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Interview | UNAIDS founder discusses global health issues

Published: Tuesday, February 26, 2013

Updated: Tuesday, February 26, 2013 02:02

Director of the London School of Hygiene and Tropical Medicine Peter Piot will deliver a lecture tonight on the newest challenges in global health. His talk, hosted by Education for Public Inquiry and International Citizenship (EPIIC), will focus on his new book, “No Time to Lose: A Life in Pursuit of Deadly Viruses,” a memoir tracking his career from the frontlines as a doctor in the Demographic Republic of Congo to his role advancing the global response to the HIV/AIDS epidemic. The Daily spoke with Piot last week to discuss his experience tackling HIV/AIDS and women’s health in developing countries.

Piot served as the executive director of the Joint United Nations Programme on HIV and AIDS (UNAIDS) and Under Secretary-General of the UN from 1995 to 2008. Prior to his first foray into public policy, Piot co-discovered the Ebola virus in Democratic Republic of Congo in 1976.

Tufts Daily: You have been part of the AIDS response since its early days. What changes have you seen over the past several decades in the way that the world views the AIDS epidemic?

Peter Piot: Tremendous change. There was first a terrible stage of denial — that this was a threat to people’s lives and this was a societal issue. Part of that was because of the fact that AIDS is associated with sex and drugs.…Then, a moderate response internationally. In all fairness, it was not clear what the extent of the problem was, so we had to document that. In 1995, I founded UNAIDS, and the first thing I did was document fully the problem — how many people are infected, where, who are the most infected.…It was only around the millennium that the world really woke up.

First, because AIDS was part of the Millennium Development Goals. There was also a special session of the UN General Assembly in June 2001 where the member states of the UN agreed \ a road map to deal with AIDS. That was very important because then for the first time ,it was not only health people and ministers of health, but also presidents and prime ministers who were dealing with it. That was a very important development because it then became a matter of national survival and national security.

There was the creation of mechanisms to deal with it like the Global Fund [to Fight] AIDS, TB and Malaria that came out of the UN General Assembly meeting and former President [George W.] Bush’s creation of [President’s Emergency Plan for AIDS Relief] PEPFAR when in the 2003 State of the Union he asked Congress for $15 billion. Suddenly we moved from the “m” word to the “b” word — from millions to billions.

These were all very significant developments and that is what a lot of my book is about — how did that happen and how did science and politics come together, because it was the discovery of treatment in 1996 that really made a huge difference in terms of international globalization, and of course in the lives of people living with HIV.

TD: What are you most hopeful about in the future of the AIDS movement?

PP: We are entering now a new phase, one where, on the one hand, I am quite concerned that there is a bit of AIDS fatigue and complacency and that there is a perception that it is done and AIDS is over. AIDS is not over by any means. There were [in the 2011/2012 Report on the Global AIDS Epidemic], according to UNAIDS, 2.5 million new infections in the world and 1.7 million people died. This is not a detail. It is the first cause of death in Africa.

So there is, on the one hand, optimism because we have more means to bring this epidemic under control with treatment, with condoms, with needle exchange, with new ways of circumcision, but on the other hand, we see in a country like Uganda, which was the first one to have success in the fight against AIDS, that the number of new infections is going up again and that is very worrisome.…AIDS is not over and we need to take a long-term view, and it is going to take a few decades probably before we can really end it. It’s a sobering message.

TD: If you could wave a magic wand and change one thing about the global response to the AIDS epidemic, what would it be? What would you do?

PP: I would tailor completely what we are doing to the local environment — the local epidemic, to who is most affected, what works best in that particular environment, what are the cultural, political and other conditions. I think it’s a matter not of new technologies, but of bringing the AIDS response to the people who need it most and that is not so easy.

TD: You have been part of the AIDS movement for so long. What motivates you to do what you do every day, working on an issue as complex and devastating as HIV/AIDS?

PP: First of all, I feel very privileged that I can work on this and I think I was able to make a difference over the past 30 years because there are few issues today in the world where you can make a bigger difference. Also, it is about, for me, equity, about reducing suffering in the world and also applying what science has generated to people all over the world. On the more personal level, whenever I travel, meet with people living with HIV, infected by HIV and their stories are so heartbreaking, often it makes me say, “I know why I am doing this.” It’s not about statistics, it’s about people.

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