The world now has the opportunity to end the AIDS epidemic
as a result of recent scientific discoveries, according to speakers at the
opening ceremony of the 19th International AIDS Conference (AIDS 2012) in Washington
DC on 22 July.
Welcoming delegates to the first international AIDS
conference held in the United States for 22 years, conference co-chair
Professor Diane Havlir said: “Our big idea, which many didn’t think was on the
horizon five years ago, is that we can start to end AIDS. Future generations
are counting on our courage to think big, be bold, and seize the opportunity
Experts now believe that if, mobilised at sufficient scale, a
series of discoveries have the potential to greatly reduce the rate of new
HIV infections and drastically reduce the number of AIDS-related deaths. These
The effectiveness of antiretroviral drugs in
reducing sexual transmission of HIV, by
up to 96% in serodiscordant couples.
Male medical circumcision, which reduces the
risk of HIV acquisition by 50 to 60%.
Triple-drug antiretroviral therapy during pregnancy
and breastfeeding, which can virtually eliminate the risk of HIV transmission
if started early enough in pregnancy.
Pre-exposure prophylaxis (PrEP) with antiretroviral
drugs, which greatly reduces the risk of HIV acquisition when taken
Intensified case finding for tuberculosis in
people living with HIV, and intensified case finding for HIV in TB patients.
Earlier antiretroviral therapy for all adults
and children, especially in people with TB and in infants.
Point-of-care diagnostics to identify
HIV-infected infants as soon as possible after birth.
These recent innovations provide additional support to
well-established prevention activities such as condom provision, HIV
counselling and testing, and harm reduction for injecting drug users, all of
which still need to be scaled up in many parts of the world.
Former US Global AIDS Co-ordinator, Ambassador Mark Dybul,
dismissed pessimistic assessments of the chances of ending AIDS, noting that
the Global Fund, the President’s Emergency Plan for AIDS Relief (PEPFAR), and
antiretroviral treatment programmes managed by Africans had all been considered
impossible until they were attempted, with US financial support and political
“PEPFAR needs to be celebrated as one of the great success
stories of the early 21st century,” said US Health Secretary
Professor Elly Katabira, outgoing President of the
International AIDS Society, thanked the American people for their support for
antiretroviral treatment through the PEPFAR programme.
Professor Havlir called on delegates and supporters
worldwide to sign the Washington Declaration,
a statement of the steps that need to be taken, based on the latest scientific
evidence, to drive down new infections and increase the proportion of people
who are receiving lifesaving treatment.
increase in targeted investments. We can save lives, avert infections and
reduce the global price-tag of the epidemic with an immediate, strategic
increase in investments now.
Ensure evidence-based HIV
prevention, treatment and care in accord with the human rights
of those at greatest risk and in greatest need.
End stigma, discrimination,
legal sanctions and human rights abuses against people living
with HIV and those at risk.
Markedly increase HIV
testing, counselling and linkages to prevention, care and support services.
Provide treatment for all
pregnant and nursing women living with HIV and end peri-natal
Expand access to
antiretroviral treatment to all in need.
Identify, diagnose and treat
on new HIV prevention and treatment tools.
Mobilisation and meaningful
involvement of affected communities must be at the core of
An investment in science always pays off far more than the
initial investment, said Professor Havlir.
“It would be an extraordinary
failure of global will and conscience if financial constraints truncated our
ability to begin to end AIDS just when the science is showing us that this goal
is achievable,” she concluded.