Call to intensify HIV prevention
02 July 2007
AIDS experts estimate expanded HIV prevention could avert 30 million HIV infections by 2015.
In a new report released on HIV prevention, a panel of leading AIDS experts calls for a major increase in global HIV prevention programs, citing new projections that expanded access to prevention could avert approximately 30 million of the 60 million HIV infections expected to occur by 2015.
The report, released by the Global HIV Prevention Working Group, warns that HIV prevention efforts are not keeping pace with the gains being made in treating people infected with HIV. For every person who began antiretroviral therapy in 2006, the report says, six people were newly infected.
“We need to make the same gains in HIV prevention that we are making in HIV treatment,” said Helene Gayle, President and CEO of CARE USA and co-chair of the Working Group. “We have a critical window of opportunity over the next 10 years to dramatically slow the rate of new infections, and ultimately reverse the epidemic.”
“It’s widely assumed that HIV continues to spread because prevention isn’t effective, and that’s simply not true. The problem is that effective prevention isn’t reaching the people who need it,” said David Serwadda, Director of the Institute of Public Health at Makerere University in Uganda, and co-chair of the Working Group.
The report, titled Bringing HIV Prevention to Scale: An Urgent Global Priority, finds that scientifically proven HIV prevention programs – such as those to reduce the risk of mother-to-child HIV transmission – are not being implemented on a sufficient scale, meaning they do not reach enough people, with enough intensity, to curb the epidemic. The report recommends that global spending on AIDS double over the next three years, and calls on governments and donors to ensure that resources are spent on proven prevention strategies targeted to people at highest risk.
Better allocation of resources
Although annual global spending on AIDS has increased six-fold since 2001, it is still only half of what UNAIDS recommends is needed. The Working Group calls for global AIDS spending to double within three years, from the current level of US$10 billion annually to the UNAIDS target of $22 billion by 2010, and for approximately half of this spending to be allocated for prevention, as UNAIDS recommends.
“Over the past few years there have been major increases in funding for AIDS, but we are still well short of what is needed,” said Nicholas Hellmann, interim Director of the HIV and TB programs at the Gates Foundation and a member of the Working Group. “Increasing spending now will save both lives and money over the long term.”
The report notes that as AIDS spending increases, it is critical for governments and international donors to ensure resources are used strategically. For example, a number of countries focus prevention efforts on general HIV awareness campaigns even though the vast majority of new infections in those countries are occurring among specific high-risk groups such as men who have sex with men and commercial sex workers. Donors should also remove any politically-based funding restrictions that limit access to scientifically proven and evidence informed HIV prevention strategies.
“Knowing the dynamics of your own HIV epidemic, and how the last 1000 infections have been transmitted, is key to tailoring HIV prevention strategies to really benefit those most in need,” said Catherine Hankins, UNAIDS Chief Scientific Advisor and Steering Committee member of the Working Group.
The Working Group is an international panel of more than 50 leading public health experts, clinicians, researchers, and people living with HIV. It is co-convened by the Henry J. Kaiser Family Foundation and the Bill & Melinda Gates Foundation.