[Ed. Note — Contributor Michael Harney is writing to us from the International AIDS Conference in Melbourne, Australia. This is his fifth contribution from the conference this week. Follow other updates from Harney here.]

MELBOURNE, Australia – Scientists and community members have striven to make their points and find common ground on this last full day of the XX International AIDS Conference on Thursday.

The big story is that new and evolving hepatitis C (HCV) oral treatments such as Gilead Sciences’ Sovaldi (sofosbuvir), achieve unprecedented cure rates of the virus that is a major cause of liver cirrhosis and cancer and is estimated to have infected over 170 million people worldwide .

Sovaldi, with the most profitable roll-out in pharmaceutical history, reportedly has had sales of $3 billion since approved by the Food and Drug Administration (FDA) last October.

In the United States, an estimated 3-5 million people are living with HCV, many of whom will have difficulty accessing a drug whose wholesale price is $84,000 for a twelve week course of treatment.

Gregg Alton, Gilead’s Executive Vice President of Corporate and Medical Affairs disputed Sovaldi’s inaccessibility stating, ”70,000 people in the U.S. have already been successfully treated with it.”

“That’s a drop in the bucket,” commented a delegate who advocates for lower drug prices and more accessibility, noting that in a volume-sales model, Gilead and other companies whose products will soon reach the market will generate large profit margins as the millions who need treatment without delay and in years to come receive their medications.

Activists sat quietly until Mr. Alton came to the podium to make his case.  At that point, the O’Jay’s song “For the Love of Money” rang out, and sign-carrying protesters surrounded him with a variety of messages including: Pills Cost Pennies, Greed Costs Lives; Wanted (photo of Alton) for Crimes Against Access; and Hep C Criminal.  Other protesters fell to the floor in a “die-in.”

What advocates demand is that all pharmaceutical companies, even generic producers, find a way through obstacles of regulatory bureaucracy that force manufactuers to apply in many cases for product and patent licensing one country at a time.

Asking to remain anonymous, a pharmaceutical employee said he hopes the World Health Organization (WHO) can become involved as a liaison to international health ministries — especially in the middle income countries — connecting the interests of the pharmaceutical industry to the social interests of healthcare providers and society in general. Middle income countries are estimated to have 73 percent of all HCV cases worldwide, as remarked by Pauline Londeix of ACT-UP France, in her presentation today.

Egypt, with a disproportionate number of hepatitis C patients, is a major example of a middle-income country in need of reduced drug costs.  Earlier this year, the country reportedly negotiated a 99 percent discount on Sovaldi. But activists assert that the resulting $900 price is far too high compared to the estimated total manufacturing cost of $101. The difference is critical because so many more patients could be treated at the lower price.

An update on HIV vaccine research was part of the morning plenary session. Proof of concept was reported from journals like Science, Cell, and Nature, that broadly neutralizing antibodies (bNAbs) are a route to prevention, or even therapeutic control of the virus in already infected people.   Vectors, trimers, glycans, long-acting nanoparticles, and immunoprophylactics were potential vaccine elements presented to an audience that was a blend of scientists and society.  Innovative platforms for vaccines, and ”on-demand” products such as nanofilms, gels, and vaginal rings for use around time of intercourse, and even e-technology, are all components of the armamentarium emerging from clinical trials and investigations toward “the cure.”

Concluding the plenary presentations, Laurindo Garcia, creative activist and PLWHA (Person Living With HIV/AIDS) in the Philippines, came up with what he hopes scientists will bring to Durban, South Africa for the next International AIDS Conference in 2016; namely, an intolerance vaccine to be given at birth and to politicians and lawmakers to help them make inclusive policies for all; a violence condom to protect people from hate-related assault; and post-hate prophylaxis to be taken when verbal abuse comes from intolerant people — “Step Up The Pace” to eradicate hate, he said.

We have to find a way to share this space and place called Earth and take a stance for human rights for all people.

Follow the conference at aids2014.org

Michael Harney

Michael Harney is an educator with WNCAP (Western North Carolina AIDS Project), an HIV/AIDS advocate and supporter of Needle Exchange programs. He occasionally contributes his writings on various subjects...