Some members of Congress “are advocating deep cuts to funding for domestic programs such as [the Ryan White CARE Act] and international programs such as the Global Fund [to Fight AIDS, Tuberculosis and Malaria] and PEPFAR,” but “[w]hat these critics fail to realize is that though we have won a multitude of battles, we are still losing the war in many communities,” Rep. Michael Honda (D-Calif.) writes in a U.S. News & World Report opinion piece. “We must continue to find innovative, targeted solutions in the fight against this dreaded disease,” he continues, adding, “There are many of us in Congress who recognize this important fact, chief among those are my dear friend Rep. Barbara Lee [D-Calif.], whose upcoming ‘Ending the HIV/AIDS Epidemic Act of 2012’ targets at-risk populations both domestically and internationally.” Honda concludes, “From legislative action on the federal level to grassroots efforts in state communities, we need to make targeting these communities a top priority in order to move forward. This requires advocacy, this requires commitment, and most importantly, it requires more investment” (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).
Noting “the total clinic-level cost of providing a year’s worth of antiretroviral drugs … ha[s] dropped” in some countries, Charles Kenny, a fellow at the Center for Global Development and the New America Foundation, discusses “disagreement over the effectiveness of the global AIDS response” in this Bloomberg Businessweek opinion piece. Kenny highlights a debate that took place last week on the sidelines of the XIX International AIDS Conference (AIDS 2012) that “focused on the question: should we use resources for antiretrovirals at a cost (including overhead) of perhaps $350 per patient per life year saved if we could use those resources to provide a course of drugs to cure victims of tuberculosis at a cost of $5 to $50 per life year, or of extending childhood immunizations at the cost of $2 to $20 per life year?” He writes, “Simply, millions of people are dying unnecessarily, for lack of $350 a year or less. It may be those who don’t get AIDS treatment, or those that don’t get other treatments because the available money is being used to buy antiretrovirals.” He continues, “If anything could open treasury accounts in the rich world to provide a larger flow of resources to global health, perhaps it is to get policymakers in those countries to think through these gut wrenching decisions that limited funding (and lack of funding flexibility) forces doctors and ministers and activists alike to make every day” (7/27).
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).
“The XIX International AIDS Conference [AIDS 2012] drew to a close Friday without the physical presence of President Obama but with a full cast of other high-profile U.S. politicians who expressed their commitment to ending the disease,” CQ HealthBeat reports (Norman, 7/27). The conference closed “with the message that getting treatment to more of the world’s 34 million people with HIV is key to curbing the epidemic, short of a vaccine and cure that still are years away,” the Associated Press adds (Neergaard, 7/27). “Presenters at AIDS 2012, from senior government officials and heads of international organizations to civil society leaders and scientists, all echoed that for the first time in the history of AIDS, an end to the epidemic is on the horizon,” an UNAIDS feature article writes, adding, “However, speakers cautioned that there are still numerous challenges that must be addressed before the international community reaches zero new HIV infections and zero AIDS-related deaths” (7/27).
The Closing Session will be webcast live from 3:15pm on Friday. Other webcasts will be made available throughout the day at http://www.kff.org/AIDS2012.
Plenary: HIV in the Larger Global Health Context
Official Press Conference – July 27
Looking to the Future in HIV and TB
Put Your Money Where the Future Is: The Cost of Treating Children
Closing Press Conference
Getting to Zero Excuses: Understanding and Addressing HIV-Related Stigma and Discrimination
Closing Session – Live Friday 3:15pm – 5:00pm
A Look Back: The 2012 International AIDS Conference