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.”
Programs, Funding & Financing
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.
“The number of people needing food aid in Zimbabwe will rise by 60 percent this year to 1.6 million, the World Food Programme [WFP] said on Friday, citing an annual assessment carried out by the United Nations and the Zimbabwean government,” Reuters reports (7/27). “The deteriorating food situation, said the WFP, was caused by erratic rainfall and dry spells, limited access to agricultural inputs such as seeds and fertilizer, a reduction in the planted hectarage, poor farming practices and inadequate crop diversification,” VOA News writes (Dube/Zulu, 7/27). “The WFP said its $119 million (97 million euro) aid program, meant to run through to March next year, is facing a $87 million shortfall,” according to Agence France-Presse (7/27). The agency said it plans to import cereals from surrounding countries and provide cash transfers to affected populations to allow them to purchase food, Reuters notes (7/27).
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).
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).