As the AIDS Healthcare Foundation proceeds from year to year, it is important to step back and take a look at major trends that are shaping our vision. AHF has always had an expansive view of fighting AIDS that was focused on protecting the public health. Circumstance and the success of the organization allow us to act on that larger scope in very meaningful ways.

If you place HIV/AIDS in its proper context, it is primarily a sexually transmitted disease and a global public health threat. HIV is mostly acquired through the same sex acts as other STDs. Classic public health disease control measures that involve prevention, early detection and treatment of diseases apply equally to controlling AIDS at this stage.

Communities and nations that have superior public health systems already in place have generally had lower HIV, STD and other infectious disease problems. Societies that deal honestly and without judgment about sexuality have fewer STDs. The global response to HIV/AIDS overall has been thwarted by bad policies derived from political and religious prejudices taking the place of sound public health practices. AHF throughout its history has championed applying these principles consistently to HIV but did not have the power to truly challenge the entire system of public health delivery until now.

Several years ago, AHF changed the name of the Prevention and Testing Program to the Public Health Division, with the intent of placing HIV in a broader context. As AHF has emerged as the pre-eminent global AIDS organization, this name change has helped to reshape AHF internally and around the world. It is my belief that one of AHF's most profound legacies will be improvements in the public health system across the globe.

The sexual revolution that swept the developed world as a result of the introduction of the birth control pill in the ‘60s brought with it a nasty unintended consequence—epidemics of STDs. The liberation of women from unwanted pregnancy de-coupled sex and reproduction. Likewise, this cultural revolution gave rise to gay liberation. But there is important unfinished business.

Sexual Revolution 2.0 is coming. It is sexual health as a birthright. The world can keep sexual diseases to a minimum by a proactive public health approach based on science and accepting human desires and behavior. 

We have gone as far as we can go in preventing HIV at the personal or societal level without taking on the overall issue of sexual health. Sexually active people have to take personal responsibility for protecting themselves and their partners. Individuals must have routine sexual health checkups. Communities have to own the problem of sexual health and make it a priority.

Another issue the world must tackle is access to life-saving medication. Drugs whose availability we take for granted in wealthy countries are unavailable for most citizens of the world. Millions of avoidable deaths are taking place because we have prioritized drug company profits above human life.

Every thinking person knows that in order to promote innovation, intellectual property rights must be protected. The question is, “What is the appropriate balance between incentivizing new discoveries vs. access?” When millions die from treatable diseases, as they do today, it is obvious that the system is out of balance.  As health advocates, the issue of drug pricing must be at the center of our agenda.

Lastly, what is the responsibility of rich countries to help poor nations? The planet as a whole cannot survive with the disparities that currently exist. National boundaries do not stop diseases and other social perils. We breathe the same air, we enjoy the same climate, we travel the same oceans. 

Today, we see the collapse of HIV treatment programs in many places as a result of the short-sighted withdrawal of support from the United States and other countries. As a U.S.-based organization, we have a special responsibility to hold the United States accountable. Because AHF employs and trains local leadership across the globe, we can fight for more support from other governments as well.

As the world is currently awash in trillions of dollars of newly printed money, AIDS and global health in general should not be begging for money.