Ramping Up the Fight

AIDS activists loudly urged world leaders to ramp up the fight against this global scourge at the International AIDS Conference in Barcelona this past July. James Curran, dean of the Rollins School of Public Health, began his senior lecture at the conference with an acknowledgement of activism’s crucial role in accelerating drug development and distribution and bringing attention to access to care worldwide. “Silence does equal death!” he declared in his lecture titled: Reflections on AIDS: 1981 to 2031.

More than 20 scientists and clinicians from the Emory Center for AIDS Research (CFAR) brought a zealous passion for the cause of AIDS eradication to Barcelona, along with decades of experience, innovative interventions, and ground-breaking research studies. But much work remains to be done.

“After 21 years of the HIV revolution, the virus is clearly winning the battle,” Curran told delegates at the conference. “This truth and my fear for the future makes me angry about the lack of progress worldwide on prevention and about the denial, stigma, and abject poverty behind it.”

AIDS statistics remain staggering, both in lives lost and projections of future deaths. The virus has killed 22 million people—a half-million of those American—since the first handful of cases were identified more than 20 years ago. It is now the fourth leading cause of death in the world. An estimated 40 million people worldwide are living with HIV, and there are on average 8,000 new infections a day. More than 800,000 babies worldwide were born with the AIDS virus last year.

Indeed, news coming out of the 14th biannual conference was discouraging on many fronts. The 15,000 attending scientists, clinicians, health care workers, people living with AIDS, politicians, and journalists were told the following:
• AIDS will claim an additional 65 million lives by 2020—more than triple the number who died in the first twenty years of the epidemic—unless prevention programs are rapidly expanded. “The epidemic is still in its early stages,” stated a United Nations report.
• AIDS will leave 20 million children in Africa without one or both parents by 2010. “Even if by some miracle the spread of HIV stopped today, the number of orphans would still rise for a decade,” said RSPH alumna E. Anne Peterson, MD, 94MPH, of the US Agency for International Development.
• Of the 40 million HIV-infected people worldwide, just 700,000, or 1.75%, are receiving anti-viral drug treatment.
• The epidemic is growing rapidly in Russia and Eastern Europe, the Caribbean, and China.
• Half of all new HIV infections are among 15- to 24-year-olds; and many young adults who have HIV are unaware of their status.
• Rates of new HIV infections are vastly disproportionate among the world’s poor and minorities.

On a more promising note:
• Prevention programs in Zambia, Uganda, Poland, and Cambodia have been widely successful, leading to declining HIV infection rates.
• The first nationwide program in a developing country to prevent HIV-transmission from mother to newborn has proved highly successful in Thailand.
• An experimental drug called T20, or Enfuvirtide, has shown promising results in thousands of patients infected with drug-resistant AIDS.
• Low-tech, low-cost tools like condoms are still some of the best weapons against the virus.
• The search for an AIDS vaccine is progressing, with several DNA-based vaccines advancing to clinical human trials, including those developed at Emory.

Related article: Powerful Medicine