Distributing more treatment will involve encouraging social and political changes on matters including homosexuality, prostitution and drug use—changes that many countries will find hard to accept
. Held in Montreal in Canada this week, the gathering brings together experts, activists and patients from all over the world, rich and poor alike. It is this mix that has helped bear down on a disease that has killed about 40m people, 650,000 of them in 2021.
However, Canada denied visas to some delegates from poor countries, seemingly because it worried that they might fail to go home. Exactly how many were kept out is not yet clear and, thanks to work by a previous, they at least had a chance to attend virtually. Yet lockdown showed how much of a conference’s value is to be found in corridors, bars and chance encounters rather than formal sessions.
Rich-country governments, Canada’s included, give out non-trivial amounts of cash every year to assist less fortunate places with the purchase and distribution of the antiretroviral drugs that keep symptoms at bay for those infected. However, the amount of cash has been sliding—and the slide began before covid was around to blame. Possibly as a consequence the year-on-year fall in infections in 2021, 3.6%, was the smallest since 2016.than most.
All of this matters. So far, the world has done a creditable job distributing symptom-suppressing antiretroviral drugs to those in need of them. Almost 29m, around three-quarters of that number, are on treatment. Inevitably though, the first three-quarters is the easiest.
Far from sliding, the amount spent on combating HIV needs to go up, from $21bn last year to $29bn in 2025, according to an estimate published last year. In the grand scheme of things, that is not a huge ask. But if even a country as socially conscious as Canada cannot quite bring itself to admit some of those most affected, in order that they might attend the leading forum dealing with
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