In 1983 the AIDS virus, HIV, was isolated by virologists at the Institut Pasteur. There was no treatment at the time, and individuals infected with HIV generally died from this new disease. But in 1996, highly-active antiretroviral therapy (HAART) was introduced in the Global North, before becoming available in the Global South from 2001 onwards. Pauline Londeix, former Vice-President of Act Up-Paris and co-founder of the Observatory for Transparency in Drug Policies (OTMeds), looks back at this period.
This interview is the first in a series of testimonies from representatives of patient organizations to mark the 40th anniversary of the discovery of HIV.
We need to take inspiration from people like Françoise Barré-Sinoussi [a retrovirologist, laureate of the Nobel Prize in Physiology or Medicine and President of the French HIV/AIDS charity Sidaction] and never forget that innovation means nothing if it is not accessible to those who need it.
Pauline LondeixFormer Vice-President of Act Up-Paris and co-founder of OTMeds
What has changed over the past 40 years for people living with HIV?
Pauline Londeix: Everything has changed. When HIV was discovered, of course there was no treatment and it was virtually impossible to get tested. In 1996, the first treatments were introduced to keep patients alive, and now treatments are much less "toxic" for the body than the first antiretroviral therapies. That has vastly improved the quality of life of people living with HIV.
Since 2021, new injectable treatments, which are taken every two months, have even become available. So we have seen a gradual change in the types of treatment used, and continued improvements in the quality of life of people living with HIV.
What have been the milestones over the past decades?
P. L.: There have been two major milestones. The first was in 1996 with the introduction of highly-active antiretroviral therapy in the Global North. That was when we realized that a combination of three drugs was effective in tackling the virus.
The second major event was in 2001-2002, with the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which provided low- and middle-income countries with access to treatment. The Global Fund finances treatment and prevention programs for people living in all the Global South countries.
You have brought along some photos. Can you tell us about them?
P. L.: These photos encapsulate the person of Françoise Barré-Sinoussi [a retrovirologist, laureate of the Nobel Prize in Physiology or Medicine and President of the French HIV/AIDS charity Sidaction] and her work since the discovery of the virus. The first photo was taken in Cape Town in 2009. Françoise was speaking at the closing plenary session of the International AIDS Society Conference, and South African activists had asked her to wear their T-shirt with the slogan "HIV positive." She wore this red T-shirt, and she said the words "HIV is not in recession," to show that the global financial crisis must not stop the fight against HIV.
This other photo shows Françoise surrounded by people living with HIV in South and South-East Asia. For me the photo symbolizes the fact that Françoise has always been determined to connect outstanding science with access to treatment – she firmly believes that science means nothing if the fruit of science is not accessible to the people who need it. That is what really touched me in all my interactions with her.
The last two photos were taken at the International AIDS Conference in Melbourne in 2014. From 2010 onwards, I began having discussions with Françoise about hepatitis C, because it was increasingly becoming the leading cause of death for people living with HIV. The problem was that the existing treatment was extremely toxic, and the success rate was less than 50%. So we were eagerly awaiting new treatments, which began to arrive in 2013-2014 and which we wanted to make accessible to everyone. Françoise wanted me to come to Melbourne to try to shed some light on the strategies of pharmaceutical companies towards these new treatments and to come up with other strategies that would make the generic drugs accessible to a large part of the planet.
What message would you like to share with scientists and society at large?
P. L.: We need to take inspiration from people like Françoise Barré-Sinoussi and never forget that innovation means nothing if it is not accessible to those who need it. The international community today has the means to guarantee the fundamental right to health, and that right must be upheld everywhere in the world – we must never lose sight of it when we pursue policies or research in Global North or Global South countries.