(SAUL LOEB/ AFP/GETTY IMAGES ) - Secretary of State Hillary Clinton speaks during a press conference at the U.S. State Department in Washington on Nov. 28, following meetings with African Union Chairperson Nkosazana Dlamini-Zuma.
The world can control the AIDS epidemic in four or five years and set it on a trajectory to become a small, if permanent, problem, according to a State Department document made public Thursday.
An “AIDS-free generation” — a goal that Secretary of State Hillary Rodham Clinton touted a year ago — could be reached by starting more infected people on AIDS drugs, circumcising men in high-prevalence countries and making sure that every HIV-positive pregnant woman is treated.
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Done in concert, the strategies could reduce the number of new HIV infections each year to below the number of people with the infection who are put on life-extending AIDS drugs. That is an important “tipping point” that would allow the epidemic to start burning itself out.
“An AIDS-free generation will be within our sight,” Clinton said Thursday as she described the 54-page document that models various ways to quell the 30-year-old epidemic. But she warned: “Now we have to deliver. . . . The history of global health is littered with grand plans that never panned out.”
The document, however, contains no specific targets or a schedule for achieving them. It also doesn’t estimate how much more money it would cost to reach the “tipping point” in high-prevalence countries, or where the money would come from.
The document is called “PEPFAR Blueprint: Creating an AIDS-Free Generation.” PEPFAR stands for the President’s Emergency Plan for AIDS Relief, a program that President George W. Bush started in 2003 that today spends $6.6 billion a year to battle AIDS in more than 35 countries.
Foreign donors such as PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria, headquartered in Geneva, provide half the money spent on AIDS in the developing world. (The other half comes from the countries themselves.) The most visible activity is the provision of antiretroviral therapy to infected people.
PEPFAR now provides AIDS drugs to 5.1 million and the Global Fund has provided them to 4.2 million since its inception in 2002. Both programs do many other things, as well.
Clinton coined the term “AIDS-free generation” in a speech last November. At the 19th International AIDS Conference in July, where she was greeted like a conquering hero, she promised to have a roadmap ready by World AIDS Day, which is Dec. 1.
Sharing the lectern in the State Department’s Benjamin Franklin Room with four other speakers, three of them African, Clinton was effusively praised for her support of PEPFAR, which is run by the State Department. Several noted her advocacy of women’s rights and girls’ education; women account for 58 percent of Africans living with HIV.
“You will be remembered certainly as a person who has been working to change the face of this world,” Michel Sidibe, director of UNAIDS and a native of Mali, told Clinton, who has said that she will leave her job soon. “We know that you will not drop the ball. You will continue, because we need you.”
In many high-prevalence countries, the number of people becoming infected with HIV each year exceeds the number starting antiretroviral therapy — a state that will lead to continued growth of the epidemic.
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