Thirty years and 30 million funerals ago, AIDS was discovered.
So much has changed since 1981. In 30 short years, scientists have identified the virus, learned its behavior, discovered effective treatments, and are making progress toward an effective vaccine. Countless patients, relatives, and activists have powerfully demonstrated how the public voice can work to fund the demise of a disease.
Yet, numbers give shape to the daily enormity of this pandemic: 34 million living with HIV/AIDS (including 700,000 Americans), 2.7 million new infections last year, 16.6 million orphans.
Today is World AIDS Day. For the past 20 years, I and thousands of others have been lobbying our federal government to ensure that the story of AIDS is told, and is changed.
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Over those 20 years, we have made progress. The growth of the epidemic has slowed. When, five years ago, the cost of treatment was dramatically lowered to as little as $100 per year, I couldn’t keep quiet.
With the help of PEPFAR, President George W. Bush’s fund to treat AIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria, 6.6 million people are currently receiving treatment, and half of pregnant women with HIV get at least one drug to prevent passing the virus to their children.
While only 25 percent of those who need treatment are getting it, this represents enormous progress. I remember well when entire populations were written off a decade ago as too poor to treat.
But no progress from previous decades has matched the unprecedented opportunity of the discoveries of the past year. Three recent studies have shown results with such vast promise that they inspired “The Economist” magazine to publish a front-page story entitled, “The End of AIDS?”
Two of the studies demonstrate dramatic success in prevention: voluntary male circumcision reduces men’s risk of HIV infection by 60 percent, and a vaginal microbicide gel reduces women’s risk of HIV infection by 39 percent.
The third study, published just three months ago, is garnering the most excitement, though. Researchers discovered that early treatment of HIV reduced the risk of transmitting the virus to a partner by 96 percent. In other words, early treatment can nearly stop the transmission of the disease.
The implications of this study are momentous. We now know that treatment is prevention.
Combining these findings with other scientifically validated prevention methods such as condom use, needle exchange programs for injection drug users, and treatment of mothers to prevent transmission of the virus to their babies, gives us, for the first time, a well-grounded hope and excitement: The end of HIV/AIDS is in sight.
The timing of these findings is difficult: the economic crisis threatens global health on many fronts. For the first time in a decade, global funding for AIDS decreased in 2010. Yet with a relatively small investment – an additional $5 billion annually for the next several years (current spending is $16 billion) – we could prevent 12 million infections and 7.4 million AIDS-related deaths by 2020.
Further, modeling by UNAIDS has shown that this investment would cause the total costs of fighting AIDS to fall by the end of this decade.
Finally, even without expansion, we must recognize that we have assumed a moral obligation to those whom we helped start on treatment to not abandon them. Nurses and doctors are already being forced to choose who will receive newly-limited supplies of anti-retroviral drugs, and who will not, a “Sophie’s Choice” of our own making.
The challenge to Congress and the president is clear: to fulfill with our actions what science has shown us is possible. Fewer funerals is not only the right goal, it’s the smart goal.
Carolyn Prouty is a veterinarian, teacher, and volunteer working with RESULTS (www.results.org), a national grassroots lobby generating the political will to end hunger and the worst aspects of poverty. She can be reached at firstname.lastname@example.org.