The World Leaders Forum and the International Center for AIDS Care and Treatment Programs (ICAP) co-hosted a special event at Columbia University entitled “A Future without HIV/AIDS: Dream or Reality?” on 28 September.
Moderated by PBS Senior Correspondent Ray Suarez, the debate brought together global health leaders, including the Director of the National Institute of Allergy and Infectious Disease, Anthony Fauci, the United States Global AIDS Coordinator, Ambassador Eric Goosby, the UNAIDS Executive Director, Michel Sidibé, and the Director of ICAP and the Global Health Initiative at the Mailman School of Public Health, Wafaa El-Sadr.
The participants engaged in a meaningful exchange of experiences around local and global responses to AIDS. The leaders were optimistic but reminded the audience of the work that still needs to be done, including improved HIV treatment and increased funding.
“The speed with which we have been able to increase the number of people on HIV treatment in just a few years has never been seen before in the history of public health,” said Mr Sidibé. “Today, 56 countries in the world have been able to stabilize the epidemic or significantly decrease the number of new HIV infections. We have broken the trajectory of new HIV infections and created a momentum which allows us to say that we are turning the tide on AIDS. But we must continue to invest in AIDS if we want to see further returns on our investments,” he added.
Speakers reflected on future obstacles and opportunities in the global AIDS response, and the need to find the balance between realistic expectations and global aspirations. The panel looked at scientific and programmatic advances in confronting the epidemic and considered the impact of the global financial crisis, as well as other health and development priorities, on the AIDS response.
Dr El-Sadr highlighted how people are taking control of the response to AIDS at the local level: “In multiple countries in sub-Saharan Africa, alongside the scale-up of treatment we are also seeing a decrease in risky behaviour at the population level and a decrease in new HIV infections. In addition to scientific discoveries and developments in health systems, people are much more engaged in trying to control the epidemic in their own communities.”
Ambassador Goosby underscored the progress made in scaling up HIV treatment: “We are approaching a moment where the number of people who are going on to treatment will exceed the number of new infections that are occurring on the planet, but it is important to look for every possible opportunity to expand capacity.” Ambassador Goosby also noted that while some funding was reduced for the President's Emergency Program for AIDS Research (PEPFAR), enhancing the efficiencies in the delivery of HIV programmes has enabled the US government to support an unprecedented number of people on HIV prevention, treatment and care in low-income countries for fewer resources.
The recently proven efficacy of using HIV treatment as prevention was highlighted as an important breakthroughs in the AIDS response. Participants agreed on the need to use it in combination with the other prevention methods available. “The combination of HIV prevention tools we have today have the capability to turn-around the trajectory of the pandemic,” said Dr Fauci. “If you also superimpose the powerful tool of treatment as prevention, we see the light at the end of the tunnel.”
While not too long ago talking about the end of AIDS would have seemed premature, participants agreed that significant progress has been made in virtually all aspects of the global AIDS response. “Now we know we can put an end to AIDS”, said Dr Fauci. “The question is – will we?”
Participants noted that the world is on track to achieve many of the ambitious goals that were set for 2015, including 15 million people accessing HIV treatment and the elimination of new HIV infections among children and keeping their mothers alive. According to the panel, the advances in science, political support and community responses have transformed the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths into a realistic objective to end the AIDS epidemic.
“If we come together, bring the knowledge together, bring the resources together, bring the partnerships together and work together we can turn the tide and transform this epidemic. This is a transformative moment,” concluded Dr El-Sadr.