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Atlanta 1985, first AIDS conference. Amsterdam 2018, 22 e lecture on AIDS. Between these two cities, between these two dates, what changes?
Since 1985, there have been more than 35 million deaths, more than 75 million new contaminations, we pbaded the first tests Elisa (Pasteur) to self-tests bought in pharmacy. We have gone from a virtual absence of treatment (apart from a few inefficient molecules for desperate stars) to a range of molecules (for us, HIV-positive people in rich countries) that make it possible to live with HIV in acceptable conditions, always in the North, because for the moment in the South the choice of the molecules is more restricted.
We pbaded from the great fears of the population to a kind of counterproductive trivialization. We went from "off the condom no salvation" to Prep (pre-exposure prophylaxis) and / or condom. We went from being HIV-positive as a "virological bomb" to HIV-positive treated with undetectable viral load that does not transmit virus, summarized by U = U (Undetectable = Untransmittable).
But then, everything is much better? Should we continue these big demonstrations during which the main subject is and remains HIV? Should not we globalize all these health problems, and bring HIV into the mold and frame of all diseases? "We" are told that if we do not do it, "we" will lose on every painting because there is no more money!
That there is no more money, it does not did not hit me, especially here in the North, whether in Paris, or Amsterdam, or London … And then this speech of AIDS too present, too individualistic, too limited in its corner, in its "targets", its " key population, "I have been hearing it for 32 years, certainly with a steady increase in intensity over the years, as the pharmaceutical industry has made progress in stemming the virus, channeling it, reduce to tanks not yet emptied and cleaned. Because, of course, in the early years, established medical societies and established mandarins were so appalled by the arrival of these new patients, so different, if usually invisible, whether they were drug users, homobaduals, trans, bibaduals , from other countries, bad workers, that they were in no hurry to include HIV / AIDS in overall health. They were so unprepared that they preferred to separate from some badistants or badistants, young, involved in the care of this new disease, who were not afraid to attend these infrequent patients that the post-Giscardian medical bourgeoisie did not want to consider. So it was necessary to invent new ways of working, to find money, to build oneself, to make projects and it worked, UNAIDS was able to see the day, the Global Fund was created, Unitaid was created, the Coalition Plus was created.
Do not we forget?
Do not we forget that AIDS is due to a virus and that we have the means to eradicate? That there remain some years of efforts to make so that there is more contaminations, so that can be a vaccine is born? And that these billions that are harvested to fight this infection are (most of the time) used wisely and bear fruit. Do not we forget a little too fast that for the moment (until 2016) nearly 7000 people are still infected in France? Do not we forget a little too quickly that even in the countries of the North, where health systems are supposed to perform well, there is still a gap in the number of people we are able to bring to screening and, of course, treatment? when necessary
Do not forget a little too fast that many are still those who in a large part of the globe can not be tested, because a positive result means a near-sentence of death, since at the same time as the disease, it is an unacceptable way of life for the family, the neighborhood, the society, the government which is revealed? Do not we forget a little too quickly that it is not only in protected neighborhoods of a capital stretching from the Champ de Mars to the Parc de la Villette that HIV is transmitted, that AIDS exists, that HIV-positive people live?
Do we really think that the level of support for gays, DUs or trans is of such a level of excellence in sub-Saharan Africa (French or English) in Asia, or in South America, we can move on? It is not enough to have treatments available to treat well, all clinicians know it well. We have treatments, let them work! Let's crush the viral load, allow the stop of the transmissions by the change of the laws. Globalizing everything would be a good thing if AIDS were under control, if the objectives set by UNAIDS were to be achieved, but alas that is not the case.
Arguments
So I do not know if these conferences are useful, because among all those who meet during these moments, a consensus exists, around tools, strategies, means to finish, but what I know is that it allows to speak in the "real life" of this virus that has torn us away from so many of our friends, our loves, it is that this allows us, apart from the agreed 1 and December and its recurring regrets, to having shared news about HIV infection, about the lives of patients in a particular country, it allows us to be alive and to exist, to know that we are not alone, to measure the journey realized, to count, to meet again.
But we must remain humble, always, humble but in the neck era, humble but angry, humble but accessible to all and not wanting to be both the mouthpiece of the politically correct and good taste of the intelligentsia. It was the anger that drove the first activists to invest, it is the rage that drove Daniel Defert to create Aides, it is the anger that inhabited Willy Rozenbaum to fight for better care, it is is a warlike energy flooding Christine Katlama to hold her patients at arm's length. And we still need these feelings, these forces, these hopeful soldiers to roll back the epidemic, and circulate the information. We do not need a circle of insiders who auto-congregate around the best word or the best visual seen by a quarter of the privileged as highly graduated as they are away from the epidemic.
Because if it was necessary still give arguments to continue a strong and specific fight against AIDS, it should be added that the advances at the beginning of the text are most of the time recordable on paper only, because despite the non-transmissibility of the virus by the HIV-positive treated, Serophobia in the gay community, and in society as a whole, not only still exists but grows, despite the many positive results of using Prep as a prevention tool, many still do not denigrate it, but even worse, consider those who use it as perverts. So if you ask me, if a conference on AIDS is useful, if you ask me if a specific care system is still needed, here or elsewhere, you will understand that my answer is yes, yes and yes. [19659003] As long as there is discrimination against HIV-positive people, as long as in much of the world, gays, drug users, trans people, and bad workers will be prosecuted, abused, jailed, beaten, killed, the fight against AIDS will have to remain a priority in terms of global health, certainly in connection with other often badociated diseases, such as hepatitis, tuberculosis or STIs. Without a significant strengthening of a financial investment, our generation will not see the end of contaminations.
Michel Bourrelly doctor of pharmacy, social studies studies instructor
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