Part of Foreign Affairs Report: Global Public Health

Transitioning to an AIDS-Free Generation

Why Helping People Live Longer Won't End the Disease

There was much to celebrate on World AIDS Day last week. Over the last decade, an unprecedented surge in donor support for HIV/AIDS treatment has lengthened and improved the lives of millions of people living with the disease. The number of people receiving antiretroviral treatment worldwide stands at more than six million in 2011, a 16-fold increase since 2003. Accordingly, those affected with HIV/AIDS are living, on average, longer lives than at any point since the dawn of the pandemic.

But celebration is premature. Success in treatment is great, but the underlying strategy of focusing resources on treatment is flawed. The rate of new infections now outpaces the rate of AIDS-related deaths, so the number of people living with AIDS -- and therefore the number of people needing treatment -- is growing faster than the funding needed to provide care. In 2010, some 1.8 million people died from AIDS-related illnesses, but about 2.7 million were newly infected, increasing the total number of people living with the disease by approximately 900,000. In other words, although there is no question that focusing on treatment prolongs lives, it's just not a financially feasible strategy to manage the spread of the disease -- much less to eradicate it altogether.


Read more at at Foreign Affairs' Special Report: Global Public Health.


It is unfortunate that so many have focused on treatment alone because there is a way to end the global scourge of HIV/AIDS: by conditioning the rate of expansion of treatment programs on the reduction of new infections. This much-needed shift would lead to what I call an AIDS transition -- the day on which the rate of new infections falls below the rate of AIDS-related deaths so that the number of people living with HIV/AIDS decreases year-on-year. Getting to the transition would require vast changes in policy and practice for donors, recipient governments, and health practitioners. But if these changes were made effectively, after about a decade of keeping new infections ever lower than deaths, we would see AIDS taking its place among treatable chronic diseases such as diabetes, cancer, and heart disease.

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