HIV/AIDS: Are We Winning?

As years and battles against diseases go, 2010 has been a pretty good year in the global battle against the human immunodeficiency virus which results in weakened immunity, opportunistic infections and death. With the promise of  recent successes, a Huffington Post article offers a mood of cautious optimism for a world without AIDS.

In case you missed them, some 2010′s successful HIV highlights include news of new prophylactic, preventative interventions which have not only shown great promise, but because they are based on already widely used drugs, could also be close to making their real world debut beyond clinical trials. A vaginal gel trial showed that pre-exposure prophylaxis to an existing HIV drug can reduce the risk of infection by around 40%. Another study showed that daily dosing of a different anti-retroviral drug taken prior to HIV exposure can also reduce the risk of HIV infection by over 40%. People who are HIV positive can now expect to live longer with regular highly active antiretroviral therapies (HAART). Studies have shown that instead of expecting death 10 years after being diagnosed HIV positive, adults with HIV can expect to live for over 22 years after an HIV infection diagnosis and children also live longer. There is also, always, promise of new generations of effective anti-viral treatments. The Pope has suggested that the Catholic Church might not have a problem with condoms being used solely to prevent HIV. And with bans lifted, HIV positive people are now able to travel into the USA and China. To top all of this, international data published by UNAIDS have shown year on year significant declines in key numbers: fewer people are acquiring new HIV infections, fewer people are dying from AIDS and more people are gaining access to treatment.

So perhaps the time has arrived to realistically think of a world without AIDS? For the developed world, this is feasible. For developed countries, HIV is fortunately and fast becoming an infection to be treated, rather than a feared, deathly disease. Though some legal travel restrictions have been removed against HIV positive people by global powers, stigma, as well as legalised national and international discrimination remains an ever present hurdle for many who are HIV positive. The new optimistic mood should remain cautious; without caution, optimism could mean a less urgent approach to the ongoing pandemic and the stigma which surrounds it.

Global data on infection and numbers of deaths are indeed moving in the right direction. The peak global devastation of HIV/AIDS happened in the late 1990s; AIDS was announced, in 1995, as the America’s number one killer of people aged 25 to 44. Today 33.3 million people remain infected with HIV, 2.6 million still acquire the infection each year and 1.8 million people still die annually of AIDS  We can combat the changing genetic nature of the virus efficiently with changing, but targeted, combination treatments. But left untreated, HIV remains a virus that will still kill 99% of infected people within 10 years; 10 million people who need treatment are left untreated.

There is room for optimism that HIV/AIDS can be beaten as new interventions are developed, and as older, well known interventions are better implemented; there is reason, and need, to celebrate our successes. But in battling this global pandemic which gripped a whole generation with speed and ease, implementing what works is proving to be perhaps the most difficult challenge against HIV/AIDS.

December 1st  is World AIDS Day.