In her “Global Health Blog,” Guardian health editor Sarah Boseley notes that she spoke with USAID Administrator Rajiv Shah during last week’s XIX International AIDS Conference (AIDS 2012). She writes that though he “has a very clear vision of where USAID is going and what it hopes to achieve … [h]e appears to be a little concerned, however, that Europe may not keep pace — particularly on the finance but perhaps also on the approach.” She continues to say “Shah’s main anxiety is clearly … about the diminishing funding from European allies for the efforts to turn the tide of AIDS … but also about the financial commitment to global health generally.”
Global Health Conferences and Meetings
Lawrence Altman, former senior medical correspondent for the New York Times, writes in an opinion analysis in the newspaper that while there was much discussion about “ending the AIDS epidemic” and an “AIDS-free generation” at the XIX International AIDS Conference (AIDS 2012) last week in Washington, D.C., “[o]ne obstacle is a failure to clearly define the epidemic or what it means to have an AIDS-free generation.” He continues, “Definitions of terms like these may help determine how many billions of dollars the world devotes to the battle against AIDS and how many millions of lives will be extended. A failure to meet ill-defined goals could lead to public misunderstandings that limit investments and the number of people who have access to the lifesaving antiretroviral drugs in the future.”
Inter Press Service reports on HIV/AIDS in the Caribbean, a region with “the second highest incidence of HIV/AIDS after sub-Saharan Africa.” The news service highlights a report titled “Together We Will End AIDS,” released by UNAIDS ahead of the XIX International AIDS Conference (AIDS 2012) in Washington, D.C. last week, which “noted that AIDS-related deaths in the Caribbean have declined by almost 50 percent in 10 years.” The news service highlights progress made in various countries in the region and quotes a number of experts and officials who spoke at or before the conference.
GlobalPost’s “Global Pulse” blog examines questions surrounding the use of the antiretroviral Truvada for pre-exposure prophylaxis (PrEP) to reduce the risk of HIV infection among people at high risk, as studies released and panel discussions held last week at the XIX International AIDS Conference (AIDS 2012) “raised concerns about the drug’s effect on the future of the AIDS fight.” According to the blog, “Leaders in the fight against AIDS are trying to work through these issues and figure out the best way to make use of Truvada as prevention.” The blog notes that the WHO last week “released a set of guidelines for how to use PrEP in demonstration projects” and quotes AVAC Director Mitchell Warren, AIDS Healthcare Foundation President Michael Weinstein, amfAR Vice President and Director of Public Policy Chris Collins, and Black AIDS Institute President and CEO Phill Wilson (Judem, 7/27).
In this post in the Human Rights and HIV/AIDS “Now More Than Ever” blog, Michel Kazatchkine, the former executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria and newly-appointed special envoy to U.N. Secretary-General Ban Ki-moon for HIV/AIDS in Eastern Europe and Central Asia, examines why human rights are “so central to the AIDS response.” He writes, “An urgent mobilization is needed to respond to the epidemic in Eastern Europe and Central Asia, including much greater attention to, and involvement of marginalized and criminalized populations, particularly people who use drugs, sex workers, and gay men and other men who have sex with men,” adding, “As Special Envoy, I will continue to speak out loudly and clearly about the need to devote much greater attention to human rights. And I pledge to listen to the voices of those who too often are excluded” (7/26).
Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, published three new blog posts last week examining issues discussed at the XIX International AIDS Conference (AIDS 2012). The mood at the conference was “strangely optimistic,” as scientists, politicians, and advocates discussed the “end of AIDS,” she writes in one, adding, “The pandemic will not be over until the number of new infections hits zero, and the annual death toll plummets to insignificant levels.” In another, she states, “The newfound optimism that imbues this gathering of some 25,000 people in Washington, DC, is based on a few genuinely important breakthroughs. But while these insights offer hope of saving millions of lives and limiting a tidal wave of human suffering, they do not add up to the much-vaunted ‘end of AIDS.'” In a third, Garrett examines funding for the HIV/AIDS response and describes a debate that took place among experts and economists at the World Bank (7/27).
“Charged by Secretary of State Hillary Clinton with developing a blueprint for the next phase of the [U.S. government’s] involvement in the fight against HIV and AIDS, [U.S. Global AIDS Coordinator Ambassador Eric Goosby] … will lead an interagency effort to give clearer meaning to the term, ‘AIDS-free generation,’ and provide a basis for programming,” Sharon Stash, a senior fellow at the Center for Strategic & International Studies’ (CSIS) Global Health Policy Center, writes in the CSIS “Smart Global Health” blog. “Clearly the notion of an ‘AIDS-free generation’ within our reach is a powerful one,” she writes, and asks, “Is the meaning it inspires powerful enough to attract and keep the attention of national policymakers, already burdened with competing priorities in a tight economic environment?” (7/29).
Noting that “[t]he XIX International AIDS Conference [AIDS 2012] has just come to a close amid much talk of the beginning of the end of AIDS, turning the tide on HIV and even a potential cure,” Julio Montaner, former president of the International AIDS Society (IAS) and director of the B.C. Centre for Excellence in HIV/AIDS, writes in a Globe and Mail opinion piece, “It is now more certain than ever that we have the tools, medicines and expertise to stop this epidemic.” He continues, “However, without the political will to expand antiretroviral treatment to everyone in need, the audacious goals set before us in Washington last week will never be met and infection may spiral out of control once again.” He writes, “Politicians have paid little more than lip service to supporting the rollout of antiretroviral treatment in their home countries and around the globe,” and concludes, “Treatment as prevention represents the fundamental building block to achieve our goal. We must find the resolve to deliver on the promise of an ‘AIDS-free generation'” (7/30).
Highlighting the XIX International AIDS Conference (AIDS 2012), which concluded in Washington, D.C., on Friday, this New York Times editorial examines the future of the global AIDS response. “There is no prospect that scientists will any time soon find the ultimate solutions to the AIDS epidemic, namely a vaccine that would prevent infection with the AIDS virus or a ‘cure’ for people already infected with the virus,” the editorial states, adding, “Even so, health care leaders already have many tools that have been shown in rigorous trials to prevent transmission of the virus, making it feasible to talk of controlling the epidemic within the foreseeable future.” The editorial continues, “Instead of waiting for these future possibilities, [NIAID Director Anthony Fauci] and other health leaders are proposing the broad adoption of other available tools to reduce the spread of the virus so as to produce an ‘AIDS-free generation,’ a goal enunciated last year by Secretary of State Hillary Rodham Clinton.” The editorial adds, “The only question is whether the nations of the world are willing to put up enough money and make the effort to do it” (7/27).
GlobalPost correspondents John Donnelly and Charles Sennott interview USAID Administrator Rajiv Shah “about his perspectives on the AIDS fight,” in this entry in GlobalPost’s “Global Pulse” blog. They discuss U.S. Secretary of State Hillary Clinton’s announcement last week that the administration would put together a “blueprint” for achieving an “AIDS-free generation,” approaches to increasing demand for voluntary medical male circumcision in the developing world, and the closure of the Global Health Initiative office, among other topics, according to the interview transcript (7/27).