AIDS 2014: A Week of Heartbreak, Hope, and Renewed Commitment

Posted by Deborah L. Birx
August 11, 2014
Delegates Participate in the 20th International AIDS Conference in Melbourne, Australia

The recently concluded 20th International AIDS Conference in Melbourne, Australia, convened advocates, activists, scientists, and clinicians to share reports on progress, breakthroughs, and best practices in controlling HIV/AIDS epidemic and, ultimately, achieving an AIDS-free generation.  The conference included thousands of delegates from more than 200 countries representing the medical, research, government and advocacy sectors, as well as from the communities most affected by HIV/AIDS, including children, young women, men who have sex with men, transgender people, sex workers, and people who inject drugs.

Although we each brought distinct viewpoints, experiences, and opinions to the table, throughout the conference there was broad agreement on the need to focus our effort on specific geographic areas and key affected populations that experience the highest numbers of new HIV infections.  We agree on, and are in basic alignment about, the need for comprehensive impact program assessments.  We also agree on the importance of getting viral load access into resource-limited settings. It is clear that the closer we bring services to individuals and communities most in need, the better and more sustainable the outcomes.

The new UNAIDS Gap report, released in advance of the conference, underscores the tremendous progress we have made together in combatting HIV/AIDS.  Worldwide, new HIV infections have fallen by 38 percent since 2001; AIDS-related deaths have declined by 35 percent since their peak in 2005; and nearly 13 million people had access to life-saving antiretroviral therapy (ART) at the end of 2013.  Given where we were a decade ago, this is nothing short of extraordinary.

Despite this unprecedented progress, a number of critical gaps remain.  For one, as the UNAIDS Gap report highlights, an estimated 19 million of the 35 million people living with HIV/AIDS globally do not know their HIV-positive status.  This lack of awareness not only impedes people living with HIV/AIDS from receiving the care and treatment they need, but also facilitates onward transmission of HIV.  We were also all struck, once again, by the staggering HIV burden that is borne by adolescent girls and young women in sub-Saharan Africa -- who account for one in four of all new HIV infections globally.

In session after session, we heard about the ongoing and devastating impact of stigma and discrimination in fueling the HIV/AIDS epidemic and inhibiting access to HIV services, particularly among key affected populations.  In communities where stigma and discrimination prevail, so does HIV; in contrast, when comprehensive HIV services are available to all who need them in a non-discriminatory manner, we win.  AIDS 2014 reinforced that we must redouble our effort to address this gap in all its complexities.

Another sizeable gap remains in getting tuberculosis patients tested for HIV and, if they are found to be HIV-positive, on ART.  We are all in agreement that 100 percent of TB-HIV co-infected patients should be on ART, but current data show that only 45 percent are on treatment.

In Melbourne, we collectively pledged to work together to close these gaps and ensure that our programs continually innovate for more effective and efficient outcomes.  Key to our success will be how well we harness and utilize the incredible amounts of data that are increasingly at our disposal.  These data enable us to drill down further, to identify gaps in service access, uptake, and retention on a community-by-community basis, and to design solutions that are tailored to local conditions.

Improving data collection and use has long been a hallmark of the U.S. President's Emergency Plan for AIDS Relief (PEFPAR). As part of our ongoing commitment to transparency and accountability, last week PEPFAR launched our new PEPFAR Dashboards. Anyone can now go online to PEPFAR.gov and access our Planned FundingProgram Impact, and Expenditure Analysis data that illustrate the profound impact of PEPFAR programs. Over the course of the next several months, additional PEPFAR planning budgets, results, and expenditure data, as well as other information and analyses will be available in this transparent and easily-accessible format.

One last note on the Melbourne meeting, as we have all been, the conference was deeply affected by the tragic loss of life on Malaysia Airlines Flight MH17, including the death of six of our global health colleagues who were en route to the meeting.  Throughout AIDS 2014, we honored the contributions and lives of these men and women who were taken from us so suddenly.  As a community, we rallied to affirm their lives and hopefully inspire a new generation of global health advocates, activists, scientists, and clinicians to dedicate their lives to saving others.

About the Author: Ambassador Deborah L. Birx, M.D., serves as U.S. Global AIDS Coordinator.

For more information about U.S. efforts to to help save the lives of those suffering from HIV/AIDS around the world, go to www.pepfar.gov and follow @PEPFAR on Twitter.

Editor's Note: This entry also appears on The Huffington Post.

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