Guest Commentary

In order to defeat HIV, scientists and activists need to find common ground

Across the street where Cortez crushed the Aztecs, and things start to bubble.

A crowd forms; banners appear; T-shirts are donned; chants overtake other chants. From pickup trucks, women distribute free strips of condoms to giddy men who hold them up like dear antlers. Police are everywhere, some foppish in sombreros on horseback, most deadly in bulletproof vests. Guns, drums, drag queens ... and me, a straight white gringo with a pink balloon, suddenly protesting. The mob moves, and I move with it. We begin to fill the vast Zocalo.

Strange turf, but the global response to AIDS is now everyone's turf.

Mexico City graciously hosted this year's International AIDS Conference earlier this month, the first time the International AIDS Society (IAS) held its signature event in Latin America, and the signs were everywhere!

The classic AIDS red ribbon was deftly redesigned into the ancient god Quetzalcoatl, the Plumed Serpent, and plastered on everything: lampposts, kiosks, busses, buildings, tote bags, people. The government surprised many by legalizing methadone for the week, allowing needle users to come and have their say. In all, some 30,000 scientists, activists, delegates, politicians, businesses, students and journalists descended upon the largest city in the Western Hemisphere to take stock of the AIDS global pandemic.

With approximately 40 million infected worldwide, and alarming infection rates among women and children, more questions persist than have been answered. Estimates predict HIV/AIDS will orphan 25 million children by 2010; the Tucson chapter of the Children Affected by AIDS Foundation was among the sea of international exhibitors. Some pointed to this year's slightly lower infection numbers, but most attendees soberly acknowledged the outbreak-level statistics from Southern Africa, the paltry distribution of life-prolonging antiretroviral treatments and the persistent social discrimination and human-rights abuses that hinder prevention efforts. Responding to Merck's recent unsuccessful vaccine trial, IAS Executive Director Craig McClure admitted, "In terms of scientific breakthroughs, this is not the year for breakthroughs." One word that was curiously absent from the whole multifaceted discourse was the word "cure."

The human immunodeficiency virus mutates like crazy, making it a moving target for potential treatments. Many biochemical triggers which propel HIV along its viral cycle remain unknown. Further, HIV latches onto at least 10 different target cells and interacts differently in people with different preconditions.

Any caution on the scientific front at this conference, however, was countered by the raucous, rambling Global Village. The enormous glass-walled Banamex Center (scientists) and the makeshift Global Village (activists) were separated by nothing less metaphorical than an equestrian race track. Gray-washed, colonial-style planks skirted people over the mud between the two, but the distrust was sometimes palpable, especially when spectacularly displayed through the many protests that erupted during speeches and lectures. Act Up-Paris staged a "die-in" at the elaborate Bristol-Myers Squibb kiosk, and one veteran Washington, D.C., delegate exclaimed, "It's hard to do science when people are yelling at you." Human trials, reproductive rights, homophobia, drug abuse, big pharm, stem cells, global poverty and lab animals being euphemistically "challenged" (infected) and "sacrificed" (dissected) ... what hot-button issue doesn't HIV/AIDS push?

The future battle against this killer will require a better level of understanding between all parties. We need more scientists in parades, and more activists reading textbooks.

Returning from a day spent climbing mysterious pyramids, I listened to our tour guide opine in five languages, "We are a religious people in Mexico. Our families don't talk about sex. So thank you, for coming here to help break this taboo." With HIV/AIDS raging on in its middle age, we must now all be diplomats in this good fight.