The Defense Department is commemorating World AIDS Day December 1 with a broad range of activities aimed at helping more than 70 partner militaries with their prevention, care and treatment programs.
“Leading with Science, Uniting for Action,” the theme of this year’s worldwide commemoration, describes how U.S. military members work hand in hand with militaries around the world to address the disease, said Matthew Brown, deputy director of the Defense Department’s HIV/AIDS Prevention Program.
The Naval Health Research Center in San Diego serves as DOD’s executive agent providing technical assistance, management and administrative support for the program.
DOD has provided partner militaries support, technical assistance and resources for their own programs since 2001. That effort expanded in 2003, Brown said, with the launch of the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR.
The five-year governmentwide program, managed by the State Department, proved so successful that it was extended in 2008 for another five years, through 2013, Brown reported. Meanwhile, its funding more than doubled, from $15 billion — the largest commitment any country had ever made to combat a single disease — to $38 billion for the second five-year period.
DOD’s role in the broader U.S. government program, conducted in cooperation with geographic combatant commanders and embassy defense attaches, enhances what Brown calls “health security cooperation.”
It’s critical to promoting security and stability, he said, because governments realize that the prevalence of AIDS weakens governments, militaries and economies.
“HIV tackles the youngest, most productive segment of the population, and it hobbles the society’s ability to function,” Brown said. “This is exactly true in the military, because the military draws from this same population that is most at risk for HIV.”
That recognition makes nations eager to become partners in the program. “They want to work with us on HIV because it is such a devastating problem,” Brown said. “They want assistance and they want collaboration with the U.S. government.”
Working with foreign militaries, predominantly in Africa but also in Central and South America, Central Asia and the Pacific, teams assigned to DOD’s HIV/AIDs Prevention Program focus on education and prevention.
They spend about 80 percent of their time on the road, meeting with their foreign military counterparts and providing technical assistance and support, Brown said.
The scope of the cooperation varies country by country, from periodic conferences and meetings to full-time representation on the ground.
But regardless of the size of the individual program, Brown said, partner nations benefit from new research and lessons the U.S. military has learned in identifying, treating and preventing HIV within its ranks.
“We are able to share 25 years’ worth of experience with HIV in the U.S. Department of Defense and in our services with the host country department of defense and their various services,” Brown said. “What we are trying to do is provide the learning curve.”
While progress continues in developing an HIV/AIDS vaccine, Brown said the most promising way to address the problem now is through education and treatment.
“We know exactly how it is transmitted, and we know how to prevent it,” he said. “And it is 100 percent preventable.”
Identifying people who are HIV-positive is an important first step. “The literature shows that if you are affected with HIV and don’t know, you are far more likely to transmit it,” often as much as fivefold, he said. “If you simply know that you are HIV-positive, your transmission risk goes down.”
Another effective prevention tool being promoted by many partner nations is male circumcision. Circumcised males are 30 percent less likely to transmit HIV than those who aren’t, Brown said. “In the absence of a vaccine, that’s the most effective prevention strategy we have, other than just knowing that you are infected,” he said.
Partner nations share state-of-the-art developments regarding HIV and AIDS during biennial conferences sponsored by the Defense Department’s HIV/AIDS Prevention Program. Mozambique will host the next one, scheduled for early May.
Meanwhile, the additional staff of the Naval Medical Center San Diego provides foreign military health-care providers training in HIV treatment being provided there.
Thanks to the PEPFAR program, that same level of treatment — which consists of daily medication and close medical monitoring — is now available to an additional 2.7 million people around the world. “The fact that we have free treatment available in these countries is just an amazing accomplishment,” Brown said.
An epidemiologist who has spent the past 11 years focused on HIV/AIDS prevention and care in Ivory Coast, Haiti, Beijing and Kazakhstan before arriving in San Diego two years ago, Brown said he’s excited about progress made and what’s ahead.
“We have come so far and really know so much more now,” he said. “This is really an extremely exciting time where we have the knowledge and tools to be able to arrest the spread of the largest scourge that the world has seen — the AIDS epidemic.”