IAC Panelists: Scale Up, Leadership and Youth Crucial to HIV Response
August 4, 2008
By Tim Horn
The first major session of the XVII International AIDS Conference in Mexico City, held on Monday morning, August 4, provided an assessment of recent advancements and challenges toward the scale up of HIV treatment and prevention programs, along with calls for greater leadership and an urgent youth HIV/AIDS agenda.
Building on Progress to Date
Jaime Sepulveda, MD, founder of Mexico’s National AIDS Council, who is now with the Bill & Melinda Gates Foundation, noted that resources for AIDS are at all-time highs, including substantially increased funding for the Global Fund and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
According to Sepulveda, reaching the goal of 3 million people in low- and middle-income countries on treatment at the end of 2007 was a critical step forward, but he says that the world has only scratched the surface of possibilities in responding to the epidemic.
Greater resources, more effectively spent and targeted where they can have the greatest effect, would have a dramatic impact on the epidemic’s course. Highlighting the fact that more people became infected with HIV last year than began treatment, Sepulveda called for radically increased investments in prevention research, evaluation and delivery of services, as well as accelerated research on promising prevention methods, including a vaccine.
In conclusion, he reiterated that political leadership from all countries and accountability at all levels are essential to stop the epidemic. Leadership Key to Success
Citing the results in both treatment and prevention scale up in countries with sustained leadership, such as Rwanda and Tanzania, Alex Coutinho, MD, of the Infectious Disease Institute of Makerere University in Kampala, Uganda, made a passionate call for greater leadership as a path toward meeting the challenges ahead.
In looking at progress to date, Coutinho first highlighted the effectiveness of mother-to-child transmission (PMTCT) programs for pregnant women. Approximately 33 percent of HIV-positive pregnant women were enrolled in a PMTCT program last year, which include the provision of HIV drug treatment to help prevent transmission of the virus during pregnancy and delivery. In 2004, Coutinho said, only 10 percent of women had access to such programs.
Children also continue to benefit from the scale-up of treatment access initiatives. In 2005, only 75,000 children in low-income countries had access to antiretroviral therapy. Last year, approximately 200,000 children were receiving life-saving HIV treatment.
In contrast, he noted that most countries will not achieve universal access by 2010 and that the majority of people living with HIV are still unaware of their HIV status. In his call to action, Coutinho urged greater investment in prevention; financial resources flexible enough to support health systems; and systems that access rural and other hard-to-reach areas and fully embrace people living with HIV/AIDS as partners.
Coutinho also urged outreach to and support of marginalized and at-risk communities, as well as the greater involvement of people living with HIV as a catalyst for change.
Inclusion of Youth Essential
Elisabet Fadul of the Dominican Network for Youth Rights in the Dominican Republic outlined a broad and urgent youth HIV/AIDS agenda, calling for comprehensive rights- and evidence-based plans to provide access for young people.
Highlighting the 40 percent of new infections worldwide among young people between ages 15 and 24, Fadul noted that HIV prevention and treatment programs are failing to effectively reach young people, with the most vulnerable and marginalized being stigmatized, criminalized or forgotten by many of these programs.
To reverse this course, she called for actions and policies that engage youth, especially young people living with HIV/AIDS, as respected partners in developing and implementing programs that forthrightly address their needs and diversity.
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JOHN C. HOPKINS, ATLANTA, GA., 2008-08-06 16:10:28
Dr. Sepulveda speaks of worldwide resources being at an all time high with the increase of PEPFAR funds. While here in the USA we are suffering budget cuts and funding shortfalls. In the face of CDC new numbers indicating an undercount of the problem in the USA. THIS IS MADNESS.
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