FRANK TALK FROM JULIO MONTANER

FROM IAS 2015 BOB LEAHY SPEAKS (AGAIN) WITH BC’S DR. JULIO MONTANER, THE WORLD’S LEADING TREATMENT AS PREVENTION ADVOCATE, ABOUT 90-90-90, HIS FRUSTRATIONS WITH UPTAKE IN CANADA – AND MEETING THE POPE.

He’s co-chair of IAS 2015, a conference of its time notable not so much for its presentation of the latest science but for what seems like a collective determination to stop talking, move forward and IMPLEMENT what we’ve been debating for years. Which suits Julio Montaner, head of the B.C. Centre for Excellence, just fine.

“There is no discussion anymore” he says, “the science is in. IAS 2015 will finally compile a body of irrefutable evidence to make treatment as prevention the global standard of care.” He issues a bold challenge. “Political leaders of the world, you are with us or against us”.

That kind of talk is one of the things that sets this man apart. For Montaner, besides being remarkably outspoken, operates not just on the provincial stage but on the world one. He rubs shoulders with UNAIDS and WHO top brass, knows countless diplomats by name, banters with the worlds AIDS czars. If he is a maverick he is a successful one, whose policies, once considered controversial and still often outwardly rejected in Canada outside his home province, have been adopted throughout the world.

He’s one of the architects of 90-90-90 too. It’s a UNAIDS target that has gained traction in many countries but has yet to be embraced in Canada, either federally or provincially, except by B.C. But now it looks a lot like his detractors are out of step with the global response. Thus Canada as a whole performs in a lacklustre fashion, occupying middle ground in the new world order, lagging behind resource-poor countries by almost any HIV measure of performance you can think of. In fact in efforts to reduce population viral load countries like Botswana, Rwanda and Malawi are doing better than Canada in providing better treatment cascade measurements.

Acknowledged over and over this week at IAS 2015 in Vancouver by presenters from around the world though is that BC leads the way. Free HIV meds back up offers of treatment immediately on diagnosis. Innovative harm reduction strategies seen nowhere else in North America. More universal HIV testing than anywhere else. Target driven strategies. Advocacy on both the local and global stages. Much of all this is unmistakably Montaner-driven.

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