It’s difficult to pay attention to HIV. The disease has been haunting our consciousness since the 1980s. The language is familiar. The anecdotes are rusty. HIV just seems played out – we have drugs that work, and programs to make sure people get them. We keep hearing promising news about vaccines. Do we really have to continue thinking about this? Isn’t it over yet?
At this point, we need to keep pushing the expansion of HIV treatment and prevention efforts. We have achieved tipping point in many countries – where more people start treatment every year than are being diagnosed. We can get there globally. According to ONE’s 2015 AIDS report, “If we can aggressively scale up or ‘fast-track’ our investments and programmes in the next five years, we could bend the curve of the disease towards its ultimate end as an epidemic by 2030.” The scale-up won’t come cheap. ONE estimates that an additional $2 billion will be needed every year until 2020 to achieve the investment fast-track. But, to repeat, if we get this right in 15 years we could see the end of AIDS as an epidemic.
On the other hand, if services stay at 2013 levels, they won’t keep up with new infections. We won’t see tipping point in any new countries, and we’ll backslide in the ones that have already achieved it. There could be as many as 2.6 million new infections in the next fifteen years. That’s not just status quo; it’s disaster.
Right now, more than half the funding for HIV care and treatment in the developing world comes from countries’ own health budgets. That’s a good sign, but it means there isn’t a lot of room left to mobilize additional resources from exhausted health budgets. Wealthy countries will need to increase their commitment if we’re going to reach an additional $2 billion a year for HIV. It won’t be easy, but it also won’t be impossible. The ONE report lays out suggested contributions in detail. They range from new contributions from donors who don’t historically give to HIV to maintaining an upward trend in American support to the Global Fund to Fight HIV, TB and Malaria.
This is not the year to stop thinking about AIDS. This is the year we find a way to end it.