This World AIDS Day, December 1, is one of the most heartening and encouraging times in the 30-year fight against AIDS. The U.S. top infectious disease expert, Dr. Tony Fauci of the National Institutes of Health, recently wrote that “for the ﬁrst time in the history of HIV/AIDS, controlling and ending the pandemic are feasible.”
In May 2011, researchers announced the results of a breakthrough study that proved conclusively that treating HIV-positive people with anti-retroviral therapy early in the disease cycle dramatically reduces transmission of the virus to uninfected partners. In fact, researchers found that when treatment was initiated early in the progression of the disease, as opposed to waiting for the patients to become sick, there was a 96 percent reduction in the risk of transmission. According to UNAIDS, expanding treatment and pairing it with other high impact interventions can avert more than seven million deaths and twelve million new infections by 2020.
Early AIDS treatment can also protect HIV-positive people from opportunistic infections like TB. Early AIDS treatment reduced the occurrence of TB infection by 84 percent. This is critical given that TB is the biggest killer of people with HIV. The implications are momentous: we now know that treatment is prevention. Combined with other proven HIV prevention strategies we can turn the tide on the pandemic. And investing more in AIDS treatment and prevention now will not only reduce deaths but also reduce the cost of the AIDS response in the long run. When so much time has passed with so many lives lost, now is not the time to slacken our political will and funding for global health but to press forward and claim the victory within our reach.
Just last month, Secretary of State Hillary Clinton boldly announced the new U.S. policy priority of creating an “AIDS-Free Generation” saying,
“By an AIDS-free generation, I mean one where, first, virtually no children are born with the virus; second, as these children become teenagers and adults, they are at far lower risk of becoming infected than they would be today, thanks to a wide range of prevention tools; and third, if they do acquire HIV, they have access to treatment that helps prevent them from developing AIDS and passing the virus on to others.
Investing more in AIDS treatment and prevention now will not only reduce deaths but also reduce the cost of the AIDS response in the long run.
“This is an ambitious goal, and I recognize that I am not the first person to envision it. But creating an AIDS-free generation has never been a policy priority for the United States government-until today.”
Beating the AIDS pandemic is truly an example of what Americans of all political colors can do when we work together to address a huge, complex, and long term issue. It was President George W. Bush who launched PEPFAR, the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003. PEPFAR works in many countries around the world, with particular emphasis on 15 countries in Africa, Asia, and the Caribbean. It is the largest international health initiative commitment in history dedicated to combating a single disease.
Also, since 2002, both Republican and Democratic administrations and Congress have funded the Global Fund to Fight AIDS, Tuberculosis, and Malaria, a partnership between governments, civil society, the private sector, and affected communities. It invests the world’s money to save lives and to date has committed US$ 22.4 billion in 150 countries to support large-scale prevention, treatment and care programs against the three diseases.
We all can share this victory in progress and the bold policy goal announced by Secretary Clinton. On November 10, 2011, Michael Gerson, former advisor and speechwriter for President Bush, highlighted the opportunity:
“After 30 years and 30 million funerals, the end of the global AIDS epidemic is suddenly, unexpectedly, within sight. It would be a final victory for this clever killer if America were too preoccupied and inward-looking to notice and act….”
In the fight against AIDS and TB, the moment for decisive action and investment is now, and there is also ground to regain. For the first time in a decade, global AIDS spending fell in 2010, and President Obama and the 112th Congress have presided over the first decrease in U.S. global AIDS spending.
World AIDS Day is a critical moment for a renewed commitment by the administration and Congress to fully funding the Global Fund and PEPFAR. We stand, for the first time, on the brink of ending this terrible pandemic. It is no longer a question of treatment vs. prevention. It is no longer a question of whether this is possible. It is a question of whether the world’s political leaders, beginning with President Obama and the U.S. Congress, will embrace the new science and act decisively to end AIDS.
Ann Beltran is a Falls Church resident.