The made-in-BC Treatment as Prevention strategy received breakthrough scientific recognition and political support in 2011, creating further momentum to implement this proven approach to combating HIV and AIDS in Canada and around the world.

Treatment as Prevention, pioneered by the BC Centre for Excellence in HIV/AIDS (BC-CfE) a decade ago, was recently named breakthrough of the year by Science magazine and a medical breakthrough for 2012 by Readers Digest. It was also recognized as one of the top-10 medical breakthroughs by Time magazine.

In addition, as 2011 drew to a close, US President Barack Obama and Secretary of State Hillary Clinton both endorsed Treatment as Prevention as a cornerstone strategy to fight HIV and AIDS at home and around the world.

“B.C. is exceedingly proud of its role in developing, implementing and proving the Treatment as Prevention strategy over the past decade, and we hope the advancements made and recognition received in 2011 will be a springboard to worldwide implementation,” said B.C. Health Minister Michael de Jong. “We are grateful for the contributions made to global health by the BC Centre for Excellence in HIV/AIDS at St. Paul’s Hospital and the B.C. scientists, researchers, doctors and other healthcare workers that have played key roles in implementing and advancing Treatment as Prevention.”

The Treatment as Prevention strategy involves widespread HIV testing and provision of anti-HIV drugs known as Highly Active Antiretroviral Therapy (HAART) to people with HIV. The BC-CfE, a program at St. Paul’s Hospital, has showed that the benefits of early HAART treatment for medically eligible HIV-positive individuals are twofold: it reduces the level of HIV in the blood to undetectable levels, improving the health of people with HIV, while also decreasing the level of HIV in sexual fluids to undetectable levels, reducing the likelihood of HIV transmission by more than 95 per cent.

Treatment as Prevention is recognized and supported internationally by organizations such as the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO). Additionally, China has implemented a national HIV/AIDS policy based on the BC-CfE's Treatment as Prevention strategy. Similar programs are currently under evaluation by local health authorities in San Francisco, the Bronx in New York, Washington, DC, and by the Clinton Health Initiative in Swaziland.

“Thirty years of leading-edge research in B.C. has helped transform HIV/AIDS from what was once a deadly epidemic into a chronic, manageable condition,” said Dianne Doyle, President and CEO of Providence Health Care (PHC). “As home to the BC-CfE, PHC’s St. Paul’s Hospital is very pleased that this home-grown approach has been recognized globally as the gold standard of HIV/AIDS treatment.”

The BC-CfE publicly introduced its work in Treatment as Prevention in 2006 during the International AIDS Society conference in Toronto, Canada. In 2010, the BC provincial government announced funding of $48 million over four years in a BC-CfE-led Treatment as Prevention pilot project called Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS). Mathematical modelling suggests that this pilot project in two regions—Vancouver and Prince George—could avert as many as 173 HIV infections in the first five years, representing approximately $65 million in avoided lifetime HIV treatment costs.

“Treatment as Prevention has revolutionized HIV patient care in the province of B.C., decreasing HIV/AIDS-related suffering and stemmed the spread of HIV/AIDS.” said Stephen Toope, President and Vice-Chancellor of the University of British Columbia (UBC) and BC-CfE partner. “An HIV diagnosis in B.C. is no longer a death sentence.”

Due to its implementation of Treatment as Prevention, B.C. is the only Canadian province seeing a consistent decline in new cases of HIV. The 2010 published results show a reduction of nearly 65 per cent in new HIV diagnoses in B.C. to 301 cases, down from the 850 cases diagnosed annually prior to 1996. In other Canadian provinces, HIV and AIDS have not declined or have actually increased, in some cases significantly.

Dr. Julio Montaner, Director, BC-CfE and Chair in AIDS Research at the University of British Columbia’s Faculty of Medicine, was named the co-winner of the 2011 Hope is a Vaccine award, awarded annually to individuals working in the international fight against HIV/AIDS. Dr. Montaner received the award in honour of his worldwide advocacy for Treatment as Prevention and his role as “a forceful advocate for expanded access to ARVs (antiretrovirals) as early as 2006.” He shared the honour with Dr. Myron Cohen, who was also recognized by Science magazine for his work on the HIV Prevention Trials Network (HPTN) 052 study.