Column: Achieving an AIDS-free Generation

By Aleeza H. Hashmi, India Perez-Urbano, Maria L. Smith

Imagine an AIDS-free generation. This could happen, but only if we take the necessary steps at this moment. This summer, Secretary of State Hillary Clinton vowed that the United States would maintain its commitment to provide the funding and resources needed to achieve this historic milestone at the 2012 International AIDS Conference. Dec. 1 marks the 34th World AIDS Day. Although it is important to commemorate the millions of lives that have been lost to HIV/AIDS, it is even more crucial to recognize that this single day represents a greater movement to eventually end AIDS altogether. Impending sequestration cuts that could be enacted in January threaten the possibility of an AIDS-free generation.

Despite challenges combating a disease that continuously changes and adapts within the host cells of patients, recent research indicates that it may be possible to control the transmission of HIV. The HPTN 052 study, sponsored by the National Institute of Allergy and Infectious Diseases, used a randomized clinical trial to understand whether antiretroviral treatment, a combination of drugs already used to treat HIV, could prevent sexual transmission of HIV among couples in which one member was HIV-positive. Remarkably, the study demonstrated that ATRVs as a form of treatment is actually a form of prevention: The uninfected partner does not contract the virus. By providing patients with treatment, transmission of the virus can be stopped.

As a result of Congress’ failed attempt to come up with a fiscal solution to last year’s debt-ceiling crisis, the Budget Control Act of 2011 was enacted to reduce the deficit by $1.2 trillion in the next decade (starting this January). Different sectors will be impacted differently by the cuts, but all will be hurt, and small programs will get hit the hardest. For example, sequestration will be disastrous to health research, an area that already struggles with receiving adequate funding. A 7.8 percent sequester is to be enacted for agencies such as the National Institute of Health, which will lose $2.4 billion, the Centers for Disease Control and Prevention ($444 million), and the National Science Foundation ($538 million). On the whole, discretionary funding is projected to decline by $39 billion. In addition, global health funding will be slashed by 8.4 percent across the board. This reduction is estimated to result in an increase of global AIDS-related deaths by more than 60,000. Nearly 275,000 people will be left without AIDS treatment and services. Although the Budget Control Act was presented last year, there is still the possibility for Congress to enact another solution by January—a solution that would not put lives at risk.

The fight against HIV/AIDS is perhaps the single bipartisan issue of our time. Lauded by Bill Clinton as a legacy of the Bush administration, U.S. efforts to combat AIDS both at home and abroad must continue, even in the most pressing of economic times. Congress should take decisive steps to ensure that the U.S. remains an undisputed leader in the fight against AIDS. The fiscal challenge cannot be used as an excuse to slash domestic and global programs that are keeping patients alive. In the U.S. alone, the onslaught of devastating sequestration would bring life-saving research to a halt and leave thousands of people without the medicine they depend on for survival.

The time to fight the AIDS epidemic is now. In recent years, tremendous progress has resuted from research, prevention, and treatment initiatives funded by the federal budget. These allowances comprise a tiny portion of the federal budget relative to defense spending and tax breaks. As of September 30, the U.S. directly supported nearly 5.1 million people on antiretroviral treatment through the President’s Emergency Plan for AIDS Relief. This is a three-fold increase in four years, up from 1.7 million in 2008. We cannot afford to undercut this progress by defunding domestic and global programs.

This Saturday at 11:30 a.m., members of the Harvard Global Health and AIDS Coalition and ACT UP Boston, an AIDS advocacy organization, will meet outside of Senator John Kerry’s home to demand that funding for HIV/AIDS treatment programs be protected. As a member of the congressional debt super committee, he can significantly influence the outcome of the federal budget. GHAC will also be hosting a screening of “How to Survive a Plague,” a powerful documentary about the history of the AIDS movement and where it stands today. The screening will be followed with remarks from guest speaker Gregg Gonsalves, an activist featured in the film. This is the time. We invite you to stand with us on December 1 as we call on Congress to save lives.

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