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.”
Noting “President Barack Obama’s Feed the Future initiative seeks to end hunger through increasing investment in agricultural development, particularly for the vast legion of smallholder farmers in sub-Saharan Africa,” Roger Thurow, a senior fellow at the Chicago Council on Global Affairs, writes in a post in the ONE blog, “Central to this movement is that Feed the Future and U.S. leadership to end hunger through agricultural development become a cornerstone of American policy no matter who is in the White House or which party controls Congress.” He writes that PEPFAR “was embraced and authorized by Congress in an unusual display of bipartisan support,” and says, “Feed the Future is worthy of similar bipartisan support and unity of purpose. It can stand alongside PEPFAR as an example of what America does in the face of crisis and great need” (7/27).
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).
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).
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).
“What stands out in my mind from this week’s presentations [at the XIX International AIDS Conference (AIDS 2012)] is that [HIV] interventions previously proved to work in controlled clinical trials are now — over and over again — proving effective outside the research setting, in the real world, in poor and rich communities alike. The pieces are coming together,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, writes in a Washington Post opinion piece. He discusses several of the interventions, including the scale up of antiretroviral therapy (ART), treatment as prevention, voluntary medical male circumcision, and pre-exposure prophylaxis (PrEP). “Ending the HIV pandemic is an enormous and multifaceted challenge, but we know it is possible,” Fauci writes, adding that it will require “commitment” and “investments.” He continues, “We must enhance what works and eliminate what does not, overcome legal and political barriers, and remove the stigma associated with HIV.” Fauci concludes, “The global community has a historic opportunity based on solid scientific evidence to end the AIDS pandemic, opening the door to an AIDS-free generation” (7/26).
“We are at a critical moment in the response to HIV and AIDS. Progress has been made but it is not enough and will be lost if political will and financial commitments are reduced. When lives are treated like political chattel, the importance of faith communities is more important than ever to sustain an effective response to HIV,” Rev. Michael Schuenemeyer, the United Church of Christ executive for health and wholeness advocacy and executive director of the United Church of Christ HIV & AIDS Network, UCAN Inc., writes in the Washington Post’s “Guest Voices” blog. “Too many people hesitate to seek testing or treatment because of fear. That is why people of faith must continue breaking the silence in every way possible,” he says, adding, “We must ground ourselves in the value that every child is endowed by their creator with worth and dignity that human judgment cannot set aside.” Scheunemeyer continues, “Faith communities are called to deepen their theological reflection on human rights and dignity, particularly where HIV and AIDS is concerned. The door is open to people of faith to stand with all those who are living with or are vulnerable to HIV” (7/26).
As the XIX International AIDS Conference concludes in Washington, D.C., “[t]his is a moment for all Americans to be proud of the best thing George W. Bush did as president: launching an initiative to combat AIDS in Africa that has saved millions of lives,” Washington Post columnist Eugene Robinson states in an opinion piece in the newspaper. PEPFAR “deserves accolades,” he writes, adding that the Bush administration ignored dissenting opinions stating that treatment in Africa posed a risk because of potential drug resistance and was motivated “by altruism” to create the program. Robinson notes that the Obama administration has proposed shifting funds from PEPFAR to “complementary programs” and that officials say “that overall HIV/AIDS funding will rise to an all-time high.” He also notes that Obama ended restrictions on allowing visas for people living with HIV to enter the country during his first year in office. “But if Africa is gaining ground against AIDS, history will note that it was Bush, more than any other individual, who turned the tide. The man who called himself the Decider will be held accountable for a host of calamitous decisions. But for opening his heart to Africa, he deserves nothing but gratitude and praise,” Robinson concludes (7/26).
“It is outrageous that, in 2012, when we have everything we need to beat AIDS, we are still fighting prejudice, stigma, and exclusion,” UNAIDS Executive Director Michel Sidibe writes on the Human Rights and HIV/AIDS “Now More Than Ever” blog, adding, “It is my daily reminder that the AIDS response is not just about an epidemic; the AIDS response is, has been, and must be, an instrument to fight for social justice.” He concludes, “[O]ur common aspiration is clear: a world where no one gets infected with a preventable virus, no one dies of a treatable disease, and no one faces discrimination for a health condition. We have tools to stop HIV transmission, deaths and discrimination. Human rights demand that we deliver these tools to every community and person affected. By doing so, we help to transform societies into the inclusive places they should be” (7/25).
Simon Reid-Henry, a lecturer in the School of Geography at Queen Mary, University of London and a senior fellow at the Peace Research Institute, and Hans Lofgren, an associate professor in politics at Deakin University in Melbourne, write in the Guardian’s “Poverty Matters Blog” about “a triple-pronged attack on [India's] generic drug manufacturers by the west.” They discuss the European Union-India free trade agreement, currently being negotiated; an Indian supreme court case between Swiss pharmaceutical giant Novartis and the Indian government; and an “attempt by German pharmaceutical company Bayer to revoke the recent granting of a compulsory license for an Indian firm, Natco Pharma.” If the west is successful in any of these attempts, it “could delay the introduction of cheaper medicines in India and elsewhere at a time when the global financial crisis has already put the squeeze on life-saving medicines across the world,” they write (7/26).