HIV/AIDS in 2012: Is the End of the Epidemic in Sight?

The issues we face today, as a global community, have evolved, yet the epidemic remains fearsome for the millions of people living with HIV/AIDS around the world.
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My introduction as president and CEO of PATH has happily coincided with a busy season of conferences in global health and development, including this week's mother of all such conferences -- AIDS 2012, the 19th International AIDS Conference in Washington, D.C. In a busy Superbowl setting replete with JumboTron-like screens, scientific posters, trade-show booths, and a chorus of activists from all corners of the globe, some 25,000 people have come together to learn, share, question, network, and party.

I am deeply honored to represent PATH here as we showcase our expertise in addressing the global HIV/AIDS epidemic and join our colleagues from around the world to focus on the conference's theme of "turning the tide together." Among the conference's many great speakers and presenters were Hillary Clinton, who spoke powerfully about how far we've come and the many achievements we should celebrate, and Bill Gates, who urged us not to be complacent given the scale of the epidemic and the work still in front of us. This tension -- between applauding the world's collective successes and recognizing the staggering political, cultural, and scientific challenges ahead -- won't be resolved here, but this week's discussions provide a healthy platform for personal and collective reflection on the road we must travel to reach a world without AIDS.

This reflection is both professional and personal for me, and participating in this conference has provided me with one of those curious pauses that a lucky life occasionally offers. As a young gay man studying and working on global human rights in New York City and Seattle in the 1980s and 1990s, I experienced firsthand the terror of this unfolding plague -- while taking care of and burying friends, engaging in personal and professional activism with organizations like Lambda Legal, the United Nations High Commissioner for Refugees (UNHCR), and others; and recasting our fear and anger into something more powerful and meaningful. These experiences led to deeper engagement for me. I helped found projects directed at gay youth, advocated for legislative reforms, worked on campaigns and related efforts as a business leader, and, more recently, advised many of the world's largest development organizations as global director of social innovation at McKinsey & Company. Indeed, HIV/AIDS defined my generation of gay men in America and greatly influenced my professional journey as well.

Being at AIDS 2012, years later, as the new head of PATH, I have come full circle. The issues we face today, as a global community, have evolved, yet the epidemic remains fearsome for the millions of people living with HIV/AIDS around the world. And while we close in on eliminating mother-to-child transmission of the virus, expand treatment in many regions, and even recognize the possibility of a vaccine within our lifetime, we cannot take anything for granted. In fact, I believe we must double down on our resolve to end this epidemic and ensure that health systems are strengthened, civil rights are expanded, and even the most marginalized among us have access to treatment.

At PATH we envision a world where health is within reach for everyone, and that includes a world without AIDS. Our work in HIV/AIDS spans 26 countries, from Kenya to Vietnam. Nearly a quarter of PATH's 2012 budget is dedicated to combating the epidemic. We are partnering with governments, communities, and health care workers around the world to make strides toward an HIV-free generation. We are making progress on gender equity; providing more integrated services for HIV/AIDS; developing and introducing innovative technologies, including better diagnostics for resource-poor settings; and expanding the public and private channels that can distribute new tools like the woman's condom. We still have miles to go, but we are on the right road to ending this epidemic.

Two themes from the conference give me great hope. First, there appears to be a strong appreciation of, and calls for, the scientific and technological efforts that are needed to develop effective, evidence-based solutions. This focus must be carefully balanced with an emphasis on culturally relevant solutions and community-led, customer-friendly approaches. The opportunity to develop and deliver powerful, disruptive technologies -- technologies that are both effective and acceptable to the communities who will use them -- provides a lot of hope and opportunity ahead.

The second theme underscored repeatedly during the conference is the power of collaboration, which has driven the successes we've achieved to date and will be crucial for continued progress ahead. Engagement at the community level -- particularly by those living with HIV or most vulnerable to the disease -- is especially important for identifying, planning, and implementing effective interventions and ultimately for making these interventions sustainable. Collaboration and community support are essential to designing programs that work. Rigorous, data-driven evaluation is essential to knowing why they work.

An innovative example of this collaborative work is happening in Western Kenya, a densely populated area where HIV-prevalence rates are high. As part of the APHIAplus (AIDS, Population, and Health Integrated Assistance Plus) Western Kenya project, PATH has joined with international and local partners to include HIV/AIDS services in the administration of general health care. Together, we have reached about 51,000 people with antiretroviral therapy and provided more than 700,000 people with information about HIV/AIDS. In outreach aimed at pregnant women, who often are not empowered to seek medical care on their own, our combined efforts have supplied more than 13,000 HIV-positive pregnant women with antiretroviral drugs to help prevent the transmission of HIV to their children and provided almost 400,000 pregnant mothers with HIV/AIDS counseling and testing services. These are the kind of results we get when we put our heads together.

So, are we at a turning point? Probably yes. At some deeper level, we have reached a critical juncture where successes to date, combined with our global political will and social science/technology innovations, have generated extraordinary confidence in our collective mission. But at a more practical and critical level, that success is not even imaginable unless more global resources, commitments, and innovation are put to bear on this work. Tough choices must be made to ensure that the innovation, advances, and education reach those who desperately need them. That's why I'm so excited to be here, both recommitting myself again to this work and recommitting this innovation organization to the task ahead.

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