U.S. Secretary of State Hillary Clinton, at the U.S. Embassy in Bosnia on Tuesday. (Photo: Saul Loeb, AP)
By Maggie Fox, NBC News
The United States announced an ambitious new push to fight the AIDS virus by providing treatment to more people, especially vulnerable women and children.
The new U.S. plan - immediately welcomed by AIDS researchers and advocates -- also promises to target drug addicts, gay men, prostitutes and other sex workers who are at especially high risk, despite reluctance and stigma.
"We are committing to rapidly scaling up the most effective interventions and treatment," Secretary of State Hillary Clinton told a news conference.
She released new numbers showing that PEPFAR, the U.S. plan for AIDS relief, had provided AIDS drugs to more than 5 million people.
The goal is to treat as many people as possible, both to keep them well and to help keep them from infecting others. Several studies have demonstrated that people who take AIDS drugs are far less likely to pass along the virus.
"Eventually we will be able to treat more people than become infected every year," Clinton said. "That will be the tipping point. We then will get ahead of the pandemic and an AIDS-free generation will be in sight."
The announcement sets the U.S. firmly on the path of providing drugs overseas -- an approach that was controversial only a few years ago, when many politicians wanted to focus on promoting prevention, often through restraining sexual practices but also by distributing condoms.
"For us working in the field, this is great news," said AIDS expert Dr. Michael Saag of the HIV Medicine Association (HIVMA) and the University of Alabama at Birmingham.
"With all the discussion about the fiscal cliff, it always becomes a concern that they are going to start cutting programs like this that are lifesaving." Congress has until the end of December to stop an automatic budget-cutting process that will force severe budget cuts that most experts fear would push the United States back into recession.
"As HIV clinicians and researchers, the HIV Medicine Association (HIVMA) and the Infectious Diseases Society of America (IDSA) Center for Global Health Policy believe the result of that commitment can be a lasting triumph over the longest and most costly epidemic in human history," Saag's group said in a separate statement.
"We are especially encouraged that the blueprint provides concrete numbers in affected countries to illustrate the work that must be done to reach a tipping point, when the numbers of people becoming infected with HIV are surpassed by the numbers receiving life-saving medicine," said Dr. Kenneth Mayer, co-chair of the Center for Global Health Policies Scientific Advisory Committee.
Other AIDS researchers gushed over the plan, even though it did not dedicate any money to achieving its goals. "In a sense, it is quite inspiring," said Dr. Myron Cohen, a longtime AIDS researcher at the University of North Carolina, Chapel Hill, and an IDSA spokesman.
He said while former president George W. Bush's launching of PEPFAR in 2003 was a big move, the Obama administration's new approach broadens the goals. "Hillary Clinton herself has undertaken this," Cohen told NBC News. "That lends a gravitas."
The new PEPFAR plan has five goals:
- Make strategic, scientifically sound investments to rapidly scale up core HIV prevention, treatment and care interventions and maximize impact.
- Work with partner countries, donor nations, civil society, people living with HIV, faith-based organizations, the private sector, foundations and multilateral institutions to effectively mobilize, coordinate and efficiently utilize resources to expand high-impact strategies, saving more lives sooner.
- Focus on women and girls to increase gender equality in HIV services.
- End stigma and discrimination against people living with HIV and key populations, improving their access to, and uptake of, comprehensive HIV services.
- Set benchmarks for outcomes and programmatic efficiencies through regularly assessed planning and reporting processes to ensure goals are being met.
In addition, Clinton said, the U.S. will pressure countries getting aid to do more. "Partner countries must step up," she said. They'll be asked to define what sevrices they need the most, and reach out to get more funding on their own.
Cohen said he was impressed the the administration has made a point of relying on science. AIDS research has been stymied in the past by politics, including squabbles about whether AIDS is really caused by the human immunodeficiency virus - South Africa resisted treating HIV patients for years because of that quarrel.
Bush administration policy limited funding for clinics that even addressed the possibility of abortion, but Clinton said the new PEPFAR policy would push countries to integrate HIV treatment into women's health clinics, reproductive health services and programs to fight violence against women.
"It is science that has brought us to this point. It is science that will allow us to finish this job," Clinton said.
The AIDS virus has killed 25 million people and newly infects a million people every year. There is no cure or vaccine, but a cocktail of drugs can keep patients healthy.
The United States spends more on AIDS than any other country, having spent $37 billion in direct international funding and $7 billion in the Global Fund to Fight AIDS, Tuberculosis and Malaria.