New Optimism Among HIV Researchers

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Lisa Mullins: This month the international AIDS conference will be held in the United States for the first time in 22 years. The return of the conference to American soil comes with a change in attitude about AIDS. It follows the easing of US travel restrictions on HIV positive people. The conference also comes at a time when top AIDS researchers are optimistic about the future. Peter Piot is a former executive director of the United Nations agency UNAIDS. He has just written a book about his career fighting viruses. Piot is currently the director of the London School of Hygiene and Tropical Medicine, and as we are hearing, and I'm sure you are, phrases such as 'turning point' in describing where the world is now with HIV and AIDS, because of promising results of studies, do you see this as a turning point, and if so what's caused it?

Peter Piot: Well Lisa, there is no doubt that we've made enormous progress in the fight against AIDS; less people are dying because now over 7 million people in developing countries are on anti-retroviral therapy, and that, thanks to a large extent to American aid, through the President's emergency plan for AIDS relief, and also less people becoming infected. But AIDS is not over by any means and we should be realistic and think that we are in this for the long haul, for several decades, because, even if by some miracle, today nobody will become infected with HIV, we still have well over 30 million people living with HIV somewhere in the world, and all of them for decades will need treatment, so it's not over.

Mullins: Does it also depend on how much treatment they get as to how long they will live and that treatment varies in different parts of the world? How much of a concern is that?

Piot: Well, today someone with HIV who is under treatment has a life expectancy that is very similar to someone who is not infected with HIV.

Mullins: That alone is pretty amazing.

Piot: Oh, that is a revolution, I mean, before, AIDS was a death sentence. In '96 we had these drugs, anti-retroviral treatment, and then the problem was to bring down the price of these drugs so that it could be accessible in developing countries. But the big difference is that in Africa, the local people know their governments have the money to pay for this treatment, even if it is now far cheaper than before. We came down from about US $12,000 to $200-$300 per person per year. So there is an enormous important element here of let's say the political mobilization, the commitment and continuing funding from high income countries such as the US and Canada.

Mullins: Well, that brings us to a little bit more of what you've written about in your book, and that concerns your focus on infectious viruses and I wonder what that motivation arises from?

Piot: When I was in last year in medical school, I asked for some career counselling from my professors and the verdict was unanimous minus one, and that was there was no future in infectious diseases, this was in '74. You know, we've got antibiotics, we've got vaccines, and you know, it's done.

Mullins: This is just before the first couple of cases of HIV.

Piot: Ah yes, it was five years or six years before HIV, it was two years before ebola, and in the meantime there have been so many other new viruses and pathogens that have emerged.

Mullins: You were only I think 27 years old when you were in a labratory in Antwerp, as I believe a graduate student, and made a pretty amazing discovery with the help of something that came from a Catholic nun in Africa. Tell us about this.

Piot: Yeah, I was in training for microbiology and two years after graduating from medical school worked on a PhD in microbiology and there we got a sample in a thermos that a passenger had brought on a commercial flight from Kinshasa in Zaire. Blood samples from a nun, a Catholic missionary who had died from what was thought to be yellow fever. We isolated a new virus. That was the first case of what is now known as ebola hemorrhagic fever. I went to Zaire and it was in the middle of the tropical rainforest and our first mission was to stop the epidemic, but then also to figure out how this virus is transmitted, we had no clue, and that was real detective work. It was very exciting.

Mullins: What is your own next goal? I guess personal and professional since they seem to be so intertwined.

Piot: Well, first of all I think we need to be mindful that new viruses will emerge all the time, and so I want to make sure that the world is prepared for that. But secondly, the big epidemic at the moment is obesity. This is something where we can probably also learn from the response to AIDS, how to change people's behaviour, how to make sure that a health issue is at the top of the world's agenda where it should be.

Mullins: And it's kind of fun to prove your professors wrong.

Piot: Yes.

Mullins: The ones who said there is no future in infectious disease. Peter Piot, his book is called 'No time to lose, a life in the pursuit of deadly viruses'. He spoke to us from London where his work continues. Very nice to talk to you.

Piot: Thank you.