Julio Montaner has garnered a slew of awards and honorary degrees from around the world as his quest to destroy HIV/AIDS gains traction with more political leaders. But shaking the Pope's hand last week and meeting with Vatican officials about starting up a massive pilot program using the treatment he developed might have been the greatest honour yet for the Vancouver-based doctor who was raised a Catholic in the pontiff's hometown of Buenos Aires.
"It's pretty amazing. I must say it was quite a touching moment," Dr. Montaner said this week from Geneva, where he is working with the United Nations on its global HIV/AIDS reduction plan. "My mother would be very pleased with me. You can't help it – no matter how old you are, your mother is always with you."
Dr. Montaner said he had a "brief and very pleasant" meeting with the Pope during a "greeting line" at the Vatican on March 11. He also spent several hours with the Catholic church's equivalent of a minister of health and a minister of justice, who plan to use his method, called treatment as prevention (TasP), in a pilot program that could involve 140,000 patients in Tanzania. The church, which claims more than a billion members, estimates its umbrella of Catholic organizations provide treatment to about a quarter of all HIV patients around the world through more than 5,000 hospitals and 9,000 orphanages.
"If one considers that health-care services in the poorest areas of the world are often in the hands of the denominational institutions, the fact they are actively interested and involved is extremely promising," Dr. Montaner said. "The Roman Catholic Church, with all its infrastructure and outreach, would be a fantastic addition to what we're trying to achieve."
The concept he introduced at the B.C. Centre for Excellence in HIV/AIDS, which has been adopted in several countries, includes diagnosing HIV early and treating it aggressively with a cocktail of three drugs to suppress the virus to the point that it is undetectable. This led to a breakthrough when researchers noticed a dramatic decrease in the rate at which the patients receiving the treatment spread the disease, even through unprotected sex.
The church's adoption of the TasP model could have "important implications for the expansion of this work around the world," Dr. Montaner said.
He said details are still being finalized, but the pilot in Tanzania would likely treat patients over several years.
Dr. Montaner said TasP is 100-per-cent effective, and rolling out a pilot program as big as the one the Vatican is planning would help experts learn "new tricks as to how to do it more efficiently, more expeditiously" and add to the research on administering treatment to a population much different than the injection drug users or prostitutes of Vancouver's Downtown Eastside.
The approach led B.C. to a 67-per-cent decline in new diagnoses and a drop of 87 per cent in AIDS-related deaths from 1997 to 2013, according to a report published by the HIV/AIDS centre last month. Meanwhile, patients on the antiretroviral drugs are now living nearly as long as the general population.
An estimated 35 million people have HIV/AIDS, and Dr. Montaner said the UN had met its millennium goal of treating 15 million people with antiretrovirals by this year. By 2020, the UN hopes to have 90 per cent of the world's HIV-infected peopled diagnosed, 90 per cent of those who know they are infected receiving treatment, and 90 per cent of those on antiretrovirals with levels of the virus in their bodies so low they cannot infect others.
Dr. Montaner said he and his team at the B.C. centre had "always felt that the TasP model would be something that would be very attractive to the Roman Catholic Church," but the Vatican under Pope Benedict XVI was not very receptive. He increased his efforts after the 2103 inauguration of the "incredibly refreshing" Pope Francis, whose public statements on structural poverty, LGBT issues and HIV/AIDS are "very much aligned" with the discourse surrounding TasP.
He said he eventually "triangulated" a meeting with the new Pope through contacts at the church aid agency Caritas Internationalis and old friends in Argentina who "have personal connections" with the pontiff.
"I used every sort of avenue that was open to me," he said.