"Turning the tide together" is the audacious theme of the XIX International AIDS Conference that officially opened in Washington, D.C. Sunday, July 22.

"We're talking about ending AIDS," said conference co-chair Diane Havlir, a researcher at UCSF.

Two powerful forces are driving that optimism. One is the huge scientific strides made in understanding the human immunodeficiency virus, and a belief that with time and money the remaining questions will be answered.

The other is success not just in creating therapies that can save the lives of persons in the wealthy nations of the world, but in generating the political and economic will to make those same treatments available to 8 million people in sub-Saharan Africa.

Dr. Anthony Fauci (Photo: Bob Roehr)

"The scientific building blocks" of treatment and prevention "have brought us to the point where we can be bold enough to consider the possibility of an AIDS-free generation," said Dr. Anthony Fauci. The director of the National Institute of Allergy and Infectious Diseases has been a leading figure in the fight against AIDS from the start of the epidemic.

"Now that we have the scientific capability, there are no excuses to not do it," Fauci said. However, he also acknowledged ongoing "challenges" in the areas of creating a vaccine and a cure.

Carl Dieffenbach, Fauci's deputy, was a bit more reserved in reviewing scientific questions that remain to be answered in searching for a cure that goes beyond treatments available today. When asked if the cure glass is half full or half empty, his response was,
"We have a glass."

Money is the big issue in Washington and agencies are struggling to avoid making real cuts. The National Institutes of Health is no exception. The budget has been essentially flat for a decade, said NIH Director Francis Collins, "inflation has eaten away; we are about 20 percent down in terms of purchasing power."

Rally

The conference opened with a rally near the Washington Monument that was organized by the AIDS Healthcare Foundation under a theme of "Keep the Promise."

"Presidents are not born, they are made. They have to be pushed into their greatness. They must be held accountable," said television host Tavis Smiley who spoke at the rally.

"I just heard that Obama flew over us in his helicopter. I can't understand why he's not here with us," said the master of ceremony for the event, comedian Margaret Cho.

"The news that President Obama has elected to skip the International AIDS Conference speaks volumes," AHF President Michael Weinstein said earlier in the week when the White House made it official that the president would not attend.

In his place at the opening ceremony for the conference was Health and Human Services Secretary Kathleen Sebelius. She announced what the department news release called "a series of innovative public-private partnerships in the fight against the HIV/AIDS epidemic."

They were: "(1) using text messaging to improve patient management of disease; (2) partnering with a national pharmacy chain to develop an innovative medication therapy management; (3) creating a common, easy to use form for HIV patient assistance program applicants; and (4) launching online education modules to better train providers to treat people living with HIV/AIDS."