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To End or Not to End AIDS: Is There Really Any Question?

Posted: 12/05/2012 2:35 pm

Dr. Paul Zeitz, vice president of policy for ACT V: The End of AIDS, recently recalled reading a story, in 1994, on the war in Rwanda. He read it, put the paper down and went on with his day. As he did, he realized this is how the world's horrors happen. People hear about them, feel shocked -- and do nothing.

"I'm Jewish. When we're taught about the Holocaust the notion of 'never again' is impressed upon us," Zeitz said. "I always wondered why they didn't teach us 'never at all.' But for horrors to be stopped, people have to pay attention and take action. The Holocaust could have been prevented."

Zeitz had a reasonable excuse for not helping in Rwanda: His hands were full ending unnecessary childhood deaths via vaccines and other measures to keep them safe from preventable diseases like malaria and pneumonia. His current objective: ending AIDS.

But his story highlights how we avoid mass, impending tragedy: Read the news -- and take action before it's too late.

We are at a critical tipping point in the AIDS pandemic. New evidence shows that quick, aggressive action now can herald in the endgame of AIDS. Doing so will spare more than 28 million people who will otherwise get sick and die. Hundreds of thousands of them live in the U.S.

The healing of the world requires coalitions but is often initiated by a person capable of getting global attention and pivoting public thinking and behavior. Mother Theresa. Gandhi. Nelson Mandela. Desmond Tutu. Bono. You know the type.

Which is why it is significant that last Thursday, U.S. Secretary of State Hillary Rodham Clinton unveiled "The President's Emergency Plan for AIDS Relief (PEPFAR) Blueprint: Creating an AIDS-free Generation." The Blueprint is an inspiring architectural framework for improved health that compellingly demonstrates how front-loaded strategic investments based on sound science can achieve an AIDS-free generation in several years. And that today's investments will yield significant future savings -- in terms of both dollars and lives.

The 54-page Blueprint describes how we get to that critical moment when the line on the graph for cumulative cases of HIV turns sharply downward and the line for the number of people on HIV treatment globally turns sharply upward, allowing them to cross in a triumph of life over death.

How so? Partly because the same treatment that sustains the health of people with HIV doubles as prevention because it lowers -- by 96 percent -- the risk of viral spread. The more people who know they are living with HIV and get treatment, the less chance others become infected. Modeling in the Blueprint demonstrates -- through cases studies of Cambodia, Kenya, Uganda and Zambia -- that in nations where HIV prevention and treatment is sufficiently prevalent, the incidence of new HIV infections dramatically declines, AIDS-related deaths are avoided and children are not orphaned.

Implementing the Blueprint will require rapid, up-front, well-targeted investments from nations around the world, including ours, and from large, multilateral organizations focused on health such as The Global Fund to Fight AIDS, Tuberculosis and Malaria and The World Bank. World citizens must lobby their own leadership to step up, and the Blueprint can serve as a helpful tool for that advocacy. Activists in the U.K. are already leveraging it to call on their leaders. And there is an encouraging trend of more nations committing greater sums to fight AIDS of late.

Ending AIDS is not and should not be the sole responsibility of the United States. Yet while an AIDS-free generation requires global engagement, it's also true that America's commitments influence the trend of global giving to AIDS. To continue his leadership on HIV/AIDS in his second term and secure his legacy as "The President Who Initiated the End of AIDS," President Barack Obama should respond to this Blueprint by requesting sufficient funding for global AIDS in both his FY 2013 and FY 2014 budgets. And Congress should fund his requests.

But what about the federal deficit?

Since the budget for all U.S. foreign aid constitutes less than 1 percent of the federal budget, slashing foreign aid has an almost insignificant impact on righting the ship of America's solvency. Yet doing so will lead to the deaths of millions of men, women and children. Defending U.S. foreign aid as we careen towards the fiscal cliff is essential. Political maneuvering should not trump sound investment in the health of our planet. Especially when that investment protects Americans, both civilian and military, abroad.

Cutting AIDS budgets in the face of evidence that we can get to an AIDS-free generation is like taking snowplows off trucks as the first flakes of a blizzard start to fall. It's just dumb. And since it leads to mass anguish and death and millions of babies and children parent-less, it's also cruel and bad for the future of the world, as many of these children may be recruited into terrorist groups.

Though its real value will be in its implementation, the Blueprint itself is significant. It will stand as part of Clinton's legacy at the State Department, reflecting her long-term commitment to improving health care systems and resolving the AIDS crisis. And the Blueprint is a throw down of sorts. When someone maps the solution to a global challenge, it makes it more problematic for it to remain unsolved. "We didn't know how" is an excuse no one can use anymore for failing to end AIDS.

Is the Blueprint perfect? Nope. It needs specific targets, a price tag for implementation and the money to put it into play. And I believe the Blueprint should have highlighted more prominently the hunts for vaccines and a cure -- two things essential to really end AIDS. Is it a guarantee that we will stop AIDS? Far from it. But it is a successful attempt on the part of America's leadership to deliver proof positive that the end of AIDS is technically feasible. By definitively answering the question of whether AIDS can be stopped, the PEPFAR Blueprint heightens the moral imperative for those with power to do so.

We can't bring back all those who suffered when humanity and nature turned dark and no one stepped up, or they stepped up too late. But we can remember the times we failed and let them influence a future in which we don't. The Blueprint shows us how to rewrite the ending of one of the world's greatest tragedies -- and turn it into a love story.

To end or not to end AIDS? Is there really any question?

Regan Hofmann is a global health consultant and an activist. Her website is reganhofmann.com. On Twitter: @reganhofmann. On Facebook: ReganHofmann9. She was formerly the editor-in-chief of POZ Magazine and poz.com.

She is the author of I Have Something to Tell You, published by Simon and Schuster in 2009.

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