Sydney Declaration

The Sydney Declaration is not a declaration that we love the city. Although we do. The Sydney declaration is a wake-up call to people involved in funding, preventing and treating HIV/AIDS. A reminder that without research, we are all whistling in the dark.

Yet not one East African country has allocated the recommended 15 percent of their 2007/8 budgets to their health sectors, which includes HIV programmes. This is despite the 2005 Group of Eight (G8) most industrialised countries conference urging all governments to commit a minimum of 15 percent of their national budgets to health.

But there is progress. Uganda, Kenya and Tanzania substantially increased their spending on health, giving it at least 10 percent of their current budgets.

Now the Sydney Declaration is here at the International AIDS Society meeting. It urges all countries and donors to spend at least 10 percent of the resources allocated to HIV programmes on research.

With hardly enough resources for health in most of the developing world, this may sound like a far cry from reality. Most of these governments spend at least half of their limited HIV resources on buying drugs for HIV infected people.

But limited research is a problem when it comes to reacting to drug resistance and sustainable access to drugs.

The 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Sydney has called for increased research to inform and strengthen the global response to HIV.

“Good research drives good policy,” says the declaration, signed by over 2000 delegates from around the world.

If the declaration is adhered to, at least $2 billion will be allocated for research next year. UNAIDS estimates that resources amounting to $22 billion will be needed for AIDS programmes in 2008. (in comparison, only $18 billion was allocated for spending this year.

But this trend is not sustainable. Scientists have to find proven ways that can be used for prevention of the disease. This can only be done through research, said Pedro Cahn, IAS president.

HIV/AIDS funding agencies must understand that good programming can only succeed on the back of solid research, said Cahn.

UNAIDS estimates that at least half of the 60 million people that will be infected by 2010 could have been avoided with the use of effective research-proven approaches like male circumcision, constant condom use, microbicides and vaccines.

An effective response to HIV/AIDS requires sustained commitment and continuous improvement.

For example, as current first-line antiretroviral regimens become increasingly available in resource-limited settings, there is an urgent need to identify their successors: optimum, durable, and well-tolerated standardised first-line and second-line regimens. We need to monitor and respond to resistance patterns as they emerge. Outcomes will not necessarily be the same in diverse settings across the globe.

IAS is hosted by in partnership with the Australasian Society for HIV Medicine (ASHM). Esther Nakkazi, who wrote this report, is a Uganda-based correspondent for the East African weekly and is a member of the World Federation of Science Journalists.