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Letter from the Editor: Health, Vision, and Policy


By the time most of you are reading this, the XIII International AIDS Conference in Durban, South Africa, will have just concluded. A particular anticipation, as well as controversy, has surrounded this conference, and much has been said both positively and critically in the months leading up to it. People and groups ranging from small grassroots and nongovernmental organizations to major media (e.g., both ABC's "Nightline" and CBS's "60 Minutes" covered AIDS in Africa) and leaders of nations have addressed HIV and its global impact, with diverse emotions but few proposed solutions.

All the press notwithstanding, the most important fact about the conference may well be its location: For the first time ever, the conference is being held in a Third World country. The significance of this event must be clear to everyone, for the extent of the worldwide epidemic, particularly in the Third World, has now become a subject even for local U.S. evening news programs.

Certainly, HIV-related needs and hopes differ around the world. Yet the interrelatedness of different aspects of the "HIV community" today is undeniable, as diverse parties are forcibly, if not always willingly, coming together to find effective ways of combating the HIV epidemic. This type of cooperation involves daunting challenges. However, given that HIV today affects all societies in all regions of the world, and given the interconnectedness between world communities of the 21st century, any solution must involve the scientific, political, and social realities of a given society within a global context.

More simply put, the HIV community is the world community is "our" community. For a comprehensive look at HIV/AIDS around the world, see The Global HIV/AIDS Epidemic, and see the upcoming Autumn issue for a broad range of reports and updates from the XIII Conference.

Having established a global framework, one can view in perspective subgroups with unique needs. For instance, women comprise almost one-half of new AIDS cases worldwide and almost one-quarter in the U.S. Key factors in the rise of HIV among women include greater biological vulner­ability (see Women and HIV/AIDS: Key Facts and Issues) and a complete lack of female-controlled HIV prevention methods, relative, that is, to men biologically and to the "male" condom. Feasible Microbicides Remain Elusive surveys the scientific progress and obstacles in the development of microbicides, a prevention technology urgently needed by women around the world that also may be used by men.

This issue also features highlights from the 3rd International Workshop on Salvage Therapy for HIV Infection and the 10th International Symposium on Viral Hepatitis and Liver Disease, both held in April. Also in this issue are a report on an emerging phenomenon in HIV medicine called mitochondrial toxicity, which is implicated in an array of adverse effects, and an overview of issues related to postexposure prophylaxis. Drug Watch reviews the developmental status of lopinavir, a new protease inhibitor.

With hopes that the XIII International AIDS Conference will bring improved insight into the myriad HIV-related problems facing the world today, and lead to effective policies to which vision will be yoked --
Leslie Hanna


Copyright © 2000 -BETA, Publisher. All rights reserved to the San Francisco AIDS Foundation. Reproduced by permission. Reproduction of this article (other than one copy for personal reference) must be cleared through BETA: PO Box 426182, San Francisco, CA 94142-6182. Tel: 415 487 8060 Fax: 415 487 8069 San Francisco AIDS Foundation, Mail SFAF..

Information in this article was accurate in June 10, 2000. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.