Treatment as Prevention

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AIDS is a legacy of our generation. Twenty-five million people have died. Another 33 million live with HIV. Unless we intervene, 20 million more will join their ranks over the next decade. For the first time, however, we are armed with new evidence to turn the tide on this epidemic. It is time to be bold. Our response at this critical moment will reflect who we are and what we value.

A simple yet revolutionary strategy known as "treatment as prevention" has recently been shown to be effective. We know that treatment is life-saving for people with AIDS. We know it also prevents mother-to-child infection.

Now, new evidence shows that early treatment prevents AIDS and fatal complications such as tuberculosis. In a breakthrough this year, scientists also found that treating people with HIV infection -- using drugs we already have -- prevents sexual transmission.

So, what are our obstacles?

First, less than half of infected people globally are aware of their infection. Second, some communities are disproportionately affected -- rates are seven times higher in black communities than in white ones -- and we must do more to reach them. But cost is the greatest impediment. Even though HIV medicines in poor countries have become 10 times cheaper, they remains too expensive.


To turn the tide on HIV, we need to act. The private sector must continue producing better treatments and technologies. The scientific community must keep investing in research, including vaccines. Most importantly, governments need to join the U.S. to fund ramped-up treatment for the health of individuals and communities in any country that has HIV -- which means every country. Success depends on acting collectively.

A decisive response now can begin the end of the HIV epidemic, 30 years after it started. That is a legacy for which we all can and will be proud. When I began working in this field 25 years ago, most of my patients died. Today, most are living healthy lives. Imagine how many more people we can save if we act now with treatment as prevention.

With a Perspective, I'm Diane Havlir.