Thursday, December 1, was World AIDS Day. Each year, people gather worldwide to remember those lost to or affected by HIV/AIDS and to raise awareness. It’s also a time to reflect on what’s been accomplished and what remains to be done, and the day serves as a time for politicians, celebrities, implementers, and activists to speak out. This year, thirty years from the official beginning of the epidemic, proved similar. As always, discussions about increasing financial support of HIV/AIDS programs were at the forefront of most speeches, articles, and press releases. For World AIDS Day, the UN released an ambitious set of goals to reach by 2015, which they acknowledge are “aspirational.” In this uncertain funding environment, fears of budget shortfalls, program closures, and stock-outs of vital anti-retroviral drugs are very real. AIDS-related deaths and new infections are on the decline, something that felt almost unimaginable just a decade or so ago. We are close to radically altering the course of the epidemic, but the global economic recession is putting progress at jeopardy.
The Atlantic put together a series of articles for World AIDS Day. Dr. Mitch Besser of mothers2mothers (disclosure: I used to work at m2m) focuses on prevention of mother-to-child transmission of HIV (PMTCT) efforts, highlighting UNAIDS’s Global Plan for elimination of MTCT by 2015 and the importance of US foreign aid programs. Other highlights at The Atlantic include discussions on new scientific developments, a snapshot of the HIV epidemic in the United States, and what it will take to achieve an HIV-free generation.
As per usual, Bono had a thing or two to say. Although his opinion piece for The New York Times was a bit slick (and tripped in the end on an image of flag planting, which was meant to parallel the moon landing but inadvertently and unfortunately evokes colonialist imagery) , there’s no denying what he has done to shape the fight against the epidemic. The piece recalls the frustration of the early years of ART, when drugs were available in high-income countries but not elsewhere. Bono also acknowledges the vital role the US played in funding efforts to curb the epidemic, listing the names of the politicians and other figures from both sides of the aisle who contributed to the government’s legacy on HIV/AIDS. He concludes with a shrewd argument about “smart power”–that the effects of US foreign aid efforts contribute to national security and global diplomacy.
US President Barack Obama spoke on Thursday and reiterated and expanded his commitment to fighting HIV/AIDS domestically and around the world.
He pointed to the declining rates of new infections and deaths around the world and the paradoxical steady rate of new infections in the US and the toll of the epidemic on minority populations in particular. President Obama, perhaps to counter activists’ claims that he has not done enough to address HIV/AIDS, pointed out his administration’s increased financial commitment to HIV/AIDS programs and the lifting of the travel ban against people living with HIV, which will allow the next International AIDS Conference to be held in the US for the first time ever. He underlined the need to implement the new US national HIV/AIDS strategy and pledged $15 million in additional funding for the Ryan White Program (which supports HIV clinics in the US) and $35 million extra for state ARV assistance programs. He also called on countries to fulfill their pledges to the ailing Global Fund and for countries who were once recipients of aid but are now able to create foreign assistance programs, such as China, to make pledges of their own. President Obama also announced two goals: to provide ARVs for 1.5 million pregnant women over the next two years for PMTCT and to get 6 million people on ART by 2013, which was greeted with hoots and wild applause. He ended with a request that Congress continue to work together, saying that the gains made under the last three presidencies show “that we can do big things when Republicans and Democrats put common humanity before politics. We need to carry that spirit forward.” President Obama’s remarks are heartening, and it’s good to see his administration re-focus on HIV/AIDS efforts. Julie Pace of the Associated Press reports, however, that PEPFAR will not see an increase in funding and that decreasing the cost of treatment and making current programs more efficient will be required steps to fund the the ambitious goals set out on Thursday.
I’d like to end with Susan Sontag’s definitive piece from 1986 called “The Way We Live Now,” which The New Yorker re-released this week. It’s a heartbreaking reminder of the earliest days of the epidemic and of how far we have come in the twenty-five years since it was published. Here’s to making even more progress, expanding commitments, and “getting to zero.”