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Remarks by Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa: Aids Vaccine 2005 International Conference
Delivered at opening ceremony

Montreal, Canada

6 September 2005

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This is a meeting of researchers and scientists. I am an advocate. It's pretty obvious that you can't turn me into a scientist, but I want to turn you into advocates. To that end, I shall show my unbounded respect by refusing to employ scientific jargon … nor dare I even attempt it when sitting on a panel with two such illustrious and knowledgeable colleagues.

Last month, in Maputo, Mozambique, I attended the annual World Health Organization regional meeting of all the African Ministers of Health. Late in the afternoon of the second day of the conference, an hour and a half was set aside for a discussion of HIV/AIDS and prevention. A significant number of African delegations participated, raising all the conventional responses involving behaviour change, and a few responses somewhat unorthodox in content, from male circumcision to bio-chemical sexual suppressants!

What was not mentioned, by any official delegate, throughout the entire session, was a vaccine. It was as though the preventive technologies had totally fallen off the radar --- microbicides and vaccines both. If it hadn't been for the presence of the former Prime Minister of Mozambique, Pascal Mocumbi, attending as an 'observer', the word vaccine would not have passed anyone's lips. And do remember, Dr. Mocumbi has a particular interest: he's now the High Representative of the Clinical Trials Partnership in the Hague.

What was even more interesting than the omission of preventive technologies at the Maputo conclave --- 'peculiar' might be a better word --- was that the session was based on an actual report, issued by WHO, of a conference on prevention attended by a large number of African and international experts, held in Brazzaville over three days in June. The report contained every aspect of prevention with which we are all familiar, but the word vaccine did not appear from beginning to end. Again, it was as if the preventive technologies were somehow outside the fault lines of AIDS.

How can this be? Africa is the epicenter of the pandemic. Something, somewhere is profoundly out of whack. The world needs an AIDS vaccine more urgently than it needs any single medical discovery, and Africa needs it more than any other part of the world. But for some inexplicable reason, the consuming enthusiasm, the obsessive drive, the sheer, unrelenting passion for a vaccine is simply not riveting the world at large as should be and must be the case.

I would argue that the same kind of extraordinary commitment, in country after country, to achieve '3 by 5', and then to progress to universal treatment, is exactly what has to happen in the pursuit of a vaccine. And that's why I opened with the emphasis on advocacy, advocacy that can be embraced by everyone at this gathering --- advocacy that will move us closer to breaking the back of the pandemic.

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