Will Obama follow through on Clinton’s ‘AIDS-free generation’ speech?

Posted on November 23, 2011  |  Related Issues: U.S. Foreign Policy & Funding

Miami Herald, November 22, 2011 - Secretary of State Hillary Clinton gave a speech recently that most will never hear. But she said something we all should know: “Creating an AIDS-free generation has never been a policy priority for the United States government — until today.” Or in other words, we can end AIDS.

The United States has been an extraordinary leader in fighting AIDS. Ryan White and the global President’s Emergency Plan for AIDS Relief (PEPFAR) programs strive to offer the highest standards of HIV care. Their approaches demonstrate not only American respect for human rights and dignity, but also smart health, economic, and national security policy.

It’s worrisome, however, that people with HIV/AIDS are getting thrown under the bus with the current deficit-hawk climate in Washington.

Because of underfunding, increased unemployment, and the rising costs of medicines, over 6,000 people in this country are on waiting lists for drugs through the federally funded, state-run AIDS Drug Assistance Program (ADAP). These are our friends, members of our families, religious communities, schools and our neighbors.

Miami is the city with the highest transmission rates in the country, and Florida represents half of the whole country’s wait list. How can we as a society accept that 6,000 people have to live without reliable access to lifesaving medications?

Outside our borders, the numbers are even more staggering — over 60 percent of people living with HIV have no access to AIDS medications. It does not have to be this way.

Wonderfully exciting research, published in the New England Journal of Medicine in May, shows that HIV treatment can reduce transmission of the virus by 96 percent. Treatment significantly reduces the amount of virus in our bodies and our communities. In combination with other evidence-based prevention methods, this new finding means the international community can, like Clinton said, ensure an AIDS-free generation within a few decades. But only if we start now.

Clinton’s speech was a dramatic reversal of U.S. policy, which has historically viewed treatment more as a costly expense rather than our most powerful prevention investment. Epidemiologic modeling now shows that if we invest in ending AIDS by scaling up access to treatment, we can prevent 12 million new infections between now and 2020. That’s not only 12 million people who will not need ARVs. That’s 12 million people who can live HIV-free and 12 million steps closer to an AIDS free world.

Clinton’s speech was thrilling for many of us in the healthcare and allied professions, as well as the generation under 30, who have never lived in a world without AIDS. But it begs the question: what will come next?

PEPFAR has almost reached the treatment goal it set for 2013, so President Obama should take the next step and announce bold and concrete plans to scale-up treatment. Doing so on World AIDS Day, he could demonstrate to the rest of the world that we must take advantage of this unique turning point in history.

Most of us will never hear Clinton’s speech. Most didn’t hear President Obama’s remarks when he visited Miami in June, although every news outlet that covered his fundraising visit mentioned a young person who interrupted Obama by chanting, “Keep your promise! End AIDS Now!”

If Obama does not follow up Clinton’s speech by announcing a revised and more ambitious treatment scale up, there will probably be no shortage of hecklers here in Miami or at campaign stops around the country.

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