Published on September 12, 2012 by

Editorial

AIDS 2012 has come and gone. Still only a very few years after our (the South African) Government was ridiculed for its anti-scientific posturing, our Deputy President and Health Minister were well received notables at the conference, commenting astutely on key issues while on panels, and offering sound bites to the press. 

As ever, the high visibility events at this conference are not the latest scientific breakthroughs, but more the taking of the institutional pulse and the stock taking sessions. In the latter a substantial fraction of key protagonists on current debates can share a stage, or at least a room, and the status quo can be aired, if not greatly modified. For many delegates, it’s more about meeting collaborators and the random connections, new and old, amongst the research posters (700 or so new posters every day for four days) and institutional exhibitions.

South African researchers and NGOs engaged in AIDS related work were ever visible, presenting new results, chairing key sessions, or delivering invited talks. Even when not formally in the spotlight, the ripples of their work could be discerned widely and deeply.

Before the conference began, it was widely noted that an important shift in debate has occurred in recent years, concerning the coalescence of treatment and prevention. Given how much SACEMA workers have had to say on this subject – SACEMA's Brian Williams recently addressed U.S. Senators, Congress Members and Staff on this topic, as can be read in a short item in this issue of the Quarterly -, this was naturally very gratifying. The real discussion is now much more about how, practically, to access the prevention benefit of treatment. This debate, at AIDS 2012, although heated at times, at least did not just go over the same old ground. Furthermore, the progress here has largely been based on the work of South Africans pushing these ideas, and amassing the evidence of early impact of our local treatment programme.

It would be foolhardy to try summarise the International AIDS conference, but it must be said that whether showcased in the limelight or not, and whether explicitly reported at the conference or a subtext to other immediate developments, South Africans are doing some of the most important work in many aspects of HIV research, not just in applications to our specific problems, but also raising the bar internationally in the practice of good science.

To mention a few very broadly: difficult and complex trials of new interventions like antiretroviral products (pills and gels) for use by HIV negative individuals at high risk; field testing new ‘point of care’ diagnostic devices, unpacking the vicious relationship between TB and HIV; development of vaccine products and the underlying basic science; improving clinical care in option- and resource- poor settings; demographic and epidemiological surveillance; and post-marketing monitoring of adverse events associated with medications. Our short item on the conference highlights some particular items of special interest to SACEMA. Furthermore, an article by Janne Estill is featured, which was presented at AIDS 2012, on whether regular measurements of HIV concentration in blood during ARV treatment can prevent transmission.

A parting thought from AIDS 2012: a local colleague I bumped into there, related something like this on a stroll through the exhibition hall:

In South Africa, we have this thing called a weekend, when people drink. The Nurses, when they hand out the antiretrovirals, may say something like “now don’t take these with alcohol” – you see the problem? I always tell my patients “Always take your medication. Try not to drink too much alcohol.”

Even in the art of routine messaging, we are at the cutting edge.

Finally, this SACEMA Quarterly also features an article on modelling of cholera disease transmission by Yonatan Grad et al., as well as puts two SACEMA publications in the spotlight: The use of clusters to estimate recent transmission of TB by Pieter Uys, and A new biomarker-based incidence estimator by Reshma Kassanjee.