Really Rapid Review -- AIDS 2016, Durban

Paul E. Sax, M.D.
Paul E. Sax, M.D.

The International AIDS Conference returned this year to Durban, South Africa, where it was famously first held in 2000. At that time the HIV epidemic was exploding in South Africa; funding for HIV treatment was essentially non-existent, and there was ongoing HIV denialism quite openly from some very influential figures in the South African government (including the President). Globally, fewer than 1 million people were receiving antiretroviral therapy, hardly any of them in Africa.

Encouragingly, according to this UNAIDS report, the number being treated today is 17 million -- with, incidentally, the largest number in South Africa. Yes, this 17 million is only half the number who need treatment, but this is still extraordinary progress. HIV-related deaths started steadily declining in 2005, a trend one can hope will continue.

OK, on to a Really Rapid Review™ of the conference. It's organized by prevention, treatment, complications, and whatever else happened to have caught my eye; I welcome suggestions for what I've missed (undoubtedly something important) in the comments section.

OI prophylaxis chart

A few non-scientific words about being back in Durban after 16 years:

  1. Underrated beachfront. There's plenty of activity during the day, with the surfers out between 6-7AM and the walkers, joggers, bikers, skateboarders, rollerbladers, and general observers appearing just a bit later to experience the beautiful sunrise. All day long a walk on the beachfront promenade was an ideal way to clear the brain of "conference head."
  2. Great, affordable food. Not surprisingly, there is a pervasive Indian influence, as Durban has one of the largest Indian populations in the world outside of India. (If you get a bunny chow, be reassured it has nothing to do with rabbits.) And don't skip the Pinotage and Chenin Blanc (I didn't). Unfortunately, unlike my experience 2 years ago in Melbourne, the coffee is terrible.
  3. Pride. Every person I met from Durban was both extremely kind and extraordinarily proud of their city; all knew the history of the city well, and were eager to talk about it. I sensed a bit of both envy and disapproval of both Cape Town and Johannesburg.
  4. Uber rules. Cheap, reliable, and every bit (if not more) the "disruptive innovation" it is in the USA.
  5. Safety. It did seem as if the local advice about security was even stronger than the first time I visited. It was obvious stuff: don't walk alone to the conference center, don't carry your computer, don't take out your cell phone on the street, and (repeatedly) never walk alone at night. Some of this, no doubt, is that the first time we were here it was pre-9/11. It's a different world.

An ancillary benefit about going to this conference -- the noise from a certain political convention was only a faint peep, or a footnote on a distant TV that happened to be turned to CNN!

Paul E. Sax, M.D., is director of the HIV Program and Division of Infectious Diseases at Brigham and Women's Hospital in Boston.