An AIDS-free generation is possible if the world makes the most of proven preventive interventions, said US Secretary of State Hillary Clinton on 8 November at the National Institutes of Health (NIH) in Bethesda, Maryland.
Clinton announced that the US government will now commit an additional US$60 million to scale up combination prevention efforts in sub-Saharan Africa and “rigorously measure the impact.” The AIDS pandemic is most severe in sub-Saharan Africa, where 70% of AIDS-related deaths occur.
In 2010, the United States spent almost $7 billion in the fight against HIV/AIDS and associated diseases such as tuberculosis. The funding announced today will help researchers determine how well the combination prevention efforts work towards eliminating AIDS in different settings.
“Creating an AIDS-free generation has never been a policy priority for the United States government until today because this goal would have been unimaginable just a few years ago,” she said before an auditorium filled with members of the NIH community, HIV/AIDS advocates, domestic and foreign dignitaries and US government officials.
Building on the efforts of policy-makers and scientists in the United States, the world can “usher in an AIDS-free generation” by focusing on the combination of three proven strategies: ending mother-to-child transmission, expanding voluntary medical male circumcision, and scaling up treatment for people living with HIV/AIDS.
Mother-to-child transmission accounts for 1 in 7 new HIV infections. The transmission can be prevented with anti-retroviral therapies and safe birth and feeding practices. Last year, the President’s Emergency Plan for AIDS Relief (PEPFAR) helped prevent infection in some 114,000 babies, and PEPFAR and the United Nations Programme on HIV/AIDS (UNAIDS) have since launched a global plan to eliminate all new infections in children by 2015.
The US government founded PEPFAR in 2003 to fight global suffering from HIV/AIDS — the largest financial commitment by any government to fight a single disease.
PEPFAR has also had an active role in funding adult male circumcision, a low-cost procedure that reduces the risk of female-to-male transmission by more than 60%. Since 2007, PEPFAR has funded three-quarters of nearly one million adult male circumcisions for HIV prevention, said Clinton.
“An effective combination prevention strategy has to include voluntary medical male circumcision,” she said.
In addition to these two most cost-effective methods for preventing infection, Secretary Clinton also stressed the need to ramp up treatment of people who are already infected. “Thanks to US-government-funded research published few months ago, we now know if you treat a person living with HIV effectively, you reduce the risk of transmission to a partner by 96%,” she said.
She acknowledged that anti-retroviral therapies are expensive, but pointed out that the costs have declined substantially in the last few years. In 2004, the bill to PEPFAR for providing anti-retroviral therapy and services to one patient was $1,100 a year. Today, it is $335.
Scaling up treatments will significantly drive down new infections, said Clinton, an essential step towards changing the harsh fact that the number of people infected with HIV is still outpacing the number that can be treated.
“Instead of falling behind year after year, we will get ahead of the pandemic,” she said.
Creating an AIDS-free generation “is possible because of scientific advances largely funded by the United States and new practices put in place by this administration and our many partners,” Clinton said. “While the finish line is not yet in sight, we know we can get there, because now we know the route we need to take.”