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Monday, Sep. 26, 2011

The end of AIDS is within reach


By DESMOND TUTU
The Washington Post

CAPE TOWN — A study published in the New England Journal of Medicine last month has demonstrated that anti-retroviral treatment can prevent the spread of HIV, in addition to saving those infected from sickness and death.

Armed with this new data, President Barack Obama should lead the world in a massive effort to expand access to treatment and rid humanity of AIDS — the most devastating disease of our time.

But just as the end of AIDS has finally come within reach, we are witnessing an unprecedented drop in financial and political support for the cause.

The Joint United Nations Programme on HIV/AIDS and the Kaiser Family Foundation reported in August that donor funding for HIV/AIDS leveled in 2009 and then declined — 10 percent — in 2010 for the first time ever.

The United States, which accounts for more than half of global contributions to fight the disease, disbursed $700 million less in 2010 than in 2009. And projected U.S. funding in 2011 is roughly $28 million less than in 2010.

This is a great shame, as millions of people receiving treatment worldwide depend on these funds to stay alive.

Our support should be increasing. AIDS remains the leading cause of orphanhood and of death among women of reproductive age. It is a major driver of opportunistic infections — particularly tuberculosis — and keeps tens of millions of Africans mired in poverty.

Barack Obama has achieved great things thus far in his presidency. He has helped reform the U.S. health care system to ensure that all citizens have access to the medical attention they may need. He has implemented the Global Health Initiative to streamline U.S. development aid programs. Last year he announced a $4 billion commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the premier multilateral funding instrument dedicated to controlling these diseases.

He is in a position to make a game-changing impact on the war against AIDS.

The Lancet medical journal recently modeled new investments in that fight and a strategic shift to proven prevention methods. It was demonstrated that doing so could yield dramatic progress and reduce overall costs within just a few years.

The new HIV-prevention study supports this plan. Early treatment reduces the chance of passing HIV to an uninfected sexual partner by 96 percent — conferring near-total protection. A single treatment course could prevent multiple infections, reducing the need for additional treatments and saving countless public health dollars.

Since its founding, the U.S. President's Emergency Plan for AIDS Relief has put 3.2 million people around the world on lifesaving anti-retroviral treatment. Nine million more people desperately need these drugs. Obama should increase PEPFAR's treatment goal from 4 million to 6 million people by 2013.

He should then issue a challenge to other leaders — of donor nations and those countries most affected by HIV/AIDS — to scale up their contributions.

South Africa, my home, and other African nations have recently initiated commendable reforms in addressing the AIDS pandemic.

For example, South Africa's National AIDS Council is lowering the HIV treatment threshold in line with World Health Organization's recommendations. And in light of the new prevention study, Rwanda will provide treatment to newly tested HIV-positive individuals with uninfected partners. Such efforts to destigmatize, treat and prevent HIV/AIDS should be emulated across the continent.

Since the pandemic became public 30 years ago, nearly 30 million people have died from AIDS. At least 30 million others are living with HIV, and another 30 million are likely to become infected in the next decade if nothing more is done.

Yet now, the world finally possesses affordable tools and scientific knowledge that could stop HIV/AIDS in its tracks. President Obama has a profound opportunity to lead the world to this conclusion. He must take it.

Desmond Tutu is the archbishop emeritus of Cape Town.


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