This week, the eyes of the health community will be on Washington, DC, as the United States hosts the International AIDS Conference for the first time in 22 years. While the conference convenes every two years, it has not been on US soil since 1990, due to a travel ban on HIV-positive individuals into the country, instituted in the late 1980s. Congress overturned the 21-year old ban in 2008 with new legislation, which President Obama then signed into law in 2009. Almost immediately, planning for the next AIDS Conference in Washington began. The meeting this week expects to draw close to 25,000 attendees from around the world, and not just from the AIDS community – Bill Gates, President Clinton, and Nancy Pelosi are among keynote speakers, while pre-conference events, such as one hosted by the American Foundation for AIDS Research (AmFAR) will feature actors Sean Penn and Sharon Stone.
Despite the disease wreaking havoc for over 30 years now, it was not until early this century that the global fight against HIV/AIDS really began – meaning a coordinated effort by developed nations to help those in crisis – mostly in Africa and Asia. In 2010, an estimated 34-million people were HIV positive. There is little doubt that Sub-Saharan Africa has borne the brunt of this disease. Of those living with HIV/AIDS, more than 60 percent are in this region and it accounts for 75 percent of AIDS deaths.1
The 2002 establishment of the Global Fund to Fight AIDS, TB, and Malaria was the first step and resulted in a new type of development giving. It was a public-private partnership and financing institution where donors (governments, foundations, etc.) could feed resources into an organization that then was charged with working with governments and civil society to spend money in an accountable and coordinated way. While it has not been without controversy, during the past 10 years it has been a huge force in the battle against these diseases.
From the beginning, the US was the Global Fund’s largest donor. Then, in 2003, the global health community was taken completely by surprise with the creation of the President’s Emergency Program for AIDS Relief, also known as PEPFAR. First announced in President Bush’s State of the Union address that year, the program promised $15 billion over five years to address the AIDS crisis. Since then, it has spent much more. In just a few years, spending on the prevention, care, and treatment of HIV/AIDS went from millions to billions of dollars. PEPFAR changed the health landscape with an inflow of resources and a commitment to work with countries to develop specific plans to prevent and treat HIV/AIDS in their nations. The Office of Global AIDS Coordination (OGAC) is housed in the State Department, and led by a Global AIDS Coordinator (currently Ambassador Eric Goosby).
The Global Fund and PEPFAR have been game changers – and at this year’s conference, there is certainly a lot to celebrate, as denoted by the meeting theme “Turning the Tide Together.” In the past decade, deaths have been decreasing and new infections are down. Providing treatment to pregnant mothers means fewer babies are being born into an HIV-infected life. According to the WHO, 8-million people living with HIV in 2011 were receiving antiretroviral therapy in low- and middle-income countries. PEPFAR money has not only been utilized to provide life-saving drugs or safe-sex education, but also helped build (or rebuild) entire health systems – from labs that can accurately diagnose HIV (and other diseases) to trained epidemiologists that can spot outbreaks.
While the last decade has led to great strides in the fight, there is still much to do. Despite the encouraging statistic of 8-million people receiving treatment, according to WHO, there are still millions of others waiting for access. Many of these are vulnerable populations without institutional frameworks and programs to support them, and notable among those with limited access are persons with disabilities. According to a UNAIDS report, the “relationship between HIV and disability has not received due attention, although persons with disabilities are found among all key populations at higher risk of exposure to HIV.”2 At this year’s conference, for the first time, there will be a session on how to integrate the disability and HIV rights movements to support each other. Also being launched this week by a disability rights organization, One Billion Strong, is a report entitled: HIV/AIDS, Disability and Discrimination: A Thematic Guide on Inclusive Law, Policy, and Programming, whose aim is to support efforts to make HIV response inclusive and accessible to persons with disabilities. Stimson is proud to be hosting a reception on the release of this guide and to move the discussion forward on how HIV response can be improved. This past December on World AIDS Day, President Obama spoke hopefully about a future AIDS-free generation. While we can all hope for this day, it will certainly continue to take a lot of resources and support, especially for those most vulnerable to the disease. Finding the resources to continue the progress in saving lives and advancing knowledge is the greatest challenge of all.
1 World Health Organization, Regional Office for Africa. “Overview: Acquired Immune Deficiency Syndrome.”
2 UNAIDS, World Health Organization and Office of the High Commissioner for Human Rights, Policy Brief: Disability and HIV, April 2009.
Photo Credit: The AIDS Names Project