The fight against HIV/AIDS is currently viewed with considerable more optimism than in the past years because powerful interventions have been developed, proven effective and refined. If these tools are made widely available to those who need them, an AIDS-free generation may be possible. Speaking on an AIDS free generation before the opening of XIX International AIDS Conference (AIDS 2012), Dr Anthony S Fauci, Director, National Institute of Allergy and Infectious Diseases (NIAID), said ending the global HIV pandemic may be possible.
Dr Fauci said for an AIDS free generation to happen the implementation of a "multifaceted global effort that expands testing, treatment, and prevention programmes, as well as meets the scientific challenges of developing an HIV vaccine and possibly a cure" must be adopted.
According to an article "Toward an AIDS-Free Generation" co-authored by Dr Fauci and his NIAID colleague Dr Gregory K Folkers, and published in the 25 July 2012 issue of The Journal of the American Medical Association (JAMA): “Since the first cases of what is now known as AIDS were reported in 1981, an entire generation has grown up under the constant cloud of this modern-day plague. Across the globe, more than 34 million people are living with the human immunodeficiency virus (HIV), the virus that causes AIDS, including approximately 1.2 million individuals in the United States. HIV/AIDS has been responsible for the deaths of an estimated 30 million individuals.”
This article further added that, although the rate of new HIV infections has declined or stabilised in many countries, the virus continues to exact an enormous toll: 1.8 million deaths in 2010 alone, and grief and hardship for countless families and communities.
The authors found one of the most important interventions was combination antiretroviral therapy, which significantly improves the health and longevity of individuals infected with HIV.
"Since the advent of antiretroviral therapy, the annual number of deaths due to AIDS has decreased by two-thirds in the United States. Globally, an estimated 700,000 lives were saved in 2010 alone due to the increased availability of antiretroviral therapy in low- and middle-income countries. Important challenges remain—notably finding the resources and developing the infrastructure to provide antiretroviral therapy to the estimated 8 million individuals with HIV infection who need these drugs but are not receiving them."
The authors added that antiretroviral therapy can also prevent HIV infection by reducing the amount of virus in an infected person’s blood and other body fluids, making it less likely that the virus will be transmitted to others. Antiretroviral therapy is also highly effective in blocking mother-to-child HIV transmission.
Other important interventions include voluntary medical male circumcision, which offers a highly effective and durable way to protect heterosexual men from HIV infection; and potentially, pre-exposure prophylaxis (PrEP) with antiretroviral (ARV) medications, which have shown promise in reducing an individual’s risk of acquiring HIV infection.
“Each of these treatment and prevention strategies has a strong evidence base; with further refinement and scale-up and also when used in combination, they could have an extraordinary effect on decreasing the trajectory of the HIV pandemic,” the article published in JAMA stated.
According to the authors, HIV research remains focused on two key scientific challenges: the development of a vaccine and cure. A large-scale clinical trial, promising results in animal models, and advances in structure-based vaccine design suggest that an HIV vaccine is feasible. However, the prospect of an HIV cure remains challenging.
Dr Fauci concluded that ending the global HIV and AIDS pandemic “will require a global commitment of resources involving additional donor countries, strengthening healthcare systems overall, and fostering greater ownership by host countries of HIV/AIDS effort, including investing more in the health of their people. With collective and resolute action now and a steadfast commitment for years to come, an AIDS-free generation is indeed within reach.”
(The author serves as the Vice President, Jodhpur National University; and also as the Executive Director of Swasthya India. She has written extensively on HIV and health issues for Citizen News Service (CNS). Website. www.citizen-news.org)