New Optimism, Old Challenges: Prioritizing High-Risk Groups at the Frontline of AIDS

WAD_2012In a new opinion piece published December 1st on OneWorld South Asia to commemorate World AIDS Day, Alliance India’s James Robertson argues that while India’s admirable progress in achieving a greater than 50 percent reduction in new HIV infections deserves accolades and emulation, it should not be mistaken for victory over the epidemic:

2012 has been a year of heightened public optimism about the future of HIV/AIDS. From UNAIDS audacious “Getting to Zero” campaign to US Secretary of State Hillary Clinton’s aspiration for an “AIDS-Free Generation,” everywhere it seems that the end of AIDS is finally on the horizon.

New strategies and new tools have injected new hope into the global response. Last summer’s International AIDS Conference was abuzz with the potential that antiretroviral treatment has to prevent HIV transmission by reducing a treated person’s infectivity. Our investments in treatment can now be understood to contribute to limiting the epidemic’s spread: a virtuous cycle of responsible public health. 

Yet this optimism has emerged as governments and donors are questioning the scope and scale of their HIV funding. Excitement notwithstanding, who will fund treatment as prevention when we still struggle to fund treatment as treatment? In low and middle income countries, we’re a long way from relying on drug regimens to control this epidemic. Barely a quarter of the 34 million HIV-positive people around the world are currently being treated, and the quality of care remains variable at best.

Political will to scale up treatment has not yet coalesced, and even if it does, it will not suffice. Pharmaceuticals and other tools remain only part of what is needed for us to master this epidemic. Expansion of treatment must be coupled with more and better-focused prevention. We need to significantly increase our efforts to address HIV among those most at-risk, even if they are not politically popular or socially accepted. And we must address larger structural factors that continue to impede our progress the world over.

To read the complete article, please click here.

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James Robertson is Country Director of India HIV/AIDS Alliance in New Delhi.

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