Date: Wed, 31 Jul 1996 12:51:43 -0700 (PDT) From: Rex Wockner Subject: WOCKNER/Int'l Conference on AIDS coverage ---------------------------------------------------------------- Copyright (c) 1996 Rex Wockner. All rights reserved. Do not publish, broadcast, or cybertransport without permission. ---------------------------------------------------------------- GOOD NEWS FROM SMOOTH INT'L AIDS CONFAB by Rex Wockner [ 1,600 words ] VANCOUVER, British Columbia -- Canadians are very thorough. The XI International Conference on AIDS, held here July 7- 12, was likely the first scientific conference to have its own official song -- a "We Are The World" type ditty called "One World, One Hope" -- and its own "Official Condom," Durex. What's more, the official conference brochures offered a comprehensive guide to gay nightlife -- even listing bathhouses (Toto, we're not in Kansas) and the official press kit detailed activities planned by ACT UP protesters. Canada is an inclusive, PC kind of place. Several hundred PWAs and their supporters took to the streets of downtown prior to the conference opening July 7. Most were protesting Canadian Prime Minister Jean Chretien's absence from the conference (previous conferences were opened by the head of state of the host nation) and Canada's failure to announce renewal of its National AIDS Strategy, which expires in 1998. They chanted, "Where is Chretien?" and "Wake Up, Canada!" The march ended with a shouting match and scuffle between members of ACT UP/Golden Gate and ACT UP/San Francisco. The latter group aggressively promotes the discredited theory that HIV does not cause AIDS and argues that all current AIDS drugs are "toxic chemotherapy." Later in the week, two ACT UP/SFers were arrested after they busted up the stage at a scientific presentation and doused speakers with red dye. In an interview [with this news service], openly gay Canadian Member of Parliament Svend Robinson, who joined the PWA march, said: "It's appalling that the prime minister of this country has refused to attend this conference. Given the failure of his government to renew the National AIDS Strategy , I think that he understood that he'd face a lot of very angry people." Openly gay federal MP Real Menard, who also marched, told [this news service]: "I heard Chretien was playing golf. It's unacceptable. He is the shame of this country." The three-hour opening ceremonies looked rather like a very polished Academy Awards event, featuring speeches, video clips, indigenous peoples, and big-name Canadian singers. The organizers put long-time ACT UP/New York member Eric Sawyer on stage for a major address. In reference to the flood of media reports that new drug combinations suppress HIV so completely that the virus conceivably could die out in some patients, Sawyer insisted: "The cure is not here. ... The preliminary results from these hugely expensive combination treatments look great. But we are a long way from a cure, even for the rich who can afford the treatments." Sawyer demanded that drug companies lower their prices -- the promising protease inhibitors cost up to $7,200 a year -- and ended his speech by chanting, "Greed Kills, Access for All." Several hundred delegates joined in the chant as ACT UP chapters unfurled banners from the upper decks of the stadium. Organizers put spotlights on the banners and chanters for about five minutes then segued flawlessly into a video clip. Unlike at previous conferences, ACT UP was simply choreographed into the ceremonies and "protesters" "disrupted" on cue. The only moments of tension at the opening ceremony occurred during the address by Canadian Minister of Health David Dingwall. Hundreds of delegates turned their backs on him and chanted, "Shame, shame, shame" throughout his entire speech -- to express their displeasure at Chretien's absence and the lack of a new National AIDS Strategy. Immediately afterward, hundreds of singers took the stage for the world debut of the catchy soft-rock tune "One World, One Hope," which was the conference theme. Of course, the big news of the conference was that the new protease-inhibitor drugs (which only well-insured or wealthy people can afford), when combined with the older anti-HIV drugs (AZT, ddI, ddC, d4T and 3TC), reduce the level of HIV in the bloodstream to undetectable levels in many patients, thus halting disease progression. This seemingly makes AIDS a so-called chronic, manageable illness -- assuming that the drugs keep on working and the side effects don't become deadly over time. What's more, there was a great deal of theorizing that if HIV levels are kept very low for months or years, the virus might finally just die out in a given patient -- i.e., The Cure. "Nobody can call AIDS an inevitably fatal, incurable disease anymore," said Peter Piot, head of the United Nations' AIDS Program. "We have not got a cure yet but ... the new combinations of anti-retroviral drugs are holding out new hope." "We've turned a page and opened a new chapter in the history of the pandemic," said Dr. Martin Schechter, co-chair of the conference. "Many things we once thought were impossible are now within the realm of the achievable. [But] we have a long way to go. It would be premature to start using the word 'cure' without caution." There was other scientific news: * Chemical messengers called "chemokines" were shown to prevent HIV from entering blood cells, a step that is necessary for HIV replication. The search is on to develop drugs that mimic this action. * Several sessions addressed the use of the older nucleoside reverse transcriptase inhibitors (AZT, ddI, et. al.) with the brand-new non-nucleoside reverse transcriptase inhibitors (nevirapine, delavirdine, adefovir, DMP-266, loviride, HBY097). Conference Program Co-Chair Julio Montaner called results of these combinations "some of the most encouraging data we've seen in years." * Despite disappointing results to date, over 14 projects are known to be under way in the USA alone to create an HIV vaccine. A vaccine is the only answer to AIDS in the Third World where PWAs cannot afford treatment. Unfortunately, no wide-scale trial studies are expected much before the year 2000. * Current anti-HIV drugs have a rather narrow focus, targeting only two reactions (reverse transcriptase and protease) key to HIV replication. A number of potential targets are under investigation at the molecular level, including every stage in the viral life-cycle from binding to the host cell to fusion, uncoating, reverse transcription, proviral DNA integration, transcription, translation of mRNA, processing of precursor proteins and virion assembly. * And it was made clear that while counting CD4 immune- system cells provides helpful information, most treatment decisions henceforth should be based on viral-load levels. If the levels are up, you alter the ingredients of the anti-retroviral cocktail. If they are down, the right mix has been found for a given patient for the time being. Monday night, July 8, Elizabeth Taylor appeared at a private American Foundation for AIDS Research reception to blast the U.S. and Canadian governments. Looking tired and puffy, and having trouble pronouncing the words on the teleprompter, Taylor said: "The U.S. federal ban on clean-needle exchange ... is a glaring example of politics and social squeamishness standing in the way of sound public-health practice. In a society that proclaims to value human life above all, the deliberate withholding of the means to self-protection is more than passive neglect. It is a measured act of premeditated murder." In regards to Canada, she said: "The government isn't sure whether they want to [continue to] fund AIDS research at all. Here tonight, in front of the eyes of the world, amid a conference of thousands of people trying to work together, there is a tragic irony at play. In a country as wealthy and apparently progressive as Canada, frankly, I would have expected something better." Gay men got together in a number of workshops to discuss such things as negotiated unprotected anal sex between two negatives or two positives and whether oral sex is basically safe. On the latter matter, the Americans, in general, still remain more conservative than AIDS educators from other nations. There was widespread criticism of the methodology of the recent study in which scientists infected monkeys with simian immunodeficiency virus by swabbing it on their throats. Since it is known that negative gay couples often dispense with condoms, it was generally agreed that AIDS educators need to follow the Australian model of acknowledging and supporting this reality. Positive couples sometimes opt for unprotected sex also despite the fact that unless they have identical anti-retroviral drug histories, one partner could re-infect the other with a variant of HIV that is resistant to a drug the second man has not yet taken, thus limiting his future treatment options. The conference closing ceremonies on July 11 were much like the opening -- speeches, video clips, ACT UP and pop-music performers. When ACT UP seized the stage, organizers handed them a cordless microphone and projected them onto two huge video screens. The activists snidely presented Canadian Minister of Health Dingwall with a bouquet of get-well flowers, as he had left Vancouver on the conference's second day complaining of the flu. And they presented Prime Minister Chretien with a bottle of sun-blocking lotion, as it turned out he skipped the conference to go on holiday, a decision that was universally condemned throughout the week. Surely, one of the more interesting sociological aspects of the conference was organizers' decision to embrace ACT UP and give the group center stage whenever activists demanded it -- a far, far cry from the riot-police war zone at the 1990 conference in San Francisco and from the utter chaos of the opening ceremonies in 1989 in Montreal. Quite simply, ACT UP's many successes have won the respect of the people who stage and attend international AIDS meetings. And, besides, no international AIDS gathering would be complete without a few activist tantrums. The laid-back Canadians understood that and said, "Go for it." Every day, over 7,500 people -- nearly half of them women -- are newly infected with HIV. At the end of 1995, some 20.1 million adults were living with HIV/AIDS worldwide -- more than 75% of whom were infected via heterosexual sex. By the year 2000, up to 40 million people will have caught HIV. -end-