The US is adding an extra US$150 million to the global AIDS fight, with a first step toward reaching some stigmatized populations.
Despite tough fiscal times, “I am here today to make it absolutely clear the US is committed and will remain committed to achieving an AIDS-free generation,” US Secretary of State Hillary Rodham Clinton told the International AIDS Conference on Monday.
That is a big goal: About 34.2 million people worldwide are living with HIV, the virus that causes AIDS, and 2.5 million were infected last year, but the world’s largest AIDS meeting this week is debating how to spread scientific advances in ways to stem spread of the virus to get there.
The key is targeting those tools where they can have the greatest effect.
“We need to go where the virus is,” Clinton told the meeting.
That means a focus on populations at especially high risk: gay and bisexual men, sex workers and intravenous drug users. In many countries, stigma and laws that make their activities illegal drive those populations away from AIDS programs that could teach them to reduce their risk of infection, Clinton said.
“If we are going to beat AIDS, we cannot afford to avoid sensitive conversations,” she said.
Removing stigma is crucial, singer Elton John told the conference.
“We have to replace the shame with love,” the British artist said. “We have to replace the stigma with compassion. No one should be left behind.”
Included in the new US funding is US$15 million for research to identify the best HIV prevention tools to reach those key populations in different countries and US$20 million to create a challenge fund to support country-led efforts to put those findings into practice.
Closer to reality is a goal of virtually eliminating the transmission of HIV from infected pregnant women to their babies by 2015, by getting the mothers onto anti-AIDS drugs. HIV-infected births are rare in the US and are dropping steadily worldwide, although about 330,000 children became infected last year.
Clinton said the US has invested more than US$1 billion toward that goal in recent years and is providing an extra US$80 million to help poor countries finish the job.
Much of the AIDS conference is focused on how to get treatment to all people with HIV, because good treatment saves their lives and reduces their chances of infecting others.
However, drugs are not the only effective protection. Dr Anthony Fauci of the National Institutes of Health said male circumcision is “stunningly successful” at protecting men from becoming infected by a heterosexual partner. Clinton said the US would provide US$40 million to help South Africa reach its goal of providing voluntary circumcision to 500,000 boys and men this year.
The world spent US$16.8 billion fighting AIDS in poor countries, the hardest-hit, last year, and the US is the leading donor.
However, Microsoft founder and philanthropist Bill Gates said that the world is facing great uncertainty about whether wealthy nations will continue funding AIDS programs with the same vigor as in the past.
“As these budget trade-offs are made, the voices of the AIDS community and the global health community are going to have to be louder than ever,” said Gates, whose Bill & Melinda Gates Foundation has pledged more than US$1 billion to global AIDS efforts.
Another US$7 billion a year is needed to get 15 million people in low and middle-income countries onto medication by 2015, a UN goal. A record 8 million received it last year.
“We have to be innovative,” said former Botswana minister of health Sheila Tlou who is now with UNAIDS. “We have to look at new ways of funding.”
Speaking to the conference via video, French President Francois Hollande said his country was doing that by beginning what is called a financial transaction tax next month
Although the idea has received a lukewarm reception in other parts of Europe and the US, researchers from Zimbabwe described how individuals and companies in that country pay 3 percent of taxable income into a National AIDS Trust Fund that has grown large enough to fund anti-AIDS medicines for a quarter of patients using them.
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