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LIDC Podcast: Focus on World AIDS Day and a New Response to the Epidemic

Professor Peter Piot, former Executive Director of UNAIDS, calls for a new approach to tackle AIDS in a special interview recorded for World AIDS Day on 1 December. He highlights the long-term impact and exceptionalism of the epidemic, the need to end stigma and discrimination, and warns against complacency. Piot also sets out his ambitions as the new Director of the London School of Hygiene and Tropical Medicine, refers to the importance of interdisciplinary research, and mentions sanitation and water as global health challenges.
 
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“Human tragedy”
This latest episode of Development Matters begins with statistics outlining the severe human toll of HIV/AIDS. Piot describes how, since the 1980s, nearly 30 million people have died of AIDS, and 33 million people are now living with HIV. Despite the slight decline in the annual number of deaths and new infections since their peak, last year 1.8 million people still died from AIDS and 2.6 million people were infected with HIV. Piot adds: “By any measure, this remains a crisis and a human tragedy.” He charts how the virus is spreading on new fronts, particularly in East Asia and the former Soviet Republics, and how the provision of Anti-Retroviral Therapy (ART) is failing to keep up with new infections. Piot says only 40 per cent of people living with HIV have access to ART, and that AIDS remains the biggest killer in sub-Saharan Africa.

 
Redesigning the response
The impact of HIV/AIDS will continue for “generations” and this has implications for campaigners and policymakers tackling the virus. Piot adds: “It’s time to redesign the response to the AIDS epidemic.” He endorses the theme of this year’s World AIDS Day – promoting universal access and human rights – by saying we should not be content until all people living with HIV have access to ART and that human rights are “key” to dealing with HIV/AIDS, particularly in homophobic cultures. He also outlines the recommendations of AIDS 2031 – a group he created (2031 will be the fiftieth anniversary of AIDS). To coincide with World AIDS Day, AIDS 2031 is urging countries to establish minimum legal standards to ensure an effective prevention and treatment programme. These include the decriminalisation of same-sex relations, harm reduction programmes for injecting drug users, and non-discrimination of people living with HIV. Piot recognises HIV/AIDS as a global challenge and warns against complacency, including in Europe, particularly since the introduction of ART, and because of less funding for prevention. He adds: “Many programmes are not adapted to the realities of people.  We should adapt our prevention programmes to people, not the other way round.”
 
AIDS is described as “exceptional” because it is associated with social exclusion, stigma and discrimination, which makes it harder to address than other problems. However, Piot also gives examples of successful campaigns, including the Treatment Action Campaign in South Africa, where a combination of street demonstrations and legal action have been used to convince the government to provide the largest ART programme in the world.
 
Higher eduaction
Piot concludes by outlining his hopes for LSHTM under his leadership. As well as training the next generation of leaders in global health, he wants the institution to maintain its excellence in research, and create more partnerships and alliances with developing countries in an increasingly competitive era of globalised higher education.
 
By Guy Collender and Noemi Mattei, LIDC