In the aftermath of election results that could change approaches in Washington to health care funding and policies, World AIDS Day offers a chance to reflect on a public health crisis that has continued for more than 30 years despite advances that have occurred at a pace rarely seen in medical research. The United States, with an estimated 50,000 new HIV infections each year, is one of 30 countries that account for nearly 90 percent of HIV incidence worldwide. The time is right for reflection as we are at a moment of unprecedented promise when we could realize significant change in fighting HIV at home and globally.
In recent years, advances in biomedical research have brought us treatment that allows HIV-infected individuals to live long healthy lives, improved tools to prevent HIV infection, and even the possibility of eliminating the virus in those already infected. We we can now contemplate a cure for HIV, but we still have a long way to go.
While scientists work toward a cure, the research that has taken us this far will continue to require robust funding. We know now that the antiretroviral drugs used to treat HIV are also effective at preventing HIV infection. But we have much to learn about how to get this intervention to those who need it most. Research on prevention methods important for controlling the epidemic such as topical microbicides and HIV vaccines also show encouraging results that require continued study to realize their potential.
But our work won’t stop when we develop new prevention options, including a vaccine, or even when we have a cure. Highly effective drugs that cure the hepatitis C virus are now available, but their high price tags limit patients’ access to them; this experience shows us that the existence of a cure does not mean that a public health crisis will be solved. Access to treatment for all who would benefit is essential. This is a critical issue as we envision ending HIV, an epidemic that is fueled by inequities, such as the choice of 23 states to reject Medicaid expansion and leave the poorest among us without access to health insurance coverage.
In the last three decades the HIV pandemic, and more recently the Ebola virus, have taught us that this is a small world. On this World AIDS Day, we can’t lose our momentum as we contemplate a changing political environment, an unyielding epidemic at home, and our progress against it. This affects all of us; what we do now will affect the future of our children.
Adimora is chair of the HIV Medicine Association and a professior of Medicine, School of Medicine, University of North Carolina, Chapel Hill.