An AIDS-Free Generation in Reach

Posted by Sharon Hrynkow
December 2, 2011
Dr. Hrynkow Participates in Discussion in Commeroration of World AIDS Day 2011

Yesterday, the global community marked World AIDS Day, a time to reflect on the scope of the pandemic, progress made in tackling HIV/AIDS, and ways forward to ending the pandemic once and for all. I was honored to be asked by Ambassador Susan Rice and the U.S. Mission to the United Nations to lead a panel discussion on AIDS to mark World AIDS Day. Having helped forge the first U.S. International AIDS Strategy for the Department of State in 1995, and having worked for many years to build capacity in science on AIDS in poorer nations, this was both a personal opportunity to reflect on gains made as well as a critical moment for diplomats, scientists and activists to come together to take stock of ways forward.

Our panel provided much cause for optimism -- as well as a dose of reality. Picking up on both President Obama's reaffirmation of the U.S. government's commitment to combating AIDS, as he discussed during a morning Town Hall event and Secretary Clinton's recent call for an AIDS-free generation, the discussion was lively. Ambassador Charles Thembani Ntwaagae of Botswana called for prevention of HIV to be the centerpiece of the action agenda on AIDS. Botswana showed early political commitment to tackling AIDS, resulting today in stark declines in new infections, particularly in newborns. Recognizing the overarching impacts of HIV/AIDS on every aspect of society, Botswana's national plan, Vision2016, integrates action against AIDS as a central feature. Ambassador Ntwaagae expressed his personal optimism for Botswana reaching its goal for an AIDS-free generation, noting his government's strong commitment and taking into account strong international support.

Mr. John Monahan from the Department of State's Office of Global AIDS Coordinator and Dr. Austin Demby of the Department of Health and Human Services' Office of Global Affairs described progress and aspirations for the President's Emergency Plan for AIDS Relief (PEPFAR). In 2011 alone, PEPFAR supported lifesaving antiretroviral treatment for nearly 4 million people, laying the foundation for President Obama's announcement of a new goal of 6 million people on treatment by 2013. Again for 2011, close to 10 million pregnant women have received HIV testing and counseling, and antiretroviral prophylaxis was provided to more than 600,000 pregnant women. Results are encouraging: more than 200,000 infants were born HIV-free due to these interventions. And, in 2011, more than 13 million people received care and support, including 4.1 million orphans and vulnerable children.

Part of PEPFAR's success has been due to being able to drive down the costs of treatment from $1,100 per year to $335, by working more efficiently to transport and deliver drugs and to work with manufacturers on cost issues. Working more efficiently will be a priority for future efforts. Mr. Monahan echoed President Obama's commitment to continued funding for PEPFAR and for its multilateral partner, the Global Fund to Fight AIDS, tuberculosis, and malaria. He called on other nations to meet their pledges to the Global Fund, noting the Administration's reaffirmation of the multi-year U.S. pledge, and he urged new partners to join in support of the Fund. To tackle AIDS most effectively, every nation must view the challenge as one of shared responsibility.

Dr. Demby described the range of prevention strategies, some new, some not so new, that PEPFAR is implementing and that, taken together, can be as effective as many vaccines are. A scientific study this year showed that provision of AIDS drugs to an HIV-infected individual dramatically reduced spread of the virus to his or her partner. Another recent study showed the ability of voluntary medical male circumcision to prevent HIV transmission, and the ability of antiretroviral drugs to prevent mother-to-child transmission of HIV has long been established. Dr. R.J. Simonds, Vice President of Program Innovation and Policy at the Elizabeth Glaser Pediatric AIDS Foundation, called for an end to pediatric AIDS. He and others expressed optimism in reaching this goal, in part because the tools at hand are so effective. Providing AIDS drugs to a pregnant mother reduces viral load, thereby diminishing the chance of virus crossing the placenta to infect the fetus. At the same time, AIDS drugs cross the placenta and protect the baby during the period of greatest chance for infection during labor and delivery. We have known that this strategy works for years. What we need, he argued, is more drugs, more access by women to health clinics, and more trained health care professionals to provide the drugs. All of this is doable with appropriate funding and political will.

Dr. Susan Kasedde, responsible for HIV Prevention programs for adolescents for the United Nations Children's Fund, reminded us about the need to reach youth with messaging in their own style. UNICEF has for many years hosted an online global dialogue for youth, who early on opted to converse with peers about AIDS. Today, UNICEF works with diverse media outlets, including MTV, to reach youth with appropriate HIV messages. Among the most successful programs are those which support TV dramas about youth coping with HIV infection within their own group of friends.

My own remarks focused on the need to consider the social determinants of HIV-infection, including the lower social status of women in most countries, placing them at risk for infection. And, I reminded the group that while we have great cause for optimism, there remain 34 million HIV-infected persons worldwide, and 2.6 million new infections annually. Much work remains.

Many countries now face a double burden of disease, both infectious and non-infectious. As we continue to tackle AIDS with full force, we must at the same time be mindful of how our strengthened health systems being put in place to support AIDS and other infectious disease programs might be used to address the growing global burden of chronic disease.



Reverend C.
December 2, 2011

Rev. Likami C. in Kenya writes:

God bless America!

I am teaching the youth of my village how to have safe sex and follow the word of the lord. One must not only find medical solutions, but also try to educate these people.

Reverend Likami

Congo, Democratic Republic of the
December 7, 2011

Kongolo M. in the Democratic Republic of the Congo (DRC) writes:





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