Secretary of State Hillary Clinton unveiled Thursday an ambitious US blueprint on how to realize the vision of an AIDS-free generation, aiming to see virtually no babies born with HIV by 2015.
“Scientific advances and their successful implementation have brought the world to a tipping point in the fight against AIDS,” the 54-page document says.
Calling AIDS “one of the most complex global health issues in modern history,” Clinton wrote in the foreword that challenges still exist, pointing to the 1.7 million people who die every year from AIDS-related illnesses.
But she stressed that, unlike a decade ago, developing AIDS after becoming infected with HIV is no longer an automatic death sentence, and major advances have been made in treatment and prevention.
Antiretroviral drugs have been hugely successful in cutting the rate of HIV transmission from pregnant women to their unborn babies or via breast-feeding, as well as in helping HIV-positive patients from developing AIDS.
In the vision of an AIDS-free generation, almost no child is born with the virus, as they grow up they are at lower risk of becoming infected, and if they do get HIV they have access to treatment to halt its progression towards AIDS.
US Global AIDS coordinator Eric Goosby told AFP that the 390,000 children currently born every year with HIV primarily lived in about 22 countries, mostly in sub-Saharan Africa.
Taking a cocktail of three antiretroviral drugs cut the risk of a mother transmitting HIV to her baby to less than two percent, he said. It also allowed her to breast-feed and protected her in future pregnancies in countries where many women had between five to seven children.
“The idea is to strengthen our ability to identify and retain HIV-positive women at the earliest stages, initiating a three-drug antiretroviral therapy,” he said.
“Now we will not get to zero,” Goosby warned, saying many women in developing countries never enter prenatal care. There are also women such as sex workers or drug users “whose lifestyles are so chaotic that they only come in and out of care at extreme moments.”
But he hoped by 2015 that the numbers of babies born with HIV would drop globally below 40,000, adding some countries were already further along towards achieving the goal than others.
New HIV infections among children and adults around the world have fallen by 19 percent over the past decade, and AIDS-related deaths by 26 percent since a peak in 2005.
“These are encouraging trends, but more work needs to be done,” says the report, drawn up by the President’s Emergency Plan For AIDS Relief (PEPFAR).
It also “sends an unequivocal message that the US commitment to the global AIDS response will remain strong, comprehensive and driven by science.”
Clinton acknowledged though that “global health and development resources are being squeezed due to difficult economic times. And issues of stigma and discrimination exist across the globe.”
Under the road map, the United States will:
— work towards the elimination of new HIV infections in children by 2015 and keeping their mothers alive;
— increase its coverage of HIV treatment to cut the number of deaths from AIDS and boost HIV prevention, including antiretroviral drugs. President Barack Obama has set a goal of treating some six million people with such drugs by the end of 2013;
— increase the numbers of men that get circumcisions. By the end of fiscal year 2013, PEPFAR aims to have supported such operations for some 4.7 million men in eastern and southern Africa;
— step up access to testing and counseling, as well as to condoms and other prevention methods.
Those countries which manage to cut the annual number of new HIV infections below the number of new patients starting on antiretroviral drugs will be at a so-called “tipping point” in the epidemic. If that ratio falls below 1.0 percent, then the country will be getting ahead of the epidemic.
The blueprint stressed though that underpinning all these efforts would be scientific advances.
“We will go where the science takes us, translating science into program impact,” it states, adding the US will support innovative research into ways of prevention, as well as helping to halt the progression of the disease.
“In every setting, in every country, really in every city… we are on a continuum towards an AIDS-free generation,” Goosby said.
“There’s an aggregate and a kind of cumulative reflection of that for a country, and a world. But it is an individual march for each person and for each population.”