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HIV-AIDS epidemic needs greater global respon -

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(generated from captions) next year in the number of annual reports that actually reflect the

opposition to a salary arrangement

and change it. Emma Alberici with that report. Dr David Ho was a raw young medico in Los Angeles

when he treated his first AIDS victims in 1981. Of course, at that point, no-one knew the global devastation ahead. By 1996, Dr Ho was a medical hero -

'Time' magazine's Man of the Year - and in 2001 was awarded the US President's Medal for his seminal research into HIV/AIDS,

which paved the way for the most effective treatment in stalling the mortality of AIDS so far -

the so-called cocktail of retroviral drugs.

But despite this great leap forward in treatment, the drugs are still not available

to the great bulk of victims in developing countries. And Dr Ho's own birthplace, China, is just now facing up to its own looming massive tragedy after years of official denial.

David Ho now leads the Aaron Diamond AIDS Research Centre in New York,

a world-renowned bio-medical research institute

and is here for consultations with Melbourne's Burnet Institute and I spoke with him there today. David

David Ho, what is the realistic

best-case scenario for the HIV-AIDS

epidemic globally within the next

decade? That's a very tough one,

because we see many signs that are

not very promising. It already

qualifies as the worst infectious

disease disaster to affect mankind,

but for all the advances that death

toll - 25 million so but for all the advances that death toll - 25 million so far - will

still explode further, won't it?

It's not just an epidemic in the

growth of those who will contract

HIV, but the chances are the actual

death toll will explode? Absolutely.

I think 25 million dead, 45

I think 25 million dead, 45 million living with a lethal disease if not

treated and the projection suggests

that the epidemic will likely

that the epidemic will likely exceed 100 million before the

that the epidemic will likely exceed 100 million before the end of the

decade. So the numbers are truly

frightening. China alone faces the

prospect of a dramatic spread of

HIV-AIDS from about a million

infected people now to somewhere

between 10 and 20 million in the

next five years. Why has it taken

China so long to learn from the

tragic lessons of Africa? People

have a tendency to forget history and, therefore,

have a tendency to forget history and, therefore, relive history and

and, therefore, relive history and I think China was slow to adapt the

right system. Not all that

different from many other countries,

India for example and perhaps most

refactory is South Africa. But I

must say that since early 2004 must say that since early 2004 China has

must say that since early 2004 China has changed its policies quite

dramatically for the better. It's

true, isn't it, that the vast bulk

of China still has no real

recognition of - or knowledge even

recognition of - or knowledge even - of HIV-AIDS? Yes,I think it's safe

to say in China for those infected

to say in China for those infected a huge majority of them would not

huge majority of them would not know that they're infected. And if you speak to

that they're infected. And if you speak to a common person on the

street in the city or in rural

areas, most would not know much

about HIV or AIDS and so the lack

about HIV or AIDS and so the lack of awareness is a huge problem. I know

that the practice of selling blood

commercially has been a significant

factor in the spread of HIV-AIDS.

But even allowing for that, to what

extent have the stigmas But even allowing for that, to what extent have the stigmas on drug

users and homosexuals been overcome

in China's fight against HIV-AIDS?

I think it still has a long way to

go. When I go to China to address

this problem I'm reminded of the

practices in the early 1980s in

America, the stigma and

discrimination are Ramzi Mohamed

pant. There's a discrimination are Ramzi Mohamed pant. There's a lot of

misunderstanding about this --

rampant. There's a lot of

misunderstanding about this disease.

Often people who are infected are

ostracised by friends and family,

very reminiscent of US in early

1980s and I suspect Australia

1980s and I suspect Australia during that period of time, as well.

You've been on the front-line very much

You've been on the front-line very much in the front-line in the hunt

to develop a vaccine against HIV

to develop a vaccine against HIV for at least a decade now. Why is it

taking so long to produce the goods?

It is obviously taking a long time

and we won't have a vaccine for the

foreseeable future. The

foreseeable future. The fundamental problem is posed by the virus.

problem is posed by the virus. Just to give you an example,

problem is posed by the virus. Just to give you an example, myself and

many others have worked hard at

trying to come up with an AIDS

vaccine since the mid 1980s, about

20 years. This effort is not

successful so far. SARS came along

in 2003, a few labs jumped on it

immediately and within six months

immediately and within six months to a year including our effort,

a year including our effort, protective vaccines were produced

that show virtually 100 protection

in monkey experiments. And the

vaccine's pretty much use the same

general strategies. So it's

general strategies. So it's telling us that there are fundamental

problems posed by HIV has to do

problems posed by HIV has to do with the virus' capacity to change and

mutilate, has to do with the fact that the virus

mutilate, has to do with the fact that the virus on the surface has a

shield. If you watch 'Star Trek'

and such science fiction movies you

know that certain things have this

shield around it to protect it.

shield around it to protect it. The virus has developed a couple of

virus has developed a couple of very clever strategies to shield itself

from the immune system,

from the immune system, particularly from antibiotics and that makes it

very hard for us to come up with a

vaccine that would induce the right

immune response that would neutralise the

immune response that would neutralise the virus. You

neutralise the virus. You personally began to see America's first AIDS

victims, HIV-AIDS victims way back

in 1981 I think. Well, I had just

finished my medical training and

finished my medical training and was ready to launch into research and

begin an academic career in 1981

when accidentally I saw a number of the

when accidentally I saw a number of the early cases in Los Angeles and

those cases were in gay men and

those cases were in gay men and they came in one after another with a

multitude of infections that

suggested the immune system was

wiped out. And that really

mystified all of us. It must

mystified all of us. It must stagger you looking back at how that

unfolded? I never at that point

predicted that this would turn into a

predicted that this would turn into a global pandemic. To then over

time witness the same happening in

other countries, particularly in

other countries, particularly in the land of my heritage in China, I see

that it took off in 1989 and you

know, spread rapidly and quietly in

the early 1990s is a tragedy when

there was already eight, nine years

of experience with this epidemic. there was already eight, nine years of experience with this epidemic.

But that same tragedy is being

repeated every day elsewhere.

Do you ever allow yourself to get

angry though when you see

foolishness or bureaucracy or

government putting its head in the

sand actually ending in so many

deaths? I like to think I'm a

deaths? I like to think I'm a fairly calm and tranquil surface.

Certainly on the surface trying to Certainly on the surface trying to be as professional as possible.

be as professional as possible. But yes, I would say that I have as

yes, I would say that I have as much anger as anybody out there. I'm

anger as anybody out there. I'm not the type who would be jumping up

the type who would be jumping up and down and screaming but I would

down and screaming but I would state my case and I have been angry with

some of the policies in the US in

the early 1980s that let this

epidemic go from a handful of

the early 1980s that let this epidemic go from a handful of cases

to a million Americans infected.

Almost complete silence from the

White House during that period. I

was angered by what China did, for

example, in the 1990s and even say

three or four years ago by saying,

"This is not a disease that will affect us

"This is not a disease that will affect us like other parts of the

world. " I think that's also

foolishness. But I'm gratified

foolishness. But I'm gratified that that attitude has been modified. I

like to think that we and many

others have done our advocacy to

help change that way of thinking.

David Ho, thank you very much for