Special announcements and member's moments:

 

Program:

Brian Street introduced our Dr. Julio Montaner and today's topic in honour of World AIDS Day. He shared a video done by Rotary for Rotary Health Days in Africa, CLICK HERE to view. Brian shared that in 1981 his grade 12 biology teacher warned the class about a new disease on the horizon. While studying in New York in 1987, over 4 dozen friends and aquaintances died in less than 3 years. Ignorance, fear and homophobia surrounded the disease. It wasn't until 1985 (which is when Rock Hudson dies of HIV/AIDS) that President Ronald Reagan even mentioned the disease publicly. 

 

In 1996 the HIV cocktail drugs came along and as a result, many live productive lives with HIV. There is still no cure, however, the world owes a lot of gratitude to people like Dr. Montaner. 

 

Dr. Julio Montaner, the Director of BC's Centre for Excellence in HIV/AIDS and Advisor to UN Aides Program is here to speak about Treatment as Prevention: The B.C. Experience and Future Directions. He has received numerous awards for his research work, including the Queen Elizabeth II Diamond Jubilee Medal, and is a member of the Order of British Columbia and an officer of the Order of Canada.

 

Dr. Montaner has a connection to Rotary - his father is a long time Rotarian in Buenos Aires.

 

He learned of HIV/AIDS when he came to Vancouver in 1981 to do post-doctoral work in 1981. His intention at the time was to do more training so that he could work in public health alongside his Dad, Dr. Julio Gonzalez Montaner, a pulmonary specialist and tuberculosis expert in Buenos Aires, Argentina.

 

HIV/AIDS renders the immune system so weak that other opportunistic infections, (bacteria, parasites, etc.) can take advantage. They did find a way to treat the pneumonia but people were dying anyway as other pathogens took the opportunity to infect.

 

In 1994 Dr. Montaner was able to bring to Vancouver a new German drug which completed the 3-drug therapy. This therapy was able to shut down the replication of the virus and allowed for sustainable recovery.

 

The therapy was introduced to the world in July 1996. There was immediate results in that people with HIV were able to have an almost normal life expectancy and were able to live productive lives.

 

HIV is now easier to treat than hypertension and diabetes.

 

"The concept that antiretroviral therapy (ART) can impact HIV transmission has been under consideration since ART first emerged in the 80’s. While it has been clear that biologically ART can decrease HIV transmission, there has been a longstanding concern this effect could be overwhelmed by increased risk behaviors, commonly referred as behavioral disinhibition, risk overcompensation or therapeutic optimism.

However, shortly after the roll out of highly active antiretroviral therapy (HAART) in 1996, ecological data from Taiwan and British Columbia suggested that HIV new diagnoses had decreased in an unexpected fashion. Most intriguingly, in British Columbia, the effect of HAART on HIV new cases was apparent despite a steady rise in syphilis rate. At the same time, it became clear HAART had the potential to eliminate vertical transmission of HIV. Taken together, these data suggested that HAART could be much more effective in reducing HIV transmission at the population level than it had been previously suspected.

These observations fueled the interest of the BC Centre for Excellence in HIV/AIDS (BC-CfE) to further explore the potential of HIV Treatment as Prevention®. The latter was addressed using demographic and mathematical models, which surprisingly suggested that maximal coverage with HAART could lead to the near elimination of HIV transmission. These results were both published in the Lancet in 2006 and presented at the International AIDS Conference in Toronto.

In brief, HAART rapidly and effectively decreases HIV levels to undetectable in blood and sexual fluids in the vast majority of treated patients. Among those infected, HAART induced sustained HIV undetectability allows for immune reconstitution, therefore preventing the emergence of AIDS-related diseases and premature death. At the prevention level, HAART induced sustained HIV undetectability markedly reduces the likelihood of HIV transmission.

B.C. has experienced a marked decrease in HIV/AIDS morbidity and mortality since the implementation of HAART in 1996. This has been associated with a nearly 60% decrease in new HIV diagnoses, to the current level of 301 cases diagnosed in 2010. More recently, HIV Treatment as Prevention® initiatives have been initiated in a number of jurisdictions around the world, including San Francisco, New York City, Washington, D.C. and China."

In the intravenous drug using population, British Columbia is a leader in harm reduction. HIV has been virtually eliminated in this sector. The efforts to take IV drug users off the streets to administer their drugs in a safe, closed environment, it has lessened the risk for themselves and also for younger people following them.

By investing up front, money will be saved in the long run on a huge scale. 

In 2014, an ambitious treatment target was set. South America was doing the same, however were not getting the results. It became evident that having services available does not mean bringing the services to patients.

There is now a goal to eliminate HIV/AIDS by 2030. By 2020:

• 90% of all people living with HIV will know their HIV status.
• 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
• 90% of all people receiving antiretroviral therapy will have viral suppression.

• 90-90-90: Treatment for all, CLICK HERE
• British Columbia Centre for Excellence in HIV/AIDS, CLICK HERE
• Dr. Julio Montaner: HIV/AIDS and a new approach to diabetes in Canada interview, CLICK HERE
• Instead of Retirement, these two  nurses are battling Vancouver's Opioid Crisis.  (DR. JULIO MONTANER), CLICK HERE