Thursday, November 10, 2011

The United States to Have Policy Goal to Wipe Out AIDS

Certainly a worthy goal, but will the science be there?

The United States will, for the first time, make it a policy goal to have an "AIDS-free generation" in the near future, Secretary of State Hillary Clinton announced.

The administration's new AIDS-free generation goal will focus on "combination prevention strategy," combining three interventions that have been proven to slow the spread of the disease: ending mother-to-child transmissions; expanding voluntary male circumcision; and making greater use of antiretroviral medications.

Scientist now have a better understanding of the virus that has infected 60 million people and killed nearly 30 million since the first case of HIV was reported in 1981. And that better understanding of a once-mysterious virus makes it an achievable goal to eradicate AIDS, Clinton said during an event at National Institutes of Health (NIH) on Tuesday.

"HIV may be with us well into the future, but the disease that it causes need not be," Clinton said.

She outlined the three main areas of focus for the government's AIDS-free generation plan.

  • Prevention of mother-to-child transmissions, which are responsible for one in seven new infections worldwide -- it's already a global goal of the President's Emergency Plan For AIDS Relief (PEPFAR) to eliminate new infections in babies by 2015

  • Increase rates of voluntary male circumcision -- the procedure has been shown to reduce the risk of female-to-male transmission by more than 60%

  • Use treatment to prevent new infections -- recent studies show that treating HIV-positive patients with anti-retroviral drugs helps reduce transmission of the virus to a non-infected partner by 96%

Clinton said the U.S. government would commit an additional $60 million beyond the $50 million it's already spent to explore which prevention tactics work best in sub-Saharan Africa, where AIDS is the leading cause of death.

In 2003, when President George W. Bush signed the PEPFAR legislation, only 50,000 people in sub-Saharan Africa were receiving anti-retroviral drugs. Today, more than five million sub-Saharan Africans receive the drugs, along with another one million people in other regions of the world. Most of those drugs are paid for by the U.S., either through PEPFAR or through the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Speaking with MedPage Today after Clinton's speech, Anthony Fauci, MD, director of the NIH's National Institute of Allergy and Infectious Diseases, said he thought an AIDS-free generation was an achievable goal, especially in light of the relatively recent findings from the HPTN 052 trial that, in heterosexual discordant couples, if the HIV-positive partner is treated with antiretrovirals it "remarkably diminishes" the likelihood of infecting the HIV-negative partner.

"Within a reasonable amount of time, we could have an AIDS-free generation," he said.

Let's all hope - and malaria eradication too.

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