International health agencies continue to lose ground in the struggle against H.I.V., the virus that causes AIDS. Each year the number of people who become infected outpaces the number of people starting treatment for the virus. That is discouraging given that the opportunities to control the spread of the virus have never been better, scientifically and financially. It is imperative to move aggressively to change the trajectory of this epidemic.
Even in the United States, where great progress has been made, the Centers for Disease Control and Prevention warned on Tuesday that hundreds of thousands of people with diagnosed infections are not receiving drug treatments or other care and are transmitting the virus.
Still, several developments have opened the way for the world to turn this story around in the next five to 15 years. Scientists have discovered that if people with the virus take antiretroviral drugs as soon as possible after diagnosis they can live relatively normal lives with very little risk of passing the virus to their sexual partners. The World Health Organization issued guidelines in September that urged patients to be treated immediately instead of waiting until their immune systems deteriorate.
Manufacturers have learned to put several antiretroviral drugs in a single pill that is taken once a day, making treatment remarkably easy. Companies are greatly reducing prices for countries that cannot pay much, including for a pill that may be less than $100 per patient per year. And some uninfected people at high-risk of infection, like gay men who have sex with strangers or drug users who share needles, are now taking a daily pill to prevent infection.
The office of Ray Chambers, an assistant secretary general at the United Nations, estimates that 28 million infected men, women and children can be in treatment by 2020 — nearly twice as many as today — with the current funding provided by international donors and the countries afflicted with the disease. The long-term goal is to virtually end the AIDS epidemic by 2030, a daunting task given that almost 37 million people are infected and roughly half are unaware of it.
In the United States, about 1.2 million people are infected and one in eight don’t know it. There are, however, signs of progress. San Francisco, which pioneered many of the tactics now recommended globally, has greatly reduced new infections. And Gov. Andrew Cuomo announced a big increase this week in the amount of money New York will spend annually to fight the disease, with a goal of reducing new infections to 750 a year by 2020, down from 3,000.
Some experts are rightly skeptical that current measures will be enough to end the global epidemic. They think funding should focus on a vaccine to prevent infection and a cure to eliminate the virus from those already infected. Both are formidable challenges. The Foundation for AIDS Research (amfAR) and the University of California, San Francisco, Medical School announced a collaboration this week to find the scientific basis for a cure within five years, a goal the project’s leader described as more aspirational than realistic. However long it takes, research is needed to provide lasting success.
— The New York Times,