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International Conference on HIV/AIDS and Substance Abuse
HOPE 2000 PRESIDENT'S MESSAGE

Dear Dr. Merchant,
            It gives me great pleasure to welcome you all, as President of Hope 2000, to this International Conference on Substance Abuse and AIDS/HIV Prevention and Control. It is indeed a great honor for me to address such a distingushed group of guests who have made pioneering contributions. This is the first time that such group of eminent contributors to these fields have gathered together under one roof in India, and I hope that the forum of discussion will lead to the creation of a more streamlined approach towards Substance Abuse and AIDS / HIV Prevention and Control.
            It is becoming increasingly evident that the genesis, onset, progress and intervention strategies required for both these problems - Substance Abuse and AIDS / HIV are characterised by differences typical of the Social, Economic, Cultural and Political milieu of different countries. It has thus become increasingly evident that any model of treatment that is implemented in a region must be contigent on these factors. In addition, a plethora of emerging trends and approaches from both the Western and Eastern Worlds demand a revisit of all existing approaches being utilised. It would indeed be foolish of any of us to ignore the advances being made in treatment not only by way of modern treatment methodologies but also by way of application of traditional ideas to these problems.
            It is disturbing that even in advanced countries like The United States, public school administrators are putting school children as young as 7 years old on to a cocktail of psychatric drugs like Ritalin, Dexadrin and Paxil, after classifying their behaviour as disruptive. Parents who try to take their children off these drugs are being pulled up for child abuse by protective services.
            On a more positive note, Scientists claim to have identified a drug which would potentially cure millions of people of addiction to drugs, alcohol and even gambling. Vigabatrin is marketed by pharmaceutical giant Aventis in more than 70 countries, including the UK, as a treatment for epilepsy. In animal studies it appears to have remarkable effects on addiction. Some addicts claim to have been cured in weeks after decades of dependency on cocaine and amphetamines.
            On the AIDS / HIV front, according to UNAIDS estimates, 33.6 million people are living with HIV infection, and 16,000 people become infected every day. Rates vary greatly by country and by area, with the most important distinction being whether the pattern of transmission is 'concentrated' or 'generalised'. Concentrated transmission is restricted mainly to high-risk groups. In time this progresses to generalised transmission, where the disease is spread more widely through the population, mainly by hetrosexual contact.
            Research continues into preventative vaccines. Possible lines of enquiry include:
  • Subunit Vaccines - Genetically engineered to include a part of the outer surface of HIV.
  • Recombinant Vector Vaccines - Uses a harmless live virus or bacteria which carries a part of the HIV gene to trigger an immune response.
  • DNA Vaccines - which introduce parts of HIV genes directly into the host bloodstream.
  • Live-attenuated Vaccines - which seem to work on monkeys, are currently thought too risky for humans, given HIV's capacity to mutate.
  • Virus-like Particle Vaccines - the most hopeful at this point, lookalikes which contain some of HIV's proteins.
            Huge advances have been made which aim at arresting or at least slowing down the progression from HIV-positive status to AIDS. Diagnosis of HIV/AIDS is no longer a death sentence. We are looking at indefinite survival rates as long as we can drive the virus down.
            On the other hand the relationship between HIV and other social ills afflicting third world societies, such as poverty and disease, particularly TB and STDs, is complex. The notion that simply defines the adequacy of national response to the issue of provision of anti-retroviral drugs is insensitive to North / South realities to say the least.
            The greatest stumbling block lies by way of the high cost of the drugs, poor health infrastructure and livelihood problems -"where there was not enough water to wash down the anti-retroviral pill". Critical to good health, irrespective of one's HIV status, are clean water and good nutrition.
            Treatment of opportunistic infections, like TB and pneumococcal infections, which are curable with relatively cheap interventions, should be simultaneous with highly active anti-retroviral therapy, or HAART. This plays a major role in the decline of mortality rates.
            The obstacles that face treatment methodologies in the third world are complex. TV remains a luxury for the masses and newspapers are a privilege. While aggressive education and advertising campaigns can get the message through in cities, countless languages, dialects, religions and cultures fragment the rural population beyond the reach of any publicity machine.Many traditional practices like widow inheritance and polygamy also fuel the disease.
            The doctor patient ratio is lop-sided and health facilities are underequipped, understaffed and underfunded. In the absence of a proper health infrastructure, traditional healers need to step in to fill the void.
            On behalf of The Drug Abuse Information Rehabilitation and Research centre, I thank all organisations that are associated with us to present hope 2000, including UNAIDS, United Nations Drug Control Program, National Aids Control Organisation and The Ministry of Health of The Government of India; our sponsors The Mukti Foundation, Bank of Baroda and Indian Oil and our supporters The Oil and Natural Gas Commission and Reliance Industries.
            It has been my endeavour that Hope 2000 be a forum for discussing all aspects of Substance Abuse and AIDS / HIV Problems. If all such information and ideas discussed at Hope 2000 percolate down to the grassroot level by way of an actionable model, I feel, hope 2000 will become a milestone in the history of HIV and Substance Abuse Prevention & Control in the world.
With this plea and request to all of you I would like to welcome you once again to Hope 2000.

Dr.Yusuf Merchant.
President, Hope 2000.

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President: Dr.Yusuf Merchant
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