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Science Points Way to Lifesaving HIV/AIDS Programs
December 15, 2011

An AIDS patient is treated in this South African clinic that is partially funded by the President’s Emergency Plan for AIDS Relief (PEPFAR)

By Charlene Porter
IIP Staff Writer
14 December 2011


Moving swiftly to implement the findings of successful research has saved lives and slowed the global pandemic of HIV/AIDS, according to a U.S. leader in the campaign, Ambassador-at-Large Eric Goosby.

Dr. Goosby, the U.S. global AIDS coordinator, spoke December 13 to an audience at the National Institutes of Health, which has been a world leader in scientific breakthroughs about HIV/AIDS and ways to combat it. “The link between knowledge generation and rapid deployment in the epicenter of the epidemic makes for a powerful combination,” Goosby said.

That approach will lead the world to an AIDS-free generation, Goosby said, a goal President Obama set in a World AIDS Day message December 1.

The President’s Emergency Plan for AIDS Relief (PEPFAR), first funded by the U.S. Congress in 2003, has worked for broad distribution of the medicines and methods that have tamed the global pandemic. In 2003 only 50,000 people in sub-Saharan Africa had access to antiretroviral (ARV) drugs, the cocktail of medicines that research discovered will arrest HIV and allow a person to live a reasonably healthy life. Now, Goosby said, almost 4 million receive this treatment through PEPFAR.

Treatment programs run by the Global Fund to Fight AIDS, Tuberculosis and Malaria have also expanded in the hard-hit nations, with 3.3 million now receiving medicines through that internationally backed funding mechanism.

The HIV/AIDS pandemic began as a problem for medical science to solve, but over time, social and economic consequences of widespread disease emerged as threats to the stability of the worst-affected nations. Goosby said expanding treatment has also helped to ease some of those broad social problems.

“For every 1,000 people we support on treatment for one year, we avert the orphanhood of 449 children,” Goosby said. “That is another dimension of the concept of treatment as prevention.”

One of the earliest studies that demonstrated the effectiveness of AIDS treatment as a preventive measure came in 1994, Goosby said, when a study showed that treatment of HIV-positive pregnant mothers could prevent the transmission of the virus to their infants. Within months of that finding, AIDS specialists developed guidelines for treating pregnant mothers with ARVs.

The practice of treatment-as-prevention has also been proven effective among couples in which one partner is HIV-positive and the other is not. Earlier onset of treatment for the HIV-positive partner leads to a lower likelihood of transmission of the virus to the other.

Expanded treatment and expanded prevention programs have been important in PEPFAR’s almost eight-year history, but Goosby said the program is also dedicated to public health diplomacy. It isn’t just about the lives that are saved today.

“Improving public health requires creating a lasting, durable improvement in the capacity of our partner countries to address their needs,” Goosby said. The history of foreign assistance programs does not show that aid alone can create that capability.

“We are also supporting the development of capable leadership, good governance, peace and stability and sensible economic and social policies,” Goosby said. Those goals are harder to achieve than the distribution of drugs and medical technology alone. “But we want our impact to last, and there really are no shortcuts,” he said.

As PEPFAR works to improve health care systems in partner countries, the program also aims to help develop the next generation of leaders who will work on an array of issues including both health and development.