Causecast

By Josh Ruxin

This December 1st marks the 20th commemoration of World AIDS Day. The international commemoration has perennially been accompanied by new, bleak reports, and bureaucratic hand-wringing over the invariable failure of supply – in the form of drugs, management and financing – to keep up with the needs of the desperately ill around the world. However, there’s actually some rather interesting news on this World AIDS Day.

A new study just released by Harvard shows that President Mbeki has now topped the charts as one of the world’s top killers of all time. His outrageous ignorance and deadly policies resulted in excess deaths of at least 350,000 South Africans. The study does not include the lives lost in other countries, particularly in sub-Saharan Africa where South Africa’s perspectives are deeply influential. Quantifying the toll of Mbeki’s malfeasance is an important step toward rectifying the challenges in Africa: leadership in the fight against AIDS does make a difference and those who choose not to lead must be identified as collaborators in the killing.

Meanwhile, for the first time since the advent of anti-retroviral therapy and vaccine trials, hope for a cure has emerged. Through a bone marrow transplant, a German scientist has perhaps cleared the first AIDS patient of the virus – quite possibly the first time in human history that a person with AIDS has been effectively freed of the virus. There is nothing easily replicable about this case, but this breakthrough offers a glimmer of hope for what is essential to bring the pandemic to a halt: a cure. Despite nearly a quarter of a century of treatment and research, over 30 million people are currently afflicted with HIV and close to 2 million die from AIDS each year. Most worrisome is the momentum of the pandemic itself: 2008 registered nearly 3 million new cases of the disease, and only a small proportion of them are likely to receive treatment before perishing.
Treatment is an area of notable success in spite of its failure to reach a high proportion of those in need. In 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria was born and the dream of billions for fighting the pandemic became a reality. In 2003, President Bush launched the President’s Emergency Plan for AIDS Relief (PEPFAR) to combat global HIV/AIDS – the largest commitment by any nation to combat a single disease in human history. In 2003, approximately 50,000 people in all of Sub-Saharan Africa were receiving anti-retroviral treatment. Today, the Global Fund and PEPFAR support anti-retroviral treatment for nearly 1.7 million people in the region – and tens of thousands more around the world, from Asia to Eastern Europe. Unfortunately, that is still not enough. In June of this past year, a joint WHO/UN Aids report showed that nearly three million people are now receiving anti-retroviral drugs in the developing world, but this is less than a third of the estimated 9.7 million people who need them today (what isn’t stated is those 2/3rds in need will likely die in the next 24 months). We must reach more people and we must do it quickly.
As we see a world-wide recession take root, we have to redouble efforts to raise money for treatment and research. Global surges in poverty are a recipe for increases in diseases like AIDS. Short-term budgetary cuts can have massive and multiplied effect in the public health world: now is the time to increase, not decrease expenditures. For example, we have made remarkable advances in the fight against malaria over the past few years, so much so, that deaths can potentially be eliminated over the next few years with the proper infrastructure and funding. The same could be true for AIDS with the right approach and commitment.

To read the rest of Josh’s blog, click here.

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