now have an idea of what drugs can

achieve--that they can dramatically alter the course of the disease

and prolong life--but we also know they will not end the epidemic. "

To do this will require effective policies and programmes that

promote science-based prevention and provide affordable access to

effective treatments, he says.

The challenge is to translate what we know into effective action, he

says, for good science is of little use without good programmes and

policies. " Often there is a disconnect between what we know works and

policy " , he notes. " Laws that prevent needle exchange programmes are

a good example of this. Needle exchange is restricted because of

cultural and political concerns, despite the scientific evidence that

it works. " Thus, to try to forge closer ties between scientists and

the community, the conference organisers have created the " Barcelona

framework " , which organises the conference programme around two main

components: one, dedicated to " science " and one dedicated to " action "

with bridging sessions where scientists and those working in

programmes and policy can meet and discuss the issues.

Casabona says the goal of the framework is to maintain the scientific

quality of the meeting, which will continue to have tracks featuring

presentations of new work by the world's top researchers in the

basic, clinical, and public-health sciences, but also to provide a

high-profile venue where programme and policy issues can be presented

and discussed.

In addition to the new format, the conference will have three new

tracks: " Prevention Science " , " Interventions and Program

Implementation " , and " Advocacy and Policy " . The prevention science

track will be added to the science component. In past meetings, the

conferences had no special venue for prevention research, Casabona

says, and, as a result, good papers on prevention were often

scattered throughout the meeting diluting their effect. There was

also a feeling that prevention research was less scientific than

clinical studies. This perception is untrue, Casabona says, pointing

to a growing body of prevention research that has been conducted as

rigorously as are clinical trials of drugs.

The prevention science track will bring together researchers in all

areas of the field, from scientists working on new vaccines and

microbicides to field workers conducting behavioural work in the

community. " You can't separate biological and non-biological

interventions, because they must be used together " , Casabona

says. " To prevent mother-to-child HIV transmission, for example, you

need to give antiretrovirals to infected pregnant women, but you also

need to increase testing coverage and primary prevention among young

women. "

The interventions and programme implementation track, which will be

part of the second " action " component of the conference, will focus

on how to take research findings and put them into practice, says the

track's co-chair Ron Valdiserri, deputy director of the National

Centre for HIV, STD, and TB Prevention at the US Centers for Disease

Control (CDC) and Prevention. " For example, how do you take a

successful study that involved a few hundred people and translate its

findings into a programme involving thousands, even tens of thousands

of people " , Valdiserri says. The track's sessions will include a mix

of presentations of peer-reviewed abstracts, talks by invited

speakers, as well as debates and group discussions. The focus will be

on how to design, implement, and sustain effective programmes.

The last new track, advocacy and policy, will focus on how to create

a political, social, and cultural climate that will help people

fighting HIV/AIDS succeed. The sessions will address such issues as

the mobilisation of community resources, priority setting and

resource allocation, trade and intellectual property rights, and how

to empower marginalised groups such as sex workers, sexual

minorities, and refugees. " In my mind, policy and advocacy underlies

everything that has happened, is happening, and will happen in

response to HIV/AIDS, but we have never addressed it before in a

coherent way " , says track co-chair Margaret Duckett.

The goal of bridging sessions will be to bring people from all the

tracks together to discuss common concerns. " My own personal view is

that the real challenge for the Barcelona conference is the bridging

sessions " , says Guerra Romero, a technical adviser to the

Secretary of the Spanish National Plan on AIDS and an advocacy and

policy track co-chair. One such session might be entitled " Vertical

transmission: from molecules to programmes " , he says, and would

include presentations on the biology and epidemiology of mother-to-

child HIV transmission, the efficacy and effectiveness of drug

treatment, and community support and advocacy for HIV testing,

counselling, and treatment in pregnancy.

The strength of the Barcelona meeting will be its scientific rigour

and its multisectorial approach says Casabona. " As a public health

problem, the fight against AIDS needs both of them. " (More

information is available at www.aids2002.com. The deadline is Jan 14

for abstracts on paper or disk, Jan 21 for online submissions, and

June 1 for late-breaking reports.)

McCarthy

http://www.thelancet.com/journal/journal.isa

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