2011 World AIDS Day Editorial Packet

Contact: Blair Hinderliter

Email: [email protected]

Ending AIDS is Possible

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As the world prepares to commemorate the 24th annual World AIDS Day, 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 questions 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 boldly act on it, to end AIDS.

AIDS Treatment is Prevention

In May 2011, researchers announced the results of a breakthrough study, HPTN 052, that proved conclusively what AIDS researchers had long suspected: treating HIV-positive people with anti-retroviral therapy (ART) 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 not only reduces transmission of HIV, it can also protect HIV-positive people from opportunistic infections like TB. The study found that 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 of the study for the future of HIV/AIDS and TB are momentous. We now know that treatment is prevention. Combined with other proven HIV prevention strategies like circumcision, microbicides, and others, and scaled up TB-HIVefforts, we can turn the tide on the pandemic.

This evidence, combined with recent economic modeling by the U.S. Centers for Disease Control and Prevention, shows that investing more in AIDS treatment and prevention now will not only reduce deaths but will also reduce the cost of the AIDS response in the long run, shows that we can end AIDS if we have the political will.

Promising Signals

On November 8, 2011, U.S. Secretary of State Hillary Clinton gave a speech announcing the new U.S. policy priority of creating an “AIDS-Free Generation” saying,

Our efforts have helped set the stage for the historic opportunity the world has today: to change the course of this pandemic and usher in an AIDS-free generation.

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.

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.

Will Evidence be Translated into Action?

On November 10, 2011, Michael Gerson, former advisor and speechwriter for President George W. Bush, highlighted the opportunity to now end AIDS, and also the need for U.S. leadership, in a Washington Post op-ed,

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...

Ending the global AIDS epidemic would require a major presidential push. It would also require congressional Republicans to make a human life exception to austerity...Having abruptly gained the scientific tools to defeat this epidemic, what remains is a test of will and conscience.

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.

For fiscal year 2012, the US House of Representatives has proposed cuts to global health funding overall that would severely impact AIDS funding, and the fight against TB and malaria, as well, not just impeding progress but reversing it.

World AIDS Day is December 1, and it is a critical moment for bold, concrete steps by the White House, including expanded AIDS treatment targets, and a renewed commitment by the administration and Congress to fully funding the Global Fund to Fight AIDS TB and Malaria and PEPFAR, the U.S. bilateral AIDS initiative. In Secretary Clinton’s speech, she lauded the Global Fund, saying, “Consider just one example of what the Global Fund has already done. In 2004, virtually none of the people in Malawi who were eligible to receive anti-retroviral treatment actually received it. As of last year, with significant help from the Global Fund, nearly half did. This kind of progress deserves our support.”

What also makes this World AIDS Day so significant is that it will kick off the run-up to the 2012 International AIDS Conference (AIDS 2012) to be held in Washington, DC next July. AIDS 2012 will attract tens of thousands of AIDS researchers, clinicians, activists, and people living with the disease. Historically, this biannual conference has served as a key forum to generate global political momentum in the fight against HIV/AIDS. Next year’s conference comes with new, hopeful research and a shot at an endgame for AIDS. With thousands of journalists reporting and the entire world watching, AIDS 2012 will provide exactly the kind of venue needed to rally the world around ending AIDS. The eyes of the world will be on Washington, DC and the big question is, will President Obama seize the moment and take bold leadership to end AIDS?

First Steps

The U.S. has led the way in scaling up treatment so that today 6.6 million people are on AIDS treatment, and its top infectious disease expert, Dr. Tony Fauci of the National Institutes of Health, recently wrote, “for the first time in the history of HIV/AIDS, controlling and ending the pandemic are feasible; however, a truly global commitment, including investments by those in rich and middle-income countries whose contributions have thus far been limited, is essential. Major investments in implementation now will save even greater expenditures in the future; and in the meantime, countless lives can be saved.”  
President Obama can be the president to begin ending AIDS. To do so, he should commit to treat an additional two million HIV-positive people, bringing the total number supported by U.S. treatment to six million by 2013; made totally feasible not only by the treatment platform already created, but also by the falling cost of that treatment.

To fully address the crisis of tuberculosis among people who are HIV positive, he should also expand access to TB services, including TB screening, and set a goal of reducing TB deaths among people who are HIV positive by 80 percent—as modeling by the Stop TB Partnership has shown is fully possible, and a huge bargain for its impact.

And he should call on other donor and developing nations to heed the research and step up their treatment targets and investments so that all those in need of treatment have access to it. The President’s 2013 budget must reflect these priorities, including fully funding the Global Fund to Fight AIDS, TB and Malaria and PEPFAR, in order to make scale-up possible.

In the crucial FY 2012 budget negotiations happening right now, the House must reverse cuts that will cost lives, and provide the Global Fund to Fight AIDS, Tuberculosis and Malaria and PEPFAR urgently needed funding. 

The world turned away and ignored science when the AIDS crisis first emerged — we must not fail to end it when the solutions are now in our grasp.

Ending AIDS is the “go to the moon” moment for President Obama and global leaders. History will judge them and find either that they embraced science and the enormous moral imperative it illuminates for us, or that they turned away while millions more died.