Michael Weinstein, President of AIDS Healthcare Foundation
Reading the various and sundry headlines about the state of AIDS research, you may find them very confusing and often misleading. There is no question that the rate of scientific progress in understanding and treating HIV has accelerated, and there is tremendous promise. However, we have to carefully consider headlines about being on the verge of a cure or “the end of AIDS.“
I am not looking to rain on anyone's parade. I think it is fully within our reach to conquer AIDS in the next decade. However, with these inflated headlines, we run the risk of minimizing the risk that we still face from AIDS. In fact, there are 34 million people living with this disease in the world; there were an estimated 1.7 million deaths in 2012 (4,600 a day); 2.5 million new infections; the majority of people with HIV don't know they are infected; less than a quarter of all infected people are being treated; and an HIV-infected person must still be treated for life.
Headlines about people who have received bone marrow transplants, whose bodies have been cleared of HIV, are interesting anomalies. We will not be doing dangerous bone marrow transplants to masses of people anytime soon. The story about the Mississippi baby is not applicable to adults with established infection.
Political headlines from the Obama administration about the end of AIDS are political spin. The Obama administration is the first to actually cut AIDS funding, close clinics and discourage the entire international response to AIDS.
There are basically three ways to end AIDS:
First, we can find a cure. There is currently no treatment for HIV having progressed to human trials that represents an actual cure. There is very promising research in genetics, immunology and other areas that could lead to a cure in the future.
Second, we can develop a vaccine that would prevent new infections. Despite tens of billions of dollars being spent on vaccine research and over-hyped results, there is no vaccine that prevents infection with HIV, and none appears on the horizon.
Third, we can treat most people with HIV, an action that will render them mostly non-infectious to others. We call this ‘treatment as prevention.’ In the United States, the 20 percent of people who are HIV-positive and don't know it are responsible for the majority of new infections. If we could find and treat those individuals, we would go a long way to controlling HIV and eventually reducing the number of people living with the disease. This combined with promoting condom use and reducing sexual partners has the most promise at this moment.
This is an extremely hopeful time in the history of this epidemic. There are many bright spots, and more will come. However, exaggerating our progress or minimizing the risks is irresponsible and will lead to more—not less—disease. There will be plenty of time to celebrate when we actually reach the point where we can look at AIDS in the rear-view mirror. In the meantime, there is a lot more work to do.