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Michel D. Kazatchkine

Michel D. Kazatchkine

Controlling AIDS in Our Time

Posted: 12/ 1/10 11:05 AM ET

As we approach the 30th anniversary of the first report of AIDS in the United States, well over five million -- more than half of all people in urgent need of AIDS treatment in the developing world -- are now receiving anti-retroviral therapy, a life-saving medication which only five years ago was beyond the reach of all but a privileged few. We are also making progress on prevention: HIV prevalence among young people has fallen by more than 25 per cent in 15 of the worst-affected countries.

This is a source of particular satisfaction for me. In 1983, when the epidemic was in its infancy and little understood, my first AIDS patients in a Paris hospital were a married couple who had fallen ill after returning from Africa. They soon died. This was the start of an agonizing decade when my colleagues and I struggled to accept that we would lose patient after patient, able only to ease their pain.

Today, major milestones are within sight that seemed unreachable only 10 years ago. Two questions burn in the hearts of every HIV-positive expecting mother: will I live to see my child grow up? And will the baby be born free from HIV? For millions of women over the years, the answer to both questions has been a devastating "no." Yet today, for more and more women, the answer is "yes."

Some time ago, I accompanied Carla Bruni-Sarkozy and Melinda Gates on a visit to a village hospital outside Cotonou, the capital of Benin, in West Africa. There we met Francoise Ade, an HIV-positive mother who had just given birth. Her son Gabriel was born free of HIV because Francoise was able to follow a course of anti-retroviral therapy for free. Her enormous relief moved us all. By 2015, with a determined effort, we should be able to help every mother in this way. Eliminating HIV transmission from mothers to their infants could be the first "end-game" in the fight against AIDS.

The frontlines of the battle against HIV and AIDS are moving beyond the medical arena. If we are to end AIDS as a pandemic, we need to address the issues of sexual violence against women, and work to empower women's lives. We must end human rights violations against gays, sexual minorities and AIDS activists. This will take legislation and enforcement, but above all, a change of attitudes.

We need to accept that whatever view one has of drug use, opioid substitution treatment and needle exchange are crucial to stop transmission of HIV. So is straightforward, respectful assistance and education for sex workers to provide them with the knowledge and the means to protect themselves, including condoms. Without these actions, the AIDS pandemic will continue to grow in large parts of Europe and Asia in the coming years.

The greatest obstacle to winning the war against AIDS is that public opinion and political commitment in the world's richest countries, where HIV is no longer a serious health challenge, are faltering. Those who think the fight against AIDS has now received enough attention are sorely mistaken. A job half done quickly unravels.

Raising the additional funds we need to achieve an AIDS-free world is a huge challenge. Until now, the G8 countries continue have led the way in the fight against AIDS. As the G20 increases its role in global governance, we need fast-growing economies like China, India, Brazil and Mexico need to play a bigger role in helping the world to overcome poverty and disease.

The corporate world is waking up to the need to make long-term investments in its business environment. The (RED) initiative, for example, is giving millions of consumers of global brands the opportunity to support the fight against AIDS in Africa. Since its launch in 2006, (RED) has raised more than $150 million for the Global Fund to Fight AIDS, Tuberculosis and Malaria. Through its visibility and appeal, (RED) has also increased corporate interest in fighting AIDS.

African companies are now also contributing to the Global Fund, as are international companies with large operations in Africa, like Anglo American. Chevron is the Global Fund's corporate champion, having not only invested $55 million through the fund, but also leveraging its people on the ground to improve health in the communities where it operates.

Yet, only if we succeed in broadening the engagement in health to include many more countries and corporations, both in the developed "north" and the emerging "south," will we have a real chance of transforming the lives of millions and bringing down the curtain on a global epidemic that has already claimed nearly 30 million lives.