The International AIDS Conference was held last week in Washington, D.C. This was the first time the conference was hosted by an American city in more than 20 years, a nod to President Obama’s 2009 lifting of the ban on people living with HIV from entering the United States. Although there is way too much to cover in a post (if you’d like more, the Kaiser Family Foundation has great round-ups on their daily global health policy reports), I want to share a few updates on the HIV/AIDS epidemic and highlights from the conference.
Two abstracts presented at AIDS 2012 and a third published last week hold out hope that we may be moving closer to a cure for HIV/AIDS. As the Washington Post reports, “None of these strategies are easy, proved, or ready for prime time,” nor are they a “cure in the usual sense,” but they are a step in the right direction. In one of the studies, two patients given stem cell transplants, like Timothy Brown (who is the only person believed to have been cured of HIV/AIDS), saw their virus killed off in a “graft vs. host disease” reaction. The second study involves patients who were given antiretroviral drugs weeks after infection, and the third, published in Nature this week, “shocks” latent HIV cells awake, which can then, in theory, be detected and killed. Although there have been many medical breakthroughs in the 30 years of the HIV/AIDS epidemic, this could be a turning point on a par with the development of antiretroviral drugs.
Although we’ve come a long way in combating stigma, marginalized groups are still at great risk for contracting the virus or not being able to access services. Sex workers and drug users are especially vulnerable. A new Human Rights Watch report details the treatment of suspected sex workers by law enforcement in four U.S. cities, including the confiscation of condoms by police. Many sex workers in Los Angeles, New York, San Francisco and Washington, D.C., do not carry condoms because it makes them more likely to be harassed by the police or to see their confiscated condoms entered into evidence against them in court by prosecutors. This is directly at odds with public health efforts — often city-supported — that include the distribution of 50 million condoms a year in the four cities.
Furthermore, Foreign Policy Blogger for human rights Allyn Gaestel provides an interesting perspective on the exclusion of sex workers and drug users from the IAS conference because the travel ban on these groups is still in place.
Executive Director of UNAIDS, Michel Sidibé, was (unsurprisingly) all over the news in the past week.
In the Huffington Post, Sidibé took a positive tone as he looked back on the past decade of the epidemic, pointing to the success of putting eight million people on treatment and dropping infection rates among children by 20 percent in many of the countries with the highest populations of mother-to-child transmission since 2009. He lauds the progress of 100,000 fewer infections per year for the past three years, but there were, it must be noted, more than five million people infected in 2009 and 2010 (new UNAIDS stats don’t come out until November).
In a post for Now More than Ever, an HIV and human rights activist group, he appropriately took on the role of a firebrand, calling on countries to lift punitive legislation against people living with HIV and vulnerable populations and to commit to ending gender-based violence and discrimination. He wrote:
It is outrageous that, in 2012, when we have everything we need to beat AIDS, we are still fighting prejudice, stigma, and exclusion—not just in homes and in the streets, but also in police stations and in courtrooms. 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.
Finally, in his remarks at AIDS 2012, Sidibé said he was “scared for the future of global solidarity” in an era of economic and political upheaval, despite the progress we’ve made towards universal access, prevention, and treatment. He also said, however, that “We are entering a new era in the AIDS response,” as we now have more people on ART than in need of treatment.
It can be difficult to gauge where we are in the HIV/AIDS epidemic. Each group takes a different stance depending on the need for funding, policy changes, and public support. It is a fact that there are still 34 million people living with HIV/AIDS and that not all of them are accessing or able to access treatment. People living with HIV and at risk of being infected are still discriminated against around the world by individuals, societies, and governments, and people, including infants, are still contracting the virus. We do not have a cure or a vaccine yet. And drugs are still too expensive or too scarce for every single person who needs them — not to mention those who may not qualify for antiretroviral therapy but could be on treatment for prevention. We have a massive funding shortfall for global HIV/AIDS programs, a gap that might reach US$7 billion by 2015, with no quick respite from the current recession on the horizon and a poisonous political atmosphere in the United States, the largest HIV/AIDS funder, that has slashed budgets and tied up financial support.
It’s hard to write repeatedly that we have much, much farther to go, but we do. Without strong commitments to fund and support prevention, treatment, and scientific research, we will not beat back the epidemic. Without societal and state changes towards acceptance and support for and behavior change by people living with HIV and at risk of contracting HIV, especially marginalized populations, we will see new infections continue. We all share responsibility, individual and collective — whether that means practicing safe sex or committing larger percentages of GDP to global health. The theme for AIDS 2012 was “turning the tide together,” and they have it right: With wide-ranging, shared action, we can see an end to HIV but only if we stand together.