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Science + Tech
The Beginning of the End of AIDS
by
Mark Brinkmoeller
Today, December 1st, is World AIDS Day. It’s likely that many of us share a similar stream of thoughts on this day. The stream’s part looking backward, remembering a friend or family member who died or thinking about how AIDS has struck Africa and other parts of the world. It’s also part looking forward, is AIDS forever? What can we do?
In a recent Washington Post column, Michael Gerson lays out that after 30 years and
30 million funerals
, the end of the global AIDS epidemic is suddenly, unexpectedly, within sight. It would be a final victory for this clever killer if Americans were too preoccupied and inward-looking to notice and act. The full column is copied below.
To combat that possibility of preoccupation and inward-looking, this World AIDS Day, ONE and (RED) launch the
(2015)QUILT
- a digital AIDS quilt designed to bring people from all over the world together to fight for a historic achievement - the delivery of the first AIDS free generation in the more than 30 years since the virus was first diagnosed.
Created in partnership with @radical.media, the (2015)QUILT lets people express their support for the fight against AIDS. Anyone can create a quilt panel by using the simple online tool. Before uploading their panel, users will be asked to make a specific commitment that will help bring about the beginning of the end of the epidemic. Add your panel
now
.
-----
After
30 years and 30 million funerals
, the end of the global AIDS epidemic is suddenly, unexpectedly, within sight. It would be a final victory for this clever killer if America were too preoccupied and inward-looking to notice and act.
During the last 18 months, the science of AIDS prevention has been transformed. Studies have shown dramatic results from male circumcision — a more than 60 percent reduction in the risk of transmission from women to men. New technologies such as microbicides have proved effective when used before exposure to the disease.
Then, three months ago, came an article in the
New England Journal of Medicine
titled “Prevention of HIV-1 Infection with Early Antiretroviral Therapy.” The study found a 96 percent decrease in transmission to a heterosexual partner when AIDS treatment was begun early. Treating AIDS sooner than later is a dramatically effective form of AIDS prevention.
Scientists began considering something previously unimaginable. What if these methods of AIDS prevention were combined — along with condom use and the prevention of mother-to-child transmission — and aggressively applied in the most affected regions and among the most vulnerable groups in Africa? Scientific models project that transmission rates, already declining in most places, would fall an additional 40 percent to 60 percent.
This raises a prospect comparable to medical achievements such as the eradication of smallpox or advances in cancer treatment. Currently, for every new AIDS patient put on treatment, about two more become infected. Millions of lives are saved — but ground is still lost to the disease. With combination prevention, the balance would shift. For every person who begins treatment, there would be fewer than one who becomes infected. This would effectively be the epidemic’s end.
The Obama administration has officially adopted the goal of “
creating an AIDS-free generation.
” “While the finish line is not yet in sight,” said Secretary of State Hillary Rodham Clinton on Tuesday, “we know we can get there, because now we know the route we need to take. It requires all of us to put a variety of scientifically proven prevention tools to work in concert with each other.”
But the political timing of these scientific breakthroughs is poor. The budget crisis has resulted in a Darwinian competition for resources. Clinton accompanied her ambitious AIDS objective with the not-very-ambitious reprogramming of $60 million for demonstration projects in four countries.
Additional resources can eventually be squeezed from existing AIDS programs. In 2004, the cost of treatment averaged about $1,200 per person. Today, it is less than $350 and still declining. Other donor nations, along with African countries themselves, can take additional burdens.
Yet the objective is not a minor one. Earlier AIDS treatment in the developing world would expand the pool of people in need of medicine. In the main U.S. HIV/AIDS program, Africans currently start drugs when their CD4 count — the measure of immune system strength — is, on average, about 150. Beginning at a CD4 count of 350 — the recommendation of the
World Health Organization
— would increase the number of Africans on treatment by more than 5 million. An aggressive treatment-as-prevention program would start treatment even earlier.
In normal economic times, the case for this effort would be fairly easy. American spending on all humanitarian aid programs amounts to about 0.7 percent of the budget. What other marginal spending increase could save millions of lives, end an epidemic and allow public officials to take part in a historic enterprise as admirable as the Marshall Plan? The proposed prevention strategies do not involve much culture war controversy. Religious conservatives have no objections to treatment and are neither shocked nor alarmed by circumcision — an old biblical acquaintance.
But with economic times far from normal, the case is complicated. Ending the global AIDS epidemic would require a major presidential push. It would also require congressional Republicans to make a human life exception to austerity.
This uphill effort would, however, be aided by a pragmatic argument. Since 2003, the United States has helped place millions on AIDS treatment. In the process, we have assumed what economists call a “treatment mortgage” — obligations that can’t be abandoned without catastrophic consequences. A major prevention effort — reducing the number of new infections to below the number of new people placed on treatment — is the only morally acceptable strategy that eventually reduces American commitments on AIDS.
Having abruptly gained the scientific tools to defeat this epidemic, what remains is a test of will and conscience.
What is your unique contribution to the fight against AIDS?
Why do you think the Church has not taken the lead on this movement?
Editor's Note: Micheal Gerson's article is shared here with permission via
The One Campaign
and can be seen in its original publishing
here
.
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Comments
Mike Stephan
Now if we could just do the same for cancer which has killed far more people.
Cameron Lucas
Mike,
I can't help but read your seemingly negative comment as a bit America-centric. If it wasn't meant to be a bit of a dig, I will stand corrected (it's hard to determine tone of voice from text).
We as Americans tend to be more concerned with the treatment of cancer, not because it's more deadly or dangerous, but because it kills more of 'our people.' We seem to be perfectly fine with 'those people' dieing of AIDS, because it doesn't affect us.
If we as Christians truly believed every life is sacred (which is what we propagate during our pro-life rallies) then we should be rejoicing at the fact that we could be a part of the saving of millions of lives!
This article was very interesting, especially because I have never heard that the 'cure' is so close. Thank you for enlightening me
Mike Stephan
Cameron,
It was not meant as a dig. I am happy to see the trend of AIDS reversed. It destroys lives in the US as well as Africa and just about every continent on the globe.
But as it stands, my family has been struck by cancer and heart disease; one took my father, the other took my mother and her father (my grandfather) and her two brothers. So yes, it is very personal for me.
AIDS is a horrible disease and needs to be eradicated. And thankfully it has begun to see its expansion put in check and reversed through education, medicine, and the posibility of a cure.
I only wish that the same could be said of the disesases that have devistated my family and other families and lives across the world.
Cameron Lucas
Mike,
Sorry for misreading the tone in your comment. I too have had family members effected by cancer, and I too would like to see an end to it! I am sorry for attacking assumptions that you didn't have.
I think I reacted in that way because someone recently (as in less than a week ago) forced me to examine the way I have viewed the AIDS issue and I read my newly-former views and assumptions into your comment.
Comments are now closed
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