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Leaders call for more research to achieve goal of AIDS-free generation
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From new antiretroviral drugs to new interventions, the treatment and prevention of HIV infection has made major headway against the disease and is paving the way to the end of the pandemic, according to the findings of several presentations made at the XIX International AIDS Conference.
“We are on scientifically solid ground when we say we can end the HIV/AIDS pandemic,” Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the NIH, said during the opening plenary session. “The end of AIDS will not be accomplished, however, without a major global commitment to make it happen. We have a historic opportunity — with science on our side — to make the achievement of an AIDS-free generation a reality.”
Fauci said there have been significant advances in both basic and clinical research for HIV/AIDS during the previous 3 decades, which have led to the development of almost 30 antiretroviral drugs. However, there are still challenges, such as more than almost half of those with HIV in low- and middle-income countries who need therapy are not receiving the necessary treatment.
“We know that retaining patients in a community-based HIV treatment setting is possible,” Fauci said. “An HIV treatment program in rural Rwanda retained 92% of its patients for 2 years, and nearly all of those patients who had viral load testing had minimal levels of virus after 2 years. We need to figure out how to make this work on a much broader scale and in different settings.”
AIDS-free generation
US Secretary of State Hillary Rodham Clinton also delivered remarks during the open plenary session and drew attention to the goal for an AIDS-free generation that she set just months ago.
Clinton defined an AIDS-free generation as a time when no child will be born with the virus, a time when children and teenagers will be at a significantly lower risk of ever becoming infected with the virus as they become adults and a time when those with HIV will have access to treatment that prevents them from developing AIDS and passing the virus on to others.
Washington D.C. Plenary Session Michel Sidibe, Executive Director of UNAIDS and Secretary of State Hillary Rodham Clinton and Françoise Barré-Sinoussi.
Photos courtesy of AIDS 2012 conference
The US government is involved in the effort toward achieving an AIDS-free generation, using a combination–prevention strategy that includes condoms, counseling and testing, and special emphases on three interventions: treatment as prevention, voluntary medical male circumcision and stopping the transmission of HIV from mothers to children.
For treatment as prevention, the United States has added funding for more than 600,000 people since September. Clinton announced that the US President’s Emergency Plan for AIDS Relief (PEPFAR) is providing $40 million to support South Africa’s plans to provide voluntary medical circumcision for nearly 500,000 boys and men in the coming year. In addition, the United States is investing $80 million to support initiatives to ensure that HIV-positive pregnant women get the treatment they need.
“Let there be no mistake, the United States is accelerating its work on all three of these fronts in the effort to create an AIDS-free generation and look at how all these elements come together to make a historic impact,” Clinton said.
Need for more research
Clinton said “science should guide our efforts” toward achieving an AIDS-free generation, adding that the United States is investing $15 million to research specific interventions for key populations, launching a $20 million challenge fund to support country-led plans to expand services for key populations. Finally, through the Robert Carr Civil Society Network Fund, $2 million is being invested to bolster the efforts of civil society groups to reach key populations.
According to Fauci, significant scientific challenges remain in HIV research, such as developing a vaccine and a cure. However, he said results from real-world settings strongly indicate that a global scale-up of existing and scientific evidence-based interventions could dramatically change the trajectory of the HIV/AIDS pandemic and ultimately lead to the end of AIDS.
“Ending the HIV/AIDS pandemic is an enormous and multifaceted challenge, but we now know it can be done,” Fauci said. “It will require continued basic and clinical research, and the development and testing of additional treatment and HIV prevention interventions and, importantly, implementing these interventions on a much wider scale.”
He said this requires a global commitment of countries, governments and communities to strengthen their health care systems and build the capacity to provide HIV treatment and prevention.
“This will require the continued investment of current donors and partners and the addition of new donor organizations and countries,” Fauci said. “Lastly, we must enhance what works and eliminate what does not, overcome legal and political barriers and remove the stigma associated with HIV.”