AIDS: Hopes to eliminate disease by 2020

Much of the following article was published by the Integrated Regional Information Network (IRIN) on June 13.

The United Nations General Assembly Special Session on AIDS (UNGASS), which took place in New York June 8-10, concluded with the adoption of a declaration that by 2015 seeks to double the number of people on antiretroviral (ARV) treatment to 15 million, end mother-to-child transmission of HIV, halve tuberculosis-related deaths in people living with HIV, and increase preventive measures for the “most vulnerable populations.” UN Secretary General Ban Ki-moon called for a global commitment to eliminate AIDS by 2020. “That is our goal – zero new infections, zero stigma and zero AIDS-related deaths,” he said.

The three-day event, attended by heads of state, civil society groups, AIDS organizations and activists from more than 30 countries, coincided with the 30th anniversary of the discovery of AIDS and was dominated by discussions on the importance of increasing access to treatment.

“This Declaration is strong, the targets are time-bound and set a clear and workable roadmap, not only for the next five years, but beyond,” said Joseph Deiss, president of the General Assembly in a statement. “UN member states have recognized that HIV is one of the most formidable challenges of our time and have demonstrated true leadership through this Declaration in their commitments to work towards a world without AIDS.”

The money to achieve these aims is still a major issue, but the document is vague on where it will come from – about US$10 billion is spent each year, and UNAIDS says another $6 billion will be required. Countries agreed to increase AIDS-related spending to reach between $22 billion and $24 billion in low- and middle-income countries by 2015.

During his talk at a session to launch the global plan to eliminate new HIV infections in babies, former U.S. President Bill Clinton discussed the importance of coordination among governmental agencies and other bodies, and the overhead costs in assisting HIV-positive people. He noted that many UN conferences have failed to achieve the goals they set for themselves, but hoped this time would be different.

Some nongovernmental organizations participating in the debate are skeptical. They see barriers to the level of appropriations for HIV and AIDS-related programs, given the budget deficit debate in the U.S. and other countries. They are also concerned about the impact of trade agreements now being negotiated between, for example, the European Union and India, on access to generics medicines and to newer cheaper medicines by millions of people dependent on them for survival. Furthermore, opposition to women- and girl-centered responses to HIV and AIDS and to even discussing the impact of AIDS on sex workers and other highly vulnerable populations leaves gaping holes in any strategy to get the AIDS pandemic under control.

Others were more optimistic. In its June 18 issue, the highly respected medical journal The Lancet wrote, “Last week saw the conclusion of a landmark event in the recent history of AIDS. The two turning points took place in New York. The visible one was a high-level meeting on AIDS, which brought 3,000 participants to the UN to review progress in defeating an epidemic 30 years into its devastating course. Ambitious new targets were agreed. Countries committed themselves to, by 2015: halving sexual transmission of HIV; halving HIV transmission among people who inject drugs; ensuring that no child will be born with HIV; getting 15 million people onto treatment; and halving deaths from tuberculosis among people living with AIDS.

“But the invisible turning point was the realization that simply strengthening the vertical program that is AIDS has to end. The new opportunity is integration. As one senior UNAIDS scientist put it: AIDS is not an exceptional disease; it is an exceptional opportunity. Part of the reason for a change in strategy is a matter of brutal reality. Investment in AIDS is in decline relative to other spheres of global health. But the incredible success of the AIDS movement also means that it is in a strong position to embrace—warmly and generously—other sectors of global health. AIDS can be the engine that broadens a front to defeat the diseases of poverty.”

Faith in action:

Contact your member of Congress to urge the highest possible appropriations for the President’s Emergency Plan for AIDS Response (PEPFAR) and the Global Fund in FY 2012.