“We have a chance to give countless lives and futures to millions of people who are alive today but equally, if not profoundly more importantly, to an entire new generation yet to be born,” Clinton said.
“The goal of an AIDS-free generation is ambitious, but it is possible,” she said. “An AIDS-free generation would be one of the greatest gifts the United States could give to our collective future.”
The speech was hailed by public health advocates.
“It’s very encouraging to see the U.S. government wanting to turn the latest HIV/AIDS science into policies that will save lives while beginning to reverse the epidemic,” said Unni Karunakara of Doctors Without Borders. “Now is the time for bold action in order to get ahead of the wave of new HIV infections.”
Since the deadly pandemic began 30 years ago, more than 60 million people have been infected with HIV worldwide and more than 30 million have died. An estimated 34 million people are living with the virus. About 2.6 million people get infected each year, but the numbers of infections and deaths have been falling.
In addition to older approaches such as condom use and the distribution of clean needles to drug addicts, recent research has shown that antiviral drugs can prevent infected pregnant women and nursing mothers from spreading the virus to their children. Last year alone, more than 114,000 mother-to-child transmissions were prevented, Clinton said.
“Today, one in seven new infections occurs when a mother passes the virus to a child,” Clinton said. “We can get that number to zero.”
The development of an effective vaccine against HIV remains one of the most frustratingly elusive goals in medicine. But recent studies have shown that male circumcision can reduce the risk that heterosexual men will spread the virus by 60 percent. More than 1 million men have been voluntarily circumcised worldwide since 2007, Clinton said.
Antiviral drugs have been shown capable of protecting men having sex with other men and of protecting the heterosexual partners of infected people.
“We now know if you treat a person living with HIV effectively, you reduce the risk of transmission to a partner by 96 percent,” she said.
Taken together, mathematical models show that these strategies could significantly reduce the spread of the virus by another 40 percent to 60 percent, she said.
“We will be on a path towards an AIDS-free generation,” Clinton said, noting that the U.S. government would commit an additional $60 million to scale up efforts in four sub-Saharan countries and challenging others to join the effort.
In June, the U.N. General Assembly called for providing prevention treatment and care to 15 million people in low- and moderate-income countries by 2015. Only about 6 million are currently receiving the therapy.
Experts estimate the cost to be as much as $26 billion annually by 2015 and perhaps $35 billion a year by 2031. About $16 billion a year is being spent on such AIDS prevention now. But the amount of spending has been dropping worldwide.
The President’s Emergency Plan for AIDS Relief, created by President George W. Bush in 2003 and expanded by President Obama, spent $6.7 billion last year on AIDS treatment and prevention. The Global Fund to Fight AIDS, Tuberculosis and Malaria, a free-standing institution in Geneva that gets money from rich countries, spent $1.6 billion.
The key to bringing treatment to more people in the developing world has been the sharp drop in the cost of antiviral drugs in the past 15 years, Clinton said. The cost of treating one person has dropped from about $1,100 in 2004 to about $335 today, she said.
“In these difficult budget times, we have to remember that investing in our future is the smartest investment we can make,” she said.
Clinton also announced that television talk-show host Ellen DeGeneres had been appointed as a special envoy for global AIDS awareness.