Treating HIV/AIDS Globally Can Be Done

In the United States and Europe, people living with AIDS received treatment to keep them alive, but there was a widely held view that treatment was too expensive and too difficult to be provided successfully in the developing world.
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In 2002 when the Clinton Health Access Initiative was founded, the AIDS epidemic was raging out of control. There were less than one hundred thousand people being treated for AIDS in Africa, Asia and the Caribbean. Millions were dying every year. In the United States and Europe, people living with AIDS received treatment to keep them alive, but there was a widely held view that treatment was too expensive and too difficult to be provided successfully in the developing world.

At a conference on AIDS in Barcelona Spain in July 2002, former Presidents Mandela of South Africa and Clinton of the United States spoke at the closing ceremony and called upon global leaders to support the scale up of treatment for people with AIDS throughout the world. President Clinton said that historians looking back one hundred years from now would find it morally unthinkable for us to turn our backs on the tens of millions of people suffering and dying from AIDS when we had the means to help them.

Much has happened since 2002. Governments in the developing world have mobilized to provide AIDS treatment to their citizens. From South Africa to Papua New Guinea, from the Bahamas to Ethiopia, from Nigeria to Cambodia, governments with their international partners have proved wrong those who thought that treatment was too difficult and too expensive. South Africa has scaled up from a few thousand people to well over two million people on treatment. Rwanda and Cambodia have scaled up from having only a handful of people on treatment to coverage rates higher than those in the United States. People living in the highlands of Papua New Guinea and in Papua in Indonesia, which are among the remotest places on earth, are being tested and treated for AIDS successfully.

Over 10 million people are now receiving treatment. 10 million people who would have died are now alive. The families of these 10 million people who would still be grieving, instead have their loved ones still with them.

Since 2002, the global community has learned how to treat people effectively and efficiently. Governments have deployed capable leadership teams and have built the systems necessary for high quality treatment. We now have drugs that work better and produce fewer side effects. We have lowered the cost of the drugs and tests necessary for treatment by as much as 90 percent. We have carried out massive testing campaigns and trained doctors, nurses, lab technicians and community health workers. We have built hospitals, health centers, laboratories and supply chains. We have also learned that treating people not only saves their lives, but dramatically reduces the spread of the disease as rates of transmission go down drastically when people are in treatment.

The Global response to AIDS over the past decade has been a great success -- but there is still more work to do. The World Health Organization is now recommending that people who are HIV positive should receive treatment before they become ill, and that all HIV positive pregnant women and children under five should receive treatment as soon as possible. These recommendations, if implemented, will mean treating over twice as many people as we treat today, saving millions of more lives and dramatically reducing the transmission of the disease.

As in 2002, there are some people who believe that achieving these goals will be too difficult and too expensive. At the Clinton Health Access Initiative, we know from over eleven years of experience in helping to build AIDS care and treatment programs around the world and negotiating agreements that lower the prices of drugs and tests, that it will be possible to meet these new goals over the next few years and to do so within existing annual spending levels.
Donor funding for treatment can be deployed more effectively and efficiently by increasing local control of resources and spreading best practices globally. Prevention efforts can be better targeted towards those activities that are most successful. The prices for drugs and diagnostic tests can be reduced from today's levels and new more effective drugs and diagnostics can be deployed economically.

To be successful, global donors must fully replenish organizations like the Global Fund and PEPFAR. And those responsible for spending these funds must commit themselves to be as efficient as possible. With renewed political commitment, we can turn the tide on the AIDS epidemic once and for all time.

The tough economic conditions in the US and Europe make it tempting to cut health funding for resource poor nations. But this would be a mistake.

There is a practical reason why taxpayer money in the United States and Europe should be used to fight AIDS in resource poor countries in Africa, the Caribbean and Asia. In our interdependent world, epidemics like AIDS originating in one part of our planet can spread quickly around the world. We cannot simply address the problem in our own countries. Epidemics like AIDS are global and the response must be global.

There is also a moral reason. We are all a part of a common human family. Several years ago, we convened a meeting of people who work for the Clinton Health Access Initiative around the world. There were people from over 30 different religious traditions present. While the explanations for the creation of the universe and the descriptions of a supreme being were different, the teachings of the revered founders and prophets of all of the religions shared a common view -- that all of us have a moral responsibility to care for people who are sick, especially for those who lack the resources to care for themselves.

AIDS does not have to be a death sentence. People who are HIV positive can live long, happy and productive lives. It is within our power as a global community to prevent children from being born with HIV, it is within our reach to dramatically reduce the transmission of the virus among adults and it is both possible and our moral responsibility to try to save the lives of people suffering from AIDS.

This can be done and it is the right thing to do.

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