>> Steve: FORTY YEARS AGO, THE FIRST FEW CASES OF WHAT WOULD COME TO BE CALLED AIDS --
ACQUIRED IMMUNE DEFICIENCY SYNDROME -- WERE REPORTED.
SINCE THEN, MORE THAN 36 MILLION PEOPLE HAVE DIED FROM IT, AND MORE THAN THAT LIVE WITH IT
AROUND THE WORLD EVERY DAY.
TREATMENTS, AND HOPEFULLY A VACCINE, ARE ESSENTIAL TO ENDING THAT EPIDEMIC.
LET'S GET THE LATEST ON THOSE FROM: DR. SHARON WALMSLEY, DIRECTOR OF
CLINICAL RESEARCH AT THE IMMUNODEFICIENCY CLINIC AT TORONTO GENERAL HOSPITAL AND A
PROFESSOR AT THE UNIVERSITY OF TORONTO'S DEPARTMENT OF MEDICINE, WHO JOINS US FROM
HOSPITAL ROW IN THE PROVINCIAL CAPITAL; AND ON THE DANFORTH,
DR. DARRELL TAN, INFECTIOUS DISEASES PHYSICIAN, CLINICIAN-SCIENTIST, AND
DIRECTOR OF THE UNIVERSITY OF TORONTO'S CLINICAL RESEARCH UNIT ON HIV PREVENTION.
IT'S GREAT TO HAVE YOU TWO WITH US ON THIS WORLD AIDS DAY.
I WANT TO START HERE.
SHARON WALMSLEY, LET ME START WITH YOU.
HOW MUCH OF WHAT WE HAVE LEARNED ABOUT HIV OVER THE PAST FEW DECADES IN YOUR VIEW HAS SERVED
US WELL AS IT RELATES TO FIGHTING CoVID-19?
>> Dr. Sharon Walmsley: WELL, STEVE, I THINK YOU RAISED A VERY IMPORTANT POINT, AND WHEN THE
CoVID PANDEMIC HIT, WHO DID THEY TURN TO BUT THOSE OF US WHO DEALT WITH THE HIV PANDEMIC.
AND AS PART OF DEALING WITH THAT PANDEMIC, WE LEARNED IMPORTANT THINGS ABOUT VIRUSES THAT WERE
CAUSING UNKNOWN DISEASE, OUR CONCERN ABOUT CONTAGION, OUR CONCERN ABOUT WHO WAS AT RISK
AND HOW TO MANAGE IT, AND MANY HIV-TREATING PHYSICIANS STEPPED UP TO THE PLATE AND SAID: YOU
KNOW, HOW CAN WE HELP WITH THE CoVID PANDEMIC TO HELP DESIGN THE CLINICAL TRIALS, THE
MANAGEMENT OF PATIENTS, THE ISOLATION PRECAUTIONS THAT MIGHT BE NECESSARY TO FIGHT THIS NEW
DISEASE?
>> Steve: ALL RIGHT.
DARRELL TAN, LET ME FOLLOW UP WITH THIS, BECAUSE YOU FOCUS ON PREVENTION OF HIV.
HAVE THOSE LESSONS HELPED IN PREVENTING THE SPREAD OF CoVID-19, IN YOUR VIEW?
>> Dr. Darrell Tan: YEAH, STEVE, I THINK THEY HAVE IN A LOT OF DIFFERENT WAYS.
I MEAN, ON A CERTAIN LEVEL, A REALLY IMPORTANT CONTRIBUTION THAT OUR UNDERSTANDING OF THE
HIV pandemic has made to the CoVID response is simply understanding how infectious
diseases like both of these viruses tend to propagate in populations.
The risk of acquiring both HIV and CoVID-19 IS NOT ACTUALLY EQUALLY DISTRIBUTED IN OUR
SOCIETY.
A LOT OF THESE EPIDEMICS TEND TO MOVE ALONG FAULT LINES IN OUR SOCIETY, SUCH THAT THOSE WHO ARE
SYSTEMATICALLY MARGINALIZED BY STRUCTURAL FORCES OF RACISM, POVERTY, DISCRIMINATION, STIGMA,
ET CETERA, TEND TO BE THE VERY FOLKS THAT ARE OVERREPRESENTED, WHETHER WE'RE TALKING ABOUT GAY,
BISEXUAL, OTHER SEXUAL MINORITY MEN OR PEOPLE WHO USE DRUG FOR THE HIV PANDEMIC OR THE ELDERLY
AND MIGRANT WORKERS AND PEOPLE WHO ARE IN MARGINALIZED POPULATIONS THAT HAVE FACED
SYSTEMIC RACISM AND THEREFORE HAVE SCEPTICISM ABOUT VACCINES.
THERE'S A LOT THAT WE'VE LEARNED ABOUT HOW THESE ILLNESSES TRANSMIT THROUGH POPULATIONS
THAT HAVE REALLY INFORMED HOW WE SHOULD TARGET OUR PREVENTION EFFORTS.
>> Steve: LET ME DO A QUICK FOLLOW-UP WITH YOU.
IS IT FAIR TO SAY THEN THAT BOTH OF THESE PANDEMICS HAVE BEEN IN SOME RESPECTS VERY UNFAIR
INASMUCH AS THEY SEEM TO PICK ON THE MOST VULNERABLE AMONG US?
>> Dr. Darrell Tan: I THINK THAT'S A NICE WAY TO PUT IT, ABSOLUTELY.
IT REMINDS US THAT OUR APPROACHES NEED TO BE I THINK INFORMED BY THAT.
WE CAN'T SIMPLY ASSUME THAT EVERYONE HAS EQUAL ACCESS TO INFORMATION AND TREATMENTS AND
PREVENTION TOOLS.
WE NEED TO IN MANY WAYS WORK EXTRA HARD TO BRING THE TOOLS THAT WE KNOW WORK TO THOSE WHO
WE KNOW CAN BENEFIT MOST AND WE NEED TO BE PREPARED FOR THE FACT THAT THOSE SAME COMMUNITIES MAY
ACTUALLY BE QUITE SKEPTICAL AND APPREHENSIVE ABOUT AUTHORITY FIGURES REACHING OUT.
SO IT'S NOT QUITE AS EASY AS SOMETIMES ONE WOULD EXPECT IT TO BE IF ALL THINGS HAD BEEN IN
FACT EQUAL.
>> Steve: SHARON, LET ME SET UP THIS NEXT QUESTION TO YOU BY SHARING SOME NUMBERS WITH OUR
VIEWERS AND LISTENERS, AND THESE ARE VERY STARK NUMBERS.
70 MILLION PEOPLE HAVE ACQUIRED AIDS.
MORE THAN 35 MILLION HAVE DIED FROM IT.
TODAY AROUND 37 MILLION PEOPLE LIVE WITH HIV.
THAT'S WORLDWIDE.
AND 22 MILLION ARE IN TREATMENT.
MILLIONS AND MILLIONS OF PEOPLE HAVE BEEN AFFECTED BY THIS.
WE'VE GOT A VACCINE FOR CORONAVIRUS LICKETY SPLIT AND HERE WE ARE FOUR DECADES LATER
AND STILL NO VACCINE FOR AIDS.
WHY NOT?
>> Dr. Sharon Walmsley: YEAH, THAT'S FOR ALL OF US WHO DEAL IN THE HIV WORLD, THAT'S BEEN A
MAJOR SOURCE OF FRUSTRATION.
AND CLEARLY A MAJOR WAY TO IMPACT A PANDEMIC OR IMPACT AN EMERGING INFECTION IS TO DEVELOP
A VACCINE.
SO, YOU KNOW, IN HIV, IN THE EARLY DAYS OF THE EPIDEMIC, A LOT OF OUR FOCUS WAS REALLY ON
TREATING PEOPLE.
WHEN PEOPLE WERE FIRST DIAGNOSED WITH HAVING HIV, THAT WAS A LIFE SENTENCE.
THEY WERE GOING TO DIE IN SIX MONTHS.
AND SO MUCH OF THE RESEARCH AT THE TIME WAS REALLY ON, HOW CAN WE TREAT PEOPLE AND MAINTAIN
HEALTH?
AND IN THE EARLY DAYS OF THE EPIDEMIC, YOU KNOW, THERE WERE SOME CANDIDATE VACCINES.
THEY WEREN'T VERY SUCCESSFUL.
AND THERE WAS NOT A LOT OF RESOURCES BEING PUT INTO DEVELOPING VACCINE FOR HIV.
SO FOR MANY YEARS, PROGRESS WAS EXTREMELY SLOW, AND THERE WAS A FEW CANDIDATE VACCINES FOR HIV,
THEY WERE NOT VERY EFFECTIVE, AND WITHOUT RESOURCES, IT'S HARD TO MOVE ALONG.
AND SO WHEN CoVID HAPPENED, THERE WAS A LOT OF MONEY GOT POURED INTO VACCINES VERY
QUICKLY.
THERE WAS A NUMBER OF PEOPLE ON THE FRONT LINES AND A NUMBER OF VACCINE COMPANIES THAT HAD BEEN
DEVELOPING THESE TECHNOLOGIES ON THE BACK BURNER AND THEY WERE READY TO DEVELOP THEM UP AND THE
MONEY WAS THERE AND THE WILL WAS THERE TO DEVELOP THESE VACCINES AND THAT'S WHY THEY HAPPENED SO
FAST.
ON THE OTHER HAND, HIV IS A DIFFERENT VIRUS, AND THE HIV VIRUS ACTUALLY INTEGRATES INTO
THE CELLS OF THE HOST, AND THAT'S WHAT MAKES IT TRICKY.
AND THE HIV VIRUS ALSO MUTATES A LOT.
WE'VE HEARD A LOT ABOUT CoVID VARIANTS.
WELL, HIV VIRUS CHANGES ITSELF A LOT TOO.
AND THE PROBLEM IS A LOT OF THE VACCINE RESEARCH HAPPENED IN THE DEVELOPED WORLD, WHEREAS THE HIV
PANDEMIC IS IN THE DEVELOPING WORLD, AND THE VACCINE THAT IS DEVELOPED IN OUR COUNTRY MAY NOT
BE EFFECTIVE AGAINST THE VIRUSES THAT ARE IN AFRICA AND OTHER PARTS OF THE WORLD.
SO THERE ARE DIFFERENCES IN THE WILL TO HAVE THAT VACCINE HAPPEN, IN THE RESOURCES TO HAVE
THAT VACCINE HAPPEN, BUT THE VIRUSES ARE VERY DIFFERENT AND THEY'RE VERY DIFFERENT IN THEIR
MECHANISM OF ACTION, AND THE HIV VIRUS HAS PROVEN TO BE A VERY TRICKY THING FOR US TO DEVELOP A
VACCINE.
>> Steve: DARRELL, LET ME FOLLOW UP WITH YOU ON THIS AND I'M REALLY NOT TRYING TO PUT
WORDS IN YOUR MOUTH HERE.
BUT I REMEMBER WHEN AIDS HAPPENED.
I REMEMBER IN THE EARLY '80s WHEN IT STARTED AND A LOT OF PEOPLE SAID, "OH, YEAH, THAT'S
THAT DISEASE THAT THOSE PEOPLE GET."
HOW MUCH OF THAT THINKING HAS DELAYED AN INTERNATIONAL EFFORT TO FIND A VACCINE?
>> Dr. Darrell Tan: WELL, I THINK THERE'S CERTAINLY SOME ELEMENTS OF THAT THINKING TODAY,
STEVE.
I MEAN, WE ALL -- IT TOOK A WHILE FOR THE GLOBAL RESPONSE TO REALLY RECOGNIZE HOW GLOBAL THE
CoVID-19 PANDEMIC TRULY IS, AND STILL TODAY, YOU KNOW, IN THE LAST SEVERAL MONTHS, I THINK
HERE IN CANADA WE'VE BEEN VERY FORTUNATE TO HAVE A SUCCESSFUL, FOR THE MOST PART, VACCINE
ROLLOUT, AND THAT'S ALLOWED MANY OF US TO START TO LIVE OUR LIVES IN A WAY THAT WAS MORE SIMILAR
TO PRIOR TO THE PANDEMIC STARTING.
AND YET WE'VE SEEN THAT THE CoVID-19 PANDEMIC RAGES ON ALL OVER THE WORLD.
AND A LOT OF THAT HAS TO DO WITH NOT NECESSARILY THINKING THAT CoVID IS A PROBLEM FOR OTHER
PEOPLE, BUT RATHER IT'S A SYMPTOM OR A FUNCTION OF US NOT REALLY RECOGNIZING THAT THIS
PANDEMIC IS A GLOBAL PANDEMIC, JUST LIKE HIV WAS, JUST LIKE SO MANY INFECTIOUS DISEASES ARE.
AND REALLY NONE OF US ARE SAFE UNTIL ALL OF US ARE SAFE.
IT SOUNDS A BIT TRITE TO SAY BUT IT'S REALLY TRUE.
THE EMERGENCE OF THIS OMICRON VARIANT WITH SARS-CoV-2, THE VIRUS THAT CAUSES COVID-19, IS
A PERFECT ILLUSTRATION OF THAT.
MUCH OF WHAT WE RECOGNIZE ALLOWS NEW VARIANTS OF BOTH VIRUSES TO EMERGE IS ONGOING SPREAD BECAUSE
THE VIRUSES CAN CONTINUE TO MUTATE AND TRANSMIT BETWEEN PEOPLE UNCHECKED.
IF WE HAD BEEN MORE SUCCESSFUL AT ROLLING OUT AND POLITICALLY PRIORITIZING THE TRUE, EQUITABLE
GLOBAL ROLLOUT OF PREVENTION TOOLS LIKE VACCINES RIGHT FROM THE GET-GO, WE MIGHT HAVE SEEN
MUCH MORE CONTROLLED PROGRESS WITH CoVID-19 THAT COULD HAVE CURBED THE EMERGENCE OF NEW
VARIANTS.
IT COULD STILL HAPPEN, OF COURSE, BUT IT MAY NOT HAVE BEEN AS DRAMATIC, AS FAST AND I THINK
IT REMINDS US OF JUST HOW GLOBAL THESE PANDEMICS CAN TRULY BE.
>> Steve: SHARON, LET ME ASK YOU A BIT MORE ABOUT YOUR WORK.
DO I HAVE THIS RIGHT THAT YOUR FOCUS IS ON THE WOMEN AND THE ELDERLY IN PARTICULAR WHO ARE
DEALING AND LIVING WITH HIV?
>> Dr. Sharon Walmsley: ABSOLUTELY, STEVE.
AND I THINK WHEN A LOT OF THE WORLD -- AND I THINK WHAT YOU'VE BEEN ALLUDING TO, THINKS ABOUT
HIV, THEY THINK ABOUT GAY MEN.
BUT, NO.
HIV DOES NOT ONLY IMPACT GAY MEN.
MY FOCUS HAS ALWAYS BEEN ON WOMEN.
WOMEN REPRESENT HALF OF THE WORLD'S PANDEMIC OF HIV.
AND OVER THE YEARS, A LOT OF THE RESEARCH HAS FOCUSED ON GAY MEN AND HAS NOT BEEN SPECIFIC TO
WOMEN.
SO I'VE TRIED TO BE THEIR VOICE.
I'VE TRIED TO MAKE SURE THAT THE CLINICAL TRIALS INVOLVE ENOUGH WOMEN SO THAT WE CAN UNDERSTAND
THE IMPACT OF THIS VIRUS.
AND NOW, IN MY RESEARCH FROM DAY ONE HAS FOLLOWED THE PANDEMIC.
SO INITIALLY WE WERE LOOKING AT OPPORTUNISTIC INFECTIONS AND THEN WE WERE LOOKING AT THE
TREATMENTS, BUT NOW PEOPLE, BECAUSE OF OUR EMPHASIS ON TREATMENT, ARE SURVIVING INTO
OLD AGE.
AND SO THE FIRST WAVE OF PEOPLE INFECTED BY HIV IN CANADA ARE NOW IN THEIR 60s AND 70s, SO
WE'VE DEVELOPED A NEW STUDY TO LOOK AT HIV IN THE AGING BECAUSE THIS IS THE FIRST GENERATION OF
PERSONS TO HAVE AGED WITH HIV.
AND PART OF THE PROBLEM IS, MANY OF THESE PEOPLE 20, 30, 40 YEARS AGO, THEY THOUGHT THEY WERE
GOING TO DIE.
THEY GAVE UP THEIR LIFE INSURANCE POLICIES.
THEY GAVE UP THEIR JOBS.
THEY LOST MANY OF THEIR FRIENDS AND FAMILIES.
AND SO THEY'RE LIVING ALONE NOW AND IN ISOLATION AND WITHOUT RESOURCES.
AND WE REALLY NEED TO LOOK TOWARDS THEIR FUTURE AND HOW THEY CAN AGE WELL WITH HIV.
>> Steve: YOU KNOW, IT KIND OF NEVER OCCURRED TO ME BUT I GUESS IF YOU DO THE MATH, ARE YOU
TELLING US THERE ARE WOMEN IN THEIR 80s TODAY THAT ARE LIVING WITH HIV?
>> Dr. Sharon Walmsley: YEAH.
DURING THE SECOND MONTH OF THE PANDEMIC, I HAD TWO WOMEN, NO PATIENTS IN MY CLINIC, THEY WERE
BOTH OVER 80, NEWLY DIAGNOSED WITH HIV.
>> Steve: AMAZING.
DARRELL, YOU FOCUS ON PREVENTION, AND WE KNOW THE MOST OBVIOUS SOLUTION OR THE MOST
OBVIOUS WAY TO MAKE SURE YOU DON'T GET HIV IS IF YOU'RE HAVING SEX, HAVE SAFE SEX.
USE A CONDOM.
NOW, BESIDES THAT, WHAT ARE OTHER WAYS THAT YOU'RE LOOKING AT, OTHER OPTIONS FOR PREVENTING
THE CONTRACTION OF HIV?
>> Dr. Darrell Tan: STEVE, IT'S A GREAT QUESTION BECAUSE I THINK A LOT OF FOLKS ARE
FAMILIAR WITH THE TRADITIONAL BEHAVIOURAL APPROACHES TO HIV PREVENTION, WHICH DEFINITELY
INCLUDE THINGS LIKE CONDOM USE, AS YOU MENTIONED, WITH RESPECT TO SEXUAL TRANSMISSION OF HIV.
BUT WHAT MANY FOLKS DON'T REALIZE IS THAT ACTUALLY A LOT OF THE BIOMEDICAL TOOLS THAT WE
HAVE DEVELOPED OVER THE LAST DECADE AND MORE ARE ACTUALLY EXTREMELY SUCCESSFUL AT
PREVENTING HIV AS WELL.
ONE OF THOSE TOOLS IS SIMPLY TREATMENT.
TREATMENT OF HIV ITSELF IN FOLKS WHO ARE LIVING WITH HIV IS ASSOCIATED WITH A DECREASE IN
THE VIRUS IN THE PERSON, AND WHEN THAT VIRAL LOAD GOES DOWN TO UNDETECTABLE LEVELS, REALLY,
REALLY LOW LEVELS, THAT IN ITSELF IS ASSOCIATED WITH A ZERO RISK OF TRANSMITTING THAT VIRUS
TO A SEXUAL PARTNER, EVEN IF NO CONDOM IS USED.
NOW, THAT'S A DRAMATIC CHANGE COMPARED TO WHAT WE KNEW JUST SEVERAL YEARS AGO.
SO THAT'S ONE IMPORTANT TOOL.
BUT ANOTHER ONE RELATES TO THE USE OF MANY OF THE VERY SAME MEDICATIONS THAT WE USE FOR HIV
TREATMENT FOR PREVENTION PURPOSES.
IN PARTICULAR, A LOT OF MY WORK FOCUSES ON SOMETHING THAT WE CALL PREP, WHICH STANDS FOR
"PREEXPOSURE PROPHYLAXIS."
THIS REFERS TO THE USE OF CERTAIN ANTI-HIV MEDICATIONS ON AN ONGOING BASIS, SOMETIMES IT'S
USED ON A DAILY BASIS, SOMETIMES IT'S USED JUST AROUND THE TIME OF EXPOSURE, SUCH AS AROUND THE
TIME OF HAVING SEX, BY PEOPLE WHO ARE ACTUALLY HIV NEGATIVE BUT WHO RECOGNIZE THAT THEY'RE
AT AN INCREASED RISK OF ACQUIRING HIV.
AND BY USING THESE MEDICATIONS ON AN ONGOING BASIS, WE CAN ACTUALLY REDUCE THOSE PEOPLE'S
RISK OF ACQUIRING HIV TO ALMOST 100% IF THEY'RE USING THEM REGULARLY.
THIS HAS REALLY REVOLUTIONIZED OUR APPROACH.
GLOBALLY THERE HAVE BEEN A NUMBER OF JURISDICTIONS THAT HAVE REALLY EMBRACED PREP AND
SIMILAR APPROACHES I WOULD SAY MORE THAN WE HAVE IN CANADA SO FAR AND THEY'VE ACTUALLY BEEN
MUCH, MUCH MORE SUCCESSFUL AS A RESULT IN ACTUALLY CURBING HIV INFECTION RATES IN THEIR
JURISDICTIONS, REALLY SEEING THOSE RATES COME DOWN.
SO IT'S SOMETHING WE REALLY NEED TO BE PUBLICLY PROMOTING AS A HEALTHY CHOICE, AS A SMART
CHOICE, AS A SAFE CHOICE AND MAKING MUCH MORE AVAILABLE TO THOSE WHO COULD BENEFIT FROM IT.
>> Steve: SHARON, I DON'T WANT TO OVERSIMPLIFY THIS, BUT I GUESS THE REALITY IS, IF
STARTING TODAY EVERYBODY PRACTISED SAFE SEX AND PEOPLE USED, FOR THOSE WHO USE DRUGS
WITH A NEEDLE, IF THEY MADE SURE THAT IT WERE DONE IN A SAFE SETTING, LET ME PUT IT THAT WAY,
NOBODY ELSE NEED GET ANOTHER CASE OF AIDS; IS THAT RIGHT?
>> Dr. Sharon Walmsley: YES, IN THEORY, WE COULD ELIMINATE THIS INFECTION THROUGH PRACTICES
THAT PREVENT TRANSMISSION.
THE PROBLEM IS, PEOPLE ARE PEOPLE, AND PEOPLE OFTEN DON'T RECOGNIZE THEY'RE AT RISK, AND
THAT'S THE PROBLEM.
IF PEOPLE DON'T RECOGNIZE THEY'RE AT RISK, THEY DON'T GO OUT AND GET TESTED, THEN THEY
CAN BE THE SOURCE OF VIRUS TO OTHER PEOPLE.
AND IN FACT EVEN TODAY, OF PEOPLE WHO NEWLY PRESENT WITH HIV, STILL, YOU KNOW, A GOOD
QUARTER OF PEOPLE PRESENT VERY ADVANCED IN THEIR HIV, DIDN'T RECOGNIZE THAT THEY WERE AT
RISK, DIDN'T GO AND GET TESTED, AND SO THAT'S THE DIFFICULT PART, IS HAVING PEOPLE REALIZE
THAT, HEY, I COULD BE AT RISK.
>> Steve: I KNOW WE TOUCHED ON THIS EARLIER, DARRELL, BUT I WANT TO CIRCLE BACK.
WELL, I'LL JUST READ IT.
THE THEME OF THIS YEAR'S WORLD AIDS DAY IS END INEQUALITIES, END AIDS, END PANDEMICS.
THREE VERY WORTHY GOALS.
LET'S JUST PICK THAT APART A LITTLE BIT.
END INEQUALITIES.
WHAT IS THAT A REFERENCE TO?
>> Dr. Darrell Tan: WELL, I THINK IT'S A REFERENCE, STEVE, TO A NUMBER OF THINGS THAT ALLOW
EPIDEMICS TO PROPAGATE.
NUMBER ONE ARE STIGMA AND DISCRIMINATION.
I THINK THESE ARE REALLY POWERFUL FORCES THAT PREVENT FOLKS, AS SHARON WAS SAYING, WHO
MAY BENEFIT FROM TESTING, FROM TREATMENT, FROM PREVENTION TECHNOLOGIES, FROM EVEN
ACCESSING IT IN THE FIRST PLACE.
AND I, IN MY PRACTICE, SEE THIS AS A CHALLENGE ALL THE TIME.
FOLKS DELAY SEEKING CARE BECAUSE OF THE DISCRIMINATION THAT IS ASSOCIATED WITH THIS VIRUS
UNNECESSARILY.
BUT ANOTHER IMPORTANT SET OF INEQUITIES RELATES TO JUST THE SHEER DOLLARS AND CENTS, JUST
THE SOCIOECONOMIC INEQUALITIES.
AND WE HERE IN ONTARIO, IN MOST OF CANADA, CONTINUE TO LIVE IN A SOCIETY THAT IS VERY PROUD OF
ITS UNIVERSAL HEALTH CARE SYSTEM.
BUT WHAT WE FAIL TO RECOGNIZE IS THAT WE DON'T ACTUALLY HAVE TRULY EQUITABLE ACCESS TO
MEDICATION, BOTH FOR TREATMENT AND FOR PREVENTION.
THE COSTS OF THESE TREATMENT AND PREVENTION TOOLS, AS SUCCESSFUL AS THEY ARE, CAN EASILY ADD UP
TO HUNDREDS OR THOUSANDS OF DOLLARS PER MONTH OR CAN ADD UP TO SIGNIFICANT CO-PAYMENTS AND A
LOT OF BUREAUCRATIC PAPERWORK THAT UNNECESSARILY IMPEDE ACCESS TO THESE LIFE-SAVING AND
HEALTH-PRESERVING TREATMENTS.
SO WE REALLY NEED TO FIX THAT PROBLEM BECAUSE I THINK THAT THOSE ECONOMIC INEQUALITIES ARE
REALLY, REALLY CORE IN ADDITION TO THE SOCIAL FACTORS LIKE DISCRIMINATION AT PERPETUATING
THESE PANDEMICS.
>> Steve: SHARON, IN OUR LAST 20 SECONDS, HOW CLOSE DO YOU THINK WE ARE TO A VACCINE
FINALLY?
>> Dr. Sharon Walmsley: I DON'T THINK WE'RE THERE IN MY LIFETIME, UNFORTUNATELY.
SO I THINK WE REALLY NEED TO CONTINUE TO FOCUS ON IMPROVING OUR TREATMENTS, MAKING THEM
EASIER FOR PEOPLE, MAKING THEM AVAILABLE FOR PEOPLE, AS DARRELL SAID, AND MAKING THEM MORE
ACCEPTABLE.
AND I THINK WHERE TREATMENT IS GOING IS REALLY INTO SOME MORE OF THESE LONG-ACTING COMPOUNDS
THAT PEOPLE MIGHT BE ABLE TO TAKE ONCE A MONTH, EVERY SIX MONTHS, MAYBE ONCE A YEAR FOR
BOTH PREVENTION AND TREATMENT.
AND I THINK THAT THOSE WILL GO A LONG WAY FOR HELPING US KEEP THE VIRUS LEVEL IN THE POPULATION
UNDER CONTROL.
>> Steve: GOTCHA.
SHARON WALMSLEY, DARRELL TAN, REALLY GOOD OF YOU TO JOIN US TONIGHT ON TVO.
THANKS SO MUCH.
>> Dr. Darrell Tan: THANK YOU, STEVE.
>> Dr. Sharon Walmsley: HAPPY AIDS DAY.