Editor's note: Fred Hutch News Service reporter Mary Engel and photographer Robert Hood are in Durban, South Africa, covering the news from the 21st International AIDS Conference.
DURBAN, South Africa — Maurine Murenga learned she had HIV when she was pregnant with her first child. In was 2002, and the antiretroviral drugs that were saving lives in developed countries were barely available, and certainly not affordable, in her native Kenya.
She assumed she would die. Her biggest fear was how.
“I saw the kind of pain people went through and heard about people who were found in their homes five days after they died, with their children still beside them,” she told a packed hall of scientists, policymakers, advocates and other people with HIV attending the AIDS 2016 conference last week in Durban, South Africa.
Murenga survived, thanks first to a group of women, also HIV positive, who embraced and supported her; and then to the arrival the following year of lifesaving drugs for both her and the son who was born with HIV. The political will to bring antiretroviral drugs to poor and low-income countries had been forged the only other time the International AIDS Society had convened in sub-Saharan Africa, also in Durban, in 2000.
Now on the staff of the International Community of Women Living with HIV, Murenga traveled to Durban in part to celebrate how much has changed in the intervening years. But she also was there to tell conference attendees — and the world — of how much has not.
Today 17 million people worldwide are on antiretroviral therapy, which was unimaginable in 2000. Eighty-five countries have virtually eliminated HIV transmission during birth or breastfeeding; Murenga’s second child was born HIV-free.
Those are some of the success stories.
But fewer than half of the 36.7 million people living with HIV are on therapy, either because they can’t afford it, don’t have access to it or don’t even know they’re infected. Almost 2 million new HIV infections still occur each year. Sub-Saharan Africa shoulders two-thirds of the global HIV burden, and women are most affected.
“Young African women remain the face of HIV on this continent,” said Dr. Elizabeth Bukusi, deputy director of the Kenyan Medical Research Institute and a professor of Global Health and Obstetrics and Gynecology at the University of Washington.
AIDS 2016 was a conference that revealed the human face of a continuing global health crisis.
Yes, there were scientists, power-point presentations and 2,400 abstracts delivered, more than half of them by women. But the five days of meetings also brought protest marches, celebrity appearances and poignant personal pleas: that women, adolescents, gay men in countries where homosexuality is stigmatized and often criminalized, transgender people, migrants, people who use intravenous drugs and other key populations most affected by this virus not be left behind.
“We are called key because we face so many locked doors,” said Nigerian activist Michael Ighodaro, who had to flee his country in response to anti-gay laws.
And while researchers, philanthropists and world leaders celebrated the progress that’s been made since the last Durban conference in getting antiretroviral drugs to low-income countries, they also reminded themselves and the world that treatment alone won’t end the pandemic. Unlike the last major AIDS conference held in sub-Saharan Africa, this one held out hope for a preventive vaccine and even of what was once unimaginable: an HIV cure or at least long-term remission.
“We need innovation and research that will deliver a vaccine and cure.” ― Michel Sidibe, executive director, UNAIDS, the joint United Nations Program on HIV/AIDS
“The rate of infection remains stubbornly high, particularly among the most vulnerable. Young women between 15 and 24 accounted for 20 percent of new infections last year. We need to ensure that adolescent girls and young women, and more broadly, young adults ― men and women ― receive information and advice and are able to access services such as condoms and where necessary, pre-exposure prophylaxis.” — Deputy President of South Africa Cyril Ramaphosa
“I call for Durban 2016 to mark the commitment to a new era, when we finish what we started.” — United Nations Secretary-General Ban Ki-moon
“The largest generation in history is entering an age where they are most at risk of HIV.” ― billionaire philanthropist Bill Gates
“I believe the single most important thing each of us can do after we leave here is to connect with a young person. Listen, truly listen, to what she has to say. Give her a seat at the table. Let her be part of the conversation. And let’s make sure our work reflects her input and her voice. The solution to this epidemic isn’t just in our laboratories, offices or conference centers like this one. It’s in our communities, in our schools and streets, where a smart choice or a helping hand can mean the difference between life and death.” — South African actress Charlize Theron
“You might have to fight for your life, but it’s worth it. Things can change for LGBT people. No human being should be left behind.” —Sir Elton John
“We are all sick of the magnitude and persistence of this epidemic. We need a potent and durable vaccine so that your family and my family, irrespective of color or gender or sexual orientation, can be protected against this disease.” — Dr. Larry Corey, former Fred Hutch president and director and founder and head of the Hutch-based global HIV Vaccine Trials Network, or HVTN
“An HIV vaccine is the ultimate female empowerment. You put it in your arm, and it works in your vagina. No one has to know. To put an intervention into the hands of women, the best thing we can do is find a vaccine.” — Dr. Glenda Gray, president, South African Medical Research Council, head of Africa programs for Fred Hutch-based HVTN
“We all agree that an HIV vaccine remains the most important tool for HIV prevention.” — Dr. Olive Shisana, president, Evidence-Based Solutions, South Africa, and co-chair of AIDS 2016
“We will move HIV vaccine research forward, and we will have an HIV vaccine.” — Dr. Nyardzo Mgodi, University of Zimbabwe–University of California San Francisco Collaborative Research Programme in Harare, Zimbabwe, and chair of the HVTN-conducted AMP trial in Africa
“We’re trying to mess with the immune system in a way old vaccinologists never thought of.” — Fred Hutch immunologist Dr. Nicole Frahm
“Science is now telling us that a remission of HIV infection allowing patients to live free from antiretroviral drugs should be achievable.” — Nobel laureate Dr. Françoise Barré-Sinoussi, the French virologist who has been a leader in HIV research since her 1983 co-discovery of the virus
“We’re trying to make the case of Timothy Ray Brown more applicable to more people.” — Fred Hutch researcher Dr. Chris Peterson
“From the second we leave here, the clock starts ticking again, and there’s not a moment to lose. During the five days of this conference, 15,000 people living with HIV have died. … 1,500 young people from this country alone have been infected. The work is simply not done.” — Incoming International AIDS Society President Dr. Linda-Gail Bekker, the first woman from Africa to lead the organization, deputy director of the Desmond Tutu HIV Centre in Cape Town and an investigator with the Fred Hutch-based HVTN who will be co-chairing a forthcoming vaccine trial
Read more about Fred Hutch's HIV work in South Africa here.
Mary Engel is a former staff writer at Fred Hutchinson Cancer Center. Previously, she covered medicine and health policy for the Los Angeles Times, where she was part of a team that won a Pulitzer Prize for Public Service. She was also a fellow at the Knight Science Journalism Program at MIT. Follow her on Twitter @Engel140.