UNIDENTIFIED MAN: The statement--the stated theme of the XIV International AIDS Conference is “Knowledge and Commitment for Action.” The data presented to the delegates as the conference began described both enormous progress in fighting HIV, while highlighting the enormous amount of work that still needs to be done. The International AIDS Vaccine Initiative reported initial progress in very early testing of a number of candidate AIDS vaccines. Paul Wataka (MS?) from Uganda is a volunteer.
PAUL WATAKA: These tests were tried with my family and friends. Some of them had mixed feelings and fears about possible scientific or injury just to try, but most of them encouraged me to go on. Of course--of course, I am a soldier and soldiers are courageous. I decided to participate with (MS?). Actually, my experience during the trial was that I had no scientific problems. The researchers warned me of possible scientific and I waited for them and updated them. Up to now, they have never (MS?). The Albak (MS?) trial has now closed (MS?). It was (MS?) and I’m happy I received the candidate vaccine.
Although, I finished with my position as a volunteer, I have remained active in Uganda’s (MS?) HIV. As an Albak volunteer, a facility was made available for (MS?) was from an order to lead scientists for this community and to study participants. And as president and an actual volunteer, I shall do well to influence a standard between all factions. When the Albak trial ended, that (MS?) was no longer needed, but currently I am a member of (MS?). As to working with, I have (MS?) HIV/AIDS (MS?) program in Uganda. I am still interested in the activities in HIV. Because before (MS?) that this was the best hope for the eradication of HIV for my country, Uganda and the entire world. I thank you very much.
UNIDENTIFIED MAN: Carl Roteks (MS?) here of the Brazilian Ministry of Health, describes the results of efforts there to fight HIV.
CARL ROTEKS: [Inaudible.]
UNIDENTIFIED MAN: Seth Berkly (MS?), the head of the International AIDS Vaccine Initiative, expressed optimism following the early results of several candidate vaccines.
SETH BERKLY: So, what are the future directions? In summary, we’ve got to make AIDS’ vaccines everybody’s priority. We’ve got to accelerate the science. Don’t let the enemy be--the excellence be the enemy of the good. We’ve got to accelerate the leading CTL candidates into Phase III trials, and at the same time, don’t assume that good is good enough. Continue to widen the pipeline of second-generation CTL vaccines. Ensure that the second-generation candidates are optimally designed, prioritized, developed and accelerated through clinical trials, and accelerate the effort to create an agent-inducing broadly neutralized in antibodies and get those into trials. And obviously, we’ve got to prepare now for success, otherwise we won’t be ready. I thank you very much.
UNIDENTIFIED MAN: A more sobering view of the AIDS epidemic came from officials in the small Southern African country of Botswana. It has the highest HIV infection rate in the world. Almost 40 percent of its population is HIV positive. In the face of this national emergency, health officials explained the country’s new ambitious prevention program and commitment to provide the latest AIDS drugs to every person in Botswana who needs them.
[clip plays]
UNIDENTIFIED BOY: My name is (MS?), just one of few of the human beings that cling to right to life on this beautiful planet. My birthplace is (MS?) on the continent of Africa, but more specifically, here in the very hub of Southern African. This is Botswana. Although a population of just 130 million is small, it has a huge heart. I am an AIDS orphan, who has great hope for the future. (MS?), but I am very much alive and it feels good to be alive. I live here in Kabula (MS?), the capitol city of Botswana. Botswana is an exciting place, which (MS?) is one of the fastest growing economies in the world. We never sleep here. Our government is very intense and our future is bright. Beyond the city there are wonderful tourist attractions, wildfire, chicory farming, manufacturing (MS?), and most importantly, mines. We boast the largest diamond mine in the world. Sadly though, (MS?) and we have a serious problem here. It is a deadly virus known as HIV/AIDS.
UNIDENTIFIED WOMAN: We have the highest infection rates in the world.
UNIDENTIFIED MAN: Africa (MS?).
UNIDENTIFIED WOMAN: We are faced with extinction.
UNIDENTIFIED MAN: (MS?).
UNIDENTIFIED MAN: (MS?).
UNIDENTIFIED BOY: I often come to this place. My mother is buried here. She died when I was just a baby. My father was sick and HIV positive. He died just before I was born. The official cause of death was listed as tuberculosis, but it would actually be of AIDS.
UNIDENTIFIED WOMAN: Stigma certainly has been our effort (MS?).
UNIDENTIFIED MAN: We don’t talk about it.
UNIDENTIFIED WOMAN: Fortunately, we do.
UNIDENTIFIED BOY: My whole (MS?) family realized the vicinity of my mother’s situation, as well as that of her unborn child. Her older sister, who is now my guardian, insisted that she go to a HIV clinic. My uncle’s telling me that he was (MS?). She was conscious before the end of this disease. Sadly, she tested HIV positive and lived only a few more months, but in the last three months, my mother had a great desire for me to live. She knew I would be the (MS?) for the prevention of mother-to-child transmission. The ARV drug and the cash she was given saved my life. People like (MS?) at their home-based camp program assisted my family. They helped my mother cope and she died with dignity.
UNIDENTIFIED WOMAN: (MS?) HIV/AIDS in this country.
UNIDENTIFIED MAN: The challenge is the time zone. (MS?).
UNIDENTIFIED WOMAN: We are very fortunate that we have many partnerships (MS?). And the African continent has this HIV/AIDS partnership.
UNIDENTIFIED MAN: (MS?).
UNIDENTIFIED WOMAN: (MS?).
UNIDENTIFIED MAN: (MS?).
UNIDENTIFIED BOY: Yes, (MS?). I am not only alive, but also HIV negative. But I will never forget that I was one of the lucky ones and in days to come there will be millions of AIDS orphans in Africa. Despite our leaders’ policies and compassion for their people, what will it take to prevent this picture becoming this picture?
UNIDENTIFIED MAN: (MS?).
UNIDENTIFIED WOMAN: You should take care of yourself.
UNIDENTIFIED MAN: (MS?).
UNIDENTIFIED BOY: I am proud to be a citizen of a country where there will always be hope for tomorrow.
UNIDENTIFIED MAN: As (MS?), as African people, we have to try and work together.
UNIDENTIFIED WOMAN: (MS?).
UNIDENTIFIED MAN: (MS?).
UNIDENTIFIED WOMAN: I am convinced that we will make it a current and manageable disease.
UNIDENTIFIED WOMAN: (MS?). [END OF CLIP]
DR. HELENE GAYLE(MS?): I welcome you all to our Welcome Program this morning. A global genocide of unprecedented proportion is unfolding around the world. It’s scale and intensity has knocked many of our society and especially now is pressed and ultimately submission. The challenge is to turn this emergency, AIDS activity into an opportunity. You have just witnessed Uganda’s study of AIDS, which begins with a promise of a new life. It begins with the defect of the pressure and secret life to both development and (MS?) that must be enjoyed by every human being from childhood to adulthood. Being at the epicenter of the epidemic, Botswana has been (MS?), painstakingly have triumphed over a decade of heartbreak and sacrifice decimated on the order of disease and suffering. This has caused us (MS?). (MS?) talking and I’m striking strictly at heart and strictly at the heart of the success of our nation, its people. No one can doubt that we in Botswana speak (MS?) when we technically call for aggressive, comprehensive global action.
UNIDENTIFIED MAN: Sir, give me your name and tell your roll in Botswana’s (MS?), HIV.
DR. URNASTARGO (MS?): My name is Dr. Urnastargo. I’m the Operations Manager for the Ministry of Health Antiretroviral Drug Assistance.
UNIDENTIFIED MAN: Tell me something about what’s going in Botswana, especially around antiretrovirals. It’s different from other countries, correct?
DR. URNASTARGO: Yes, it is. I think what’s different about Botswana is the scale, scope and magnitude of the--and aspirations of their antiretroviral (MS?). The initiative is to provide real care and to develop it nationwide. So, this is a blanket program unlike other countries. I think most other African probably (MS?) although many of them have initiatives that are ongoing, they are immediately--they have (MS?) goal type system of (MS?) type of (MS?) of antiretrovirals whereby individuals who can afford it (MS?). And Botswana is almost laterally trying to provide the medication to all qualified people who need it.
UNIDENTIFIED MAN: What’s special about Botswana that allows it to do this, both aspirationally and financially?
DR. URNASTARGO: I think what’s special about Botswana is that their leadership has been so courageous. They’ve taken the global strategy look, but also this has been backed up by, I think, a very strong political--politically stable system and also a very strong base economy. Botswana has the (MS?) and has one of the best economies--definitely the best economy in Africa; a high accreditation, better than Japan at the moment, (MS?) and I think this also is the backdrop (MS?).
UNIDENTIFIED MAN: So, I mean, part of this has to be not just sort of a moral imperative, but the credit rating and all of the--and all of the economic gains that Botswana has made over the years. I guess they feel threatened?
DR. URNASTARGO: Exactly, and the fact that it as it should be. Botswana still is largely a commodity-based economy, deep (MS?). These require people and specialized skills and especially given the particular demographic that HIV/AIDS knocked out as a population, Botswana is actually in a very serious and critical situation because it does need people who actively (MS?). These people are the engine of its economy and they are the ones that have been knocked out, so therefore, the country has to act. In addition, and in terms of absolute numbers, Botswana is very small, but actually can’t afford to be too small. We’re not talking about Nigeria with a population under 120 million. This is 1.7 million where there are 40 percent of adults are HIV positive. It’s problematic when you (MS?).
UNIDENTIFIED MAN: So, when did the plan actually get started and what do you hope to do?
DR. URNASTARGO: The plan began I’d say--in earnest it began in June of 2000--2001, and it began with a feasibility study to determine whether the government could indeed, you know, could accurately develop a therapy and make that a reality in Botswana. Real--because of real work in terms of physically implementing the program on the ground began in January of this year. And initially the aspiration is to set up the drug procurement for the distribution system to establish a very strong communication that will connect the program to an informational education--communication and community mobilization to--to implement a national IT system to track and manage patients. To implement lab and testing infrastructure nationwide, also to procure the necessary base to seek counsel and support patients.
UNIDENTIFIED MAN: So, you’re building a whole infrastructure?
DR. URNASTARGO: We’re basically building a whole infrastructure, not to mention (MS?) along the issue of keeping, assisting and training staff, which is a forever--forever a challenge that is of unprecedented proportion in Botswana where, as I mentioned, you know we have staff who are being knocked out by the disease, as well as intercontinental situation where we already have (MS?). So, this will help.
UNIDENTIFIED MAN: And I know that--but what’s been the reaction of the people who live in Botswana? There’s an awful lot of stigma that’s usually associated with HIV.
DR. URNASTARGO: Stigma is one of our greatest challenges on the side of the population. I think we’re looking at a people who previously were living in a protectional reality in which HIV and a diagnosis that means (MS?) of the victim. Now, we’re offering them hope and saying there’s antiretroviral therapy, but it’s new and I think it will take a while for the mindset that’s involved that they will actually feel comfortable to come forward in their (MS?), especially want to demonstrate the benefits of treatment. With that said, a diagnosis of HIV/AIDS is still very stigmatized and still very alienated and still leads to rejection.