Clinton reveals roadmap to end AIDS worldwide

Secretary of State Hillary Rodham Clinton speaks during a ceremony in recognition of World AIDS Day, Thursday, Nov. 29, 2012, at the State Department in Washington, where she unveiled a new roadmap for an AIDS-free generation. / AP

To achieve an AIDS-free generation, the Obama administration has announced an ambitious roadmap to slash the global spread of the disease, which infected 2.5 million people worldwide last year despite a decade-long decline in new infection rates.

The administration said Thursday that treating people sooner and more rapid expansion of other proven tools could help even the hardest-hit countries begin turning the tide of the epidemic over the next three to five years.

"An AIDS-free generation is not just a rallying cry - it is a goal that is within our reach," Secretary of State Hillary Rodham Clinton said in the report.

"Make no mistake about it, HIV may well be with us into the future but the disease that it causes need not be," she said at the State Department Thursday. Clinton had ordered the blueprint for what the U.S. and other countries should do to slow the spread of AIDS.

President Barack Obama echoed Clinton's promise.

"We stand at a tipping point in the fight against HIV/AIDS, and working together, we can realize our historic opportunity to bring that fight to an end," Obama said in a proclamation to mark World AIDS Day on Saturday.

About 34 million people worldwide are living with HIV. Given those staggering figures, what does an AIDS-free generation mean? That virtually no babies are born infected, young people have a much lower risk than today of becoming infected, and that people who already have HIV would receive life-saving treatment.

That last step is key: Treating people early in their infection, before they get sick, not only helps them survive but also dramatically cuts the chances that they'll infect others. Yet only about 8 million HIV patients in developing countries are getting treatment. The United Nations aims to have 15 million treated by 2015.

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Other important steps include include treating more pregnant women and keeping them on treatment after their babies are born; increasing male circumcision to lower men's risk of heterosexual infection; increasing access to both male and female condoms; and more HIV testing.

The world spent $16.8 billion fighting AIDS in poor countries last year. The U.S. is the leading donor, spending about $5.6 billion.

Thursday's report from PEPFAR, the President's Emergency Plan for AIDS Relief, outlines how progress could continue at current spending levels - or how, if other donors or hard-hit countries themselves can step up investments, faster progress is possible.

Clinton warned Thursday that the U.S. must continue doing its share: "In the fight against HIV/AIDS, failure to live up to our commitments isn't just disappointing, it's deadly."

Consider Zambia, which already is seeing some declines in new cases of HIV. It will have to treat only about 145,000 more patients over the next four years to meet its share of the U.N. goal, a move that could prevent more than 126,000 new infections in that same time period. But if Zambia could go further and treat nearly 198,00 more people, the benefit would be even greater - 179,000 new infections prevented, the report estimates.

In contrast, if Zambia sticks with its 2011 levels of HIV prevention, new infections will level off and may even rise again over the next four years, the report found.

Last July, Secretary Clinton announced at the International AIDS Conference that the U.S. would donate an extra $150 million to help poor countries put the tools in place to help stop the spread of HIV, in addition to setting aside funds for more research.

Last year, the world spent $16.8 billion fighting AIDS in harder-hit poor countries.

"The blueprint lays out the stark choices we have: To stick with the baseline and see an epidemic flatline or grow, or ramp up" to continue progress, said Chris Collins of amFAR, the Foundation for AIDS Research.

World AIDS Day 2012 occurs on December 1.

[thinking_about_it]

"Stallings et al. (2009)reported that, in Tanzanian women, the risk of HIV among women who had undergone FGC (female genital cutting)was roughly half that of women who had not;"

"Kanki et al. reported that, in Senegalese prostitutes, women who had undergone FGC had significantly decreased risk of HIV-2 infection when compared to those who had not"

"Kanki P, M'Boup S. Marlink R, et al. 'Prevalence and risk determinants of human immunodeficiency virus type 2 (HIV-2) and human immunodeficiency virus type 1 (HIV-1) in west African female prostitutes." Am. J. Epidemiol 136 (7: 895-907. PMID

[thinking_about_it]

Gregory J Boyle and George Hill write the following in "Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns": 'While the absolute reduction in HIV transmission associated with male circumcision across the three female-to-male trials was only about 1.3%, relative reduction was reported as 60%, but, after correction for lead-time bias, averaged 49%.' 'In the Ugandan male-to-female trial, there appears to have been a 61% relative increase in HIV infection among female partners of HIV-positive circumcised men.'

[eroteme2]

Way to go Hillary! Now about your involvement with the Benghazi incident? But I suspect you can ride it out, with assist from your helpful media and Obama. If it gets a bit close to you Obama can claim executive privilege for you. Your involvement should fade away as easily as Fast and Furious did for our Attorney General.