The End of AIDS Is Not in Sight

The end of AIDS is not in sight, and no new slogans cooked up in Geneva will change that fact.

Despite the United Nations‘ recent proclamation that AIDS could end by 2030, the constant urge to put a happy face on a deadly pandemic is a grave disservice to the 1.5 million people who will become infected with HIV this year and the one person who dies from AIDS each minute.

The global community has made progress in the war against AIDS, and that much is a miracle. We have lifted the doom that hovered over parts of the world, especially in Africa, but an estimated 9.2 million people remain untreated (a number probably much higher if we include patients who have fallen out of care), so we still have a steep climb ahead.

Declaring premature victory is a sure road to defeat. Our job as public health professionals is to remain vigilant until the final chapter is written and a happy ending is assured. We are not there yet, and there are mine fields ahead. The last replenishment of the Global Fund is clear evidence of how global funding is falling behind need, and increasingly, AIDS funding is in fierce competition with that of other health priorities, such as pandemic response.

The true end of AIDS as a global pandemic can only happen when there is a drastic reduction in new infections. And that drastic reduction simply has not taken place.

Assuming we don’t have a vaccine or cure in the foreseeable future, there are two paths we can take toward eradicating AIDS. We can make new infections virtually a thing of the past if we can get everyone with HIV in treatment and virally suppressed. To achieve that outcome, however, the public health community needs to do a better job of finding people who don’t know they are positive, linking them to care, and keeping them in care over time.

Secondly, public health professionals must promote the use of condoms. It is now rare to see campaigns that champion safer sex, even as the latex wonder continues to be the true hero in the fight against AIDS. Condom promotion seems to have all but disappeared from our arsenal, and yet condoms can reduce HIV transmission by as much as 94 percent.

No infectious disease ends without a vaccine, cure, or sustained prevention, and as of now, we have none of these weapons against AIDS—none.

At the same time, stigmas and persistent discrimination continue to make the job of ending AIDS all the more difficult. The anti-LGBTQ discrimination we too often see is not only a human rights violation; it also helps spread HIV. People need to feel safe to get tested and accept treatment. Otherwise, they can suffer grave consequences. We also enable the spread by depriving people access to HIV medication and care based on immigration status.

International institutions far from the battlefield of AIDS believe that a catchy new slogan helps the fight. It doesn’t.

Last year, about 86 percent of people living with HIV knew their status, 76 percent received some form of treatment, and 71 percent were virally suppressed. Those benchmarks do represent progress, but the job is not done—not when millions are still struggling. And the job won’t be done until a vaccine, cure, or sustained prevention is guaranteed, especially in more impoverished parts of the world.

Consider smallpox. The steadfast commitment to search the most remote places in the world for the last smallpox case—a commitment cultivated over decades—is now needed to similarly put AIDS in the rear-view mirror.

When the enemy is truly vanquished, we can celebrate. Until then, battle-hardened AIDS warriors must warn against false complacency so that the fight continues.

Michael Weinstein is the president of AIDS Healthcare Foundation, the largest global AIDS organization.

The views expressed in this article are the writer’s own.