Back grey_arrow_rt.gif
 
 
Hillary Clinton Calls For AIDS-free Generation
 
 
  'ending mother-to-child transmission, expanding voluntary medical male circumcision, and scaling up treatment for people living with HIV/AIDS.....The goal of an AIDS-free generation may be ambitious, but it is possible'

In a speech on Tuesday at the National Institutes of Health, Secretary of State Hillary Clinton called for countries to work together to establish "an AIDS-free generation," meaning virtually no children are born HIV positive, they would have a far lower risk of HIV infection when they become teenagers than they do at present, and where people who become infected with HIV are prevented from developing AIDS and from spreading the virus.

"our efforts have helped set the stage for a historic opportunity, one that the world has today: to change the course of this pandemic and usher in an AIDS-free generation.....

.....virtually no children are born with the virus; second, as these children become teenagers and adults, they are at far lower risk of becoming infected than they would be today thanks to a wide range of prevention tools; and third, if they do acquire HIV, they have access to treatment that helps prevent them from developing AIDS and passing the virus on to others.....it 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.....

.....Just as doctors talk about combination treatment - prescribing more than one drug at a time - we all must step up our use of combination prevention......America's combination prevention strategy focuses on a set of interventions that have been proven most effective - ending mother-to-child transmission, expanding voluntary medical male circumcision, and scaling up treatment for people living with HIV/AIDS......

.....to make a big dent in this pandemic, we don't need to be able to identify and treat everyone as soon as they are HIV-positive.....

......Now let me be clear: None of the interventions I've described can create an AIDS-free generation by itself. But used in combination with each other and with other powerful prevention methods, they do present an extraordinary opportunity......

......Mathematical models show that scaling up combination prevention to realistic levels in high-prevalence countries would drive down the worldwide rate of new infections by at least 40 to 60 percent. That's on top of the 25 percent drop we've already seen in the past decade......

......We recently granted more than $50 million to three of the world's leading academic institutions to develop rigorous studies that test what works in various settings. Today, I'm pleased to announce that we're stepping up our efforts. The United States, through PEPFAR, will commit an additional $60 million to rapidly scale up combination prevention in parts of four countries in Sub-Saharan Africa and to rigorously measure the impact......

......The second step is to put more emphasis on country ownership of HIV/AIDS programs. This is a priority for the United States.......So we are working with ministries of health and local organizations to strengthen their health systems so they can take on an even broader range of health problems. Country ownership also means that more partner countries need to share more responsibility for funding the fight against HIV/AIDS within their borders......

......we're calling on other donor nations to do their part, including by supporting and strengthening the Global Fund.....The Fund is conducting a number of audits and investigations that have surfaced reports of fraud and corruption. It is the Fund's responsibility to root out these abuses and end them as quickly as possible...."

----------------------------------------

An AIDS-Free Generation
Posted on Thursday, November 10, 2011
by Isobel Coleman, Council on Foreign Relations

In a speech on Tuesday at the National Institutes of Health, Secretary of State Hillary Clinton called for countries to work together to establish "an AIDS-free generation," meaning virtually no children are born HIV positive, they would have a far lower risk of HIV infection when they become teenagers than they do at present, and where people who become infected with HIV are prevented from developing AIDS and from spreading the virus. These ambitious objectives seemed impossible not long ago, but recent scientific advances make the notion of an AIDS-free generation conceivable. In the speech, Secretary Clinton proposed three main HIV/AIDS interventions, all based on successful clinical trials: voluntary medical circumcision for men, drug treatment for infected pregnant women to prevent HIV transmission to the infant, and antiretroviral drugs for recently infected patients to reduce the risk that their sexual partners will contract HIV from them. Nevertheless, although the vision of an AIDS-free generation is tremendously exciting, generating sufficient funding for AIDS treatment and prevention remains a daunting task. At present, worldwide AIDS spending is about $16 billion each year. Even if only half of the 34 million infected individuals receive drug treatment by 2015, that would require worldwide AIDS spending to grow to $23 billion. Given the current state of the global economy, the challenges of increasing government contributions loom large.

Reductions in the per capita cost of treating and preventing AIDS stand to mitigate some of the economic obstacles to achieving an AIDS-free generation. As Secretary Clinton explained, it cost about $1,100 to provide antiretroviral treatment to an individual in 2004, but only $335 in 2010. Reasons for this cost reduction include "a shift to generic drugs, reaping the benefits of initial investments in health systems, and supply chain efficiencies." The potential for new economies of scale in increasing the size of AIDS treatment and prevention efforts also seems significant. Of course, innovation rarely occurs without unintended consequences and complications. Last month, I wrote about a Lancet study that suggested that women who use long-lasting hormonal contraception are twice as likely to become infected with HIV, as were the male partners of HIV-positive women using long-lasting hormonal contraception. If this finding is accurate, the implications for HIV prevention in sub-Saharan African countries are grave: nearly 12 million women in the region rely on hormonal contraception. At present, the efforts to verify or reject the Lancet findings continue. A recent statement from the World Health Organization notes that "the weight of evidence" suggests that hormonal contraception does not increase the rate of HIV acquisition, transmission, or disease progression among the general population. Nevertheless, the organization intends to re-examine the relationship between hormonal contraception and HIV beginning in January 2012.

The economic, and scientific obstacles to an AIDS-free generation are clear. However, if various stakeholders rally behind this laudable goal, they could rewrite the previously bleak economic futures of communities devastated by AIDS around the world, but particularly in Africa. According to the October 2011 PLoS ONE article referenced in the Clinton speech, a $14.2 billion investment in antiretroviral treatment for 2011-2020 is predicted to "return $12 to $34 billion through increased labor productivity, averted orphan care, and deferred medical treatment for opportunistic infections and end-of-life care." This potential for economic growth marks a radical departure from past economic conditions that Secretary Clinton described, in which the only growth industry in some AIDS-ravaged communities is the funeral business.

 
 
 
  icon paper stack View Older Articles   Back to Top   www.natap.org