By Charlene Porter
IIP Staff Writer
July 10, 2012
Dr. Diane Havlir, the U.S. co-chair of AIDS 2012 and chief of the HIV/AIDS Division at the University of California, San Francisco, made that prediction at a July 10 press briefing previewing the meeting.
“Over the last three years, there have been a series of breakthroughs in HIV [research] which allow us to know that we can significantly curb the number of new infections and deaths from AIDS,” Havlir said. She speaks from the vantage point of an AIDS practitioner who has specialized in the disease since its emergence in the United States in the 1980s.
The prospect of halting the epidemic is raised by the rapid expansion of lifesaving antiretroviral treatment in recent years. It is now distributed to an estimated 6.6 million individuals in low- and middle-income countries.
The overwhelming majority of those — 5.6 million — receive treatment either through the U.S.-funded President’s Emergency Plan for AIDS Relief (PEPFAR) or through the Global Fund to Fight AIDS, Tuberculosis and Malaria, to which the United States has donated $5.8 billion since its organization in 2002.
Another recent game-changing discovery, Havlir said, was the finding that treatment of HIV-infected patients can reduce the likelihood that they will further transmit the virus to others by 96 percent.
“This was nothing short of astonishing,” Havlir said, “and was cause for great celebration in the scientific community.”
Havlir also said the finding over the last several years that circumcision can reduce susceptibility has also broadened the practice in sub-Saharan Africa, further curtailing the spread of HIV.
With these new tools for dismantling the epidemic, Havlir said, the 20,000 or more attendees at the conference will be looking toward the future, trying to find the best path forward in the campaign to stop the disease, and even identify a cure.
AIDS 2012 convenes under the theme of “Turning the Tide Together,” as a slogan to set the tone for this immense conference, which brings together scientists, activists and policymakers who have often clashed in their views about how to best cope with the epidemic.
A document known as the Washington, D.C. Declaration outlines one possible way forward. The International AIDS Society, a conference sponsor, and the University of California, San Francisco, have crafted the action plan for ending the epidemic and seeking online support from “concerned citizens of the world.”
The declaration calls for new investments, an end to stigma, increases in testing and counseling and further expansions of treatment. The text is available online in English, Spanish, French, Portuguese, German, Russian, Chinese, Arabic, Swahili, Japanese, Hindi and Thai.
Sponsors are hoping to build a groundswell of support that will influence government decisionmakers in Washington and elsewhere to make the commitment to end the epidemic.
The fact that scientific breakthroughs have given greater direction to the anti-AIDS campaign is “an amazing, fantastic place to be,” said Chris Collins, vice-president and director of public policy at amFAR, the Foundation for AIDS Research, who also participated in the press briefing.
“But realizing that potential isn’t going to be easy,” Collins said. “It’s going to take continued investment at a time when the United States and other countries face tough fiscal choices.”
Ending the epidemic cannot be achieved, these speakers asserted, unless the needs of marginalized populations who are particularly susceptible are addressed. Men who have sex with men, sex workers, and intravenous drug users are all at a higher risk for exposure to HIV/AIDS, but social judgments and discrimination often prevent these people from seeking testing and treatment.
On the international scale, treatment has expanded to numbers of people that may have seemed impossible at an AIDS conference 10 or 12 years ago. Still, Havlir said, treatment must expand even more to include all the estimated 34 million people thought to be HIV-positive. How to achieve that is unknown, she said, but a variety of different funding proposals will be under consideration at the Washington conference.
Treatment is one part of what Havlir described as the “cascade of care,” which includes access to a health care facility, testing and treatment, and the capability to sustain that treatment through a lifetime. In some of the under-developed countries where the epidemic is most severe, sustaining that chain of care is not certain, she said.
The Obama administration has set the goal high, working toward an AIDS-free generation in the near future.
“We have to hold ourselves accountable for the goal that’s in front of us,” said Deborah von Zinkernagel, deputy coordinator in the U.S. State Department’s Office of the Global AIDS Coordinator. She expects that intense sessions to be held during the week of the conference may lead to answers on achieving an era without AIDS.