Santiago Moreno is the head of the infectious illnesses department at the Ramón y Cajal hospital in Madrid and one of the coordinators of the Aids research network in Spain. In his opinion, Aids research has probably resulted in one of the most spectacular advances in modern medicine, turning a fatal illness into a chronic one. However, this good news also comes with a risk, he says.
"This progress has made people think there is nothing to worry about now, because we have done everything. The reality is very different; far from being controlled, the epidemic is still expanding," he says.
This expert in epidemiology says he is afraid that society and, above all, "the institutions and people who are responsible for ending this" will relax their guard and stop making efforts. In Spain 3,500 new cases are diagnosed every year (about ten a day) which shows, he says, that "the epidemic is out there and it is not under control". It is also calculated that around 18 per cent of patients are not aware that they are infected.
"One of the greatest innovations we need to introduce is for everybody to have an HIV test. It is a good idea because if you're negative you have nothing to worry about, and if you are positive they can give you a treatment which means it is as if your illness doesn't exist, and your life, including your sexual life, can carry on as normal," says Dr Moreno.
In the clinical field, the innovations have been well catalogued: discovering the causal agent, the first retroviral medication, the introduction of a triple treatment and later just taking a single pill.
The antiretroviral treatment has reached excellent levels of effectiveness, tolerance and low toxicity. "It's not easy to improve on treatment," warns Santiago Moreno. However, instead of one tablet a day the patients will be able to have injections every two, three or six months or even once a year. Dr Moreno explains that at a scientific level there have been spectacular advances in research and immunology, but work is still needed on other aspects. Although Aids is not as feared now as it was, "people with it are still stigmatised," he says, even when they are undergoing treatment and are no longer infectious.