2008 History
At the beginning of 2008 the Swiss Federal Commission for HIV/AIDS published the findings of four studies, showing that people living with HIV who take effective antiretroviral therapy cannot pass on the virus through unprotected sex, as long as they adhere to the drugs, have an undetectable viral load for at least six months, and have no other sexually transmitted infections. It was not possible to prove conclusively that transmission is impossible, however the commission reported that scientific evidence showed the risk to be “negligibly small”.21The Swiss statement was met by immediate controversy, with questions over the reliability of its conclusions coming from HIV/AIDS advocacy groups as well as scientists. Concerns focused on the fact that the research was based solely on heterosexual couples and therefore neglected to include anal sex22 . UNAIDS and the WHO quickly issued a statement stressing that consistent use of condoms was still the safest protection against HIV.23
In April, the Executive Director of UNAIDS, Peter Piot, announced that he would be stepping down at the end of the year. An editorial in The Lancet praised Piot for having “raised the profile of HIV/AIDS so successfully that the epidemic has remained a high priority on health, political and security agendas".24 Later in the year it was announced that Michel Sidibé would be Piot’s successor.25 26
In June, a team of scientists in South Africa were tried and found guilty by a South African court for conducting unauthorised medical trials and selling unregistered vitamin supplements as a treatment for AIDS. One of the supervisors of the illegal trials, Matthias Rath, was already widely criticised for his promotion of vitamins as a substitute for antiretroviral drugs. The South African court halted the medical trials and banned Rath from advertising his natural AIDS remedies. It also highlighted the responsibility of the South African government and its failure in not preventing Rath from distributing his products.27
The American PEPFAR funding program was renewed on 30th July, committing $48 billion to HIV/AIDS, malaria and tuberculosis for fiscal years 2009-2013.28 This was triple the amount of money that the fund had distributed in its initial five years, and was commended by international HIV/AIDS activists and organisations. However, they stressed that the bill only authorised the expenditure and the money would still need to be appropriated each year.29
The Reauthorization Act30 also repealed a policy that had received substantial criticism: the requirement that one third of funding be spent exclusively on the promotion of sexual abstinence. However, it was replaced with a ‘reporting requirement’ for recipients who spend less than 50 percent of prevention funds on abstinence-only programmes. It was argued that this perpetuated bias in PEPFAR spending.
The political and economic climate in Zimbabwe worsened dramatically in 2008, exacerbating an already severe AIDS epidemic. A cholera outbreak that began in August was so critical that by December, UK Prime Minister Gordon Brown was describing the crisis as an “international emergency”.31 The effect of the outbreak on people living with HIV and AIDS was compounded by the collapse of the health system, the government’s block on foreign aid, and widespread malnutrition, leading to an equally devastating AIDS crisis.32 33
Medicines Sans Frontiers (MSF) estimated that in Bulawayo (the second largest city in Zimbabwe) there were 2,500 patients still waiting to receive antiretroviral drugs by the end of 2008. Even those who were able to access drugs were put at risk by the widespread lack of food, with 2008 producing the worst harvest Zimbabwe had experienced since the country gained independence in 1980.34 The government’s decision to ban most international aid groups, which was imposed at the beginning of June and lasted throughout July and August, exacerbated food and drug shortages farther. MSF called for an urgent increase in the humanitarian response to the crisis, and stressed the importance of HIV and AIDS being a prominent part of this response35
The seventeenth International AIDS Conference took place in Mexico City in August. For the first time in the history of the Conference, 2008 saw the use of ‘conference hubs’: a network of locations around the world where conference sessions were screened and accompanied by moderated discussion. The ‘hubs’ were considered very successful in widening the reach of the conference.36
In the same month, UNAIDS published its 2008 report on the global AIDS epidemic. The report warned that with 2010 only two years away, the target of universal access by 2010 would be unattainable unless the global response to HIV was substantially strengthened and accelerated. However it also emphasised that signs of major progress in the HIV response were being seen for the first time in 2008.
“The 2008 Report on the global AIDS epidemic confirms that the world is, at last, making some real progress in its response to AIDS.”Peter Piot, Executive Director of UNAIDSDescribing a "stabilization of the global epidemic", the report estimated that by the end of 2007 there were 33 million people living with HIV worldwide (down from the 39.5 million estimate made at the end of 2006). Although much of the reduction was attributed to better surveillance techniques in many countries, it also reflected the drop in HIV prevalence in certain areas, including sub-Saharan Africa. The report estimated that the annual number of AIDS deaths had declined from 2.2 million in 2005 to 2 million in 2007, reflecting an increase in the number of people receiving antiretroviral drugs.37
In September, the resignation of president Thabo Mbeki was welcomed as a potential turning point in the controversial history of HIV and AIDS in South Africa. A Harvard study published shortly after asserted that more than 330,000 lives were lost between 2000 and 2005 as a direct result of the South African government’s failures in the provision of antiretroviral drugs.38 The decision of interim president Kgalema Motlanthe to immediately appoint a new health minister, Barbara Hogan, was celebrated by AIDS activists as a sign of a new commitment to the AIDS response.39 40
An old controversy was revived in October with the announcement of the winners of the Nobel Prize for medicine. The prize was split between Françoise Barré-Sinoussi and Luc Montagnier of the Pasteur Institute in Paris for their discovery of HIV, and a third scientist for his work on a separate disease. The decision not to credit American researcher Robert Gallo for his contribution to early work on AIDS resurrected a bitter dispute over who claimed rights to the discovery. In awarding the prize, the chair of the Nobel committee, Professor Bertil Fredholm, stated:
"I think it is really well established that the initial discovery of the virus was in the Institute Pasteur."41In November, German haematologist Gero Huetter announced that he had cured a man of HIV through a bone marrow transplant from a donor who had a genetic resistance to the virus. Huetter spoke at a press conference in Berlin stating that the patient, who was taken off antiretroviral drugs after the transplant two years before, continued to show no traces of the virus, leading doctors to declare him “functionally cured”.42 However, it was generally accepted that the operation did not present a viable cure for AIDS. Researchers cautioned that further testing was needed to ensure that the virus had been completely eradicated and not just suppressed to very low levels or become latent.43
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