What to expect from AIDS 2012
by Rebecca Haag
For the first time in 22 years, the International AIDS Conference (AIDS 2012) will be held in the United States. More than 25,000 scientists, researchers, providers, advocates, and elected officials will gather in Washington DC July 22 through 27. The mood surrounding this conference, unlike the last one held on US soil, in San Francisco in 1990, is one of optimism. And that is because today, unlike 22 years ago, we have the tools to end the AIDS epidemic, which has claimed the lives of more than 25 million people worldwide.
We can see examples of this progress here in Massachusetts, where we’ve reduced the rate of new diagnoses of HIV 54 percent since 1999, a move that will ultimately save the state more than $2 billion in health care costs. We’ve accomplished this by partnering with the state to do extensive outreach and prevention education to those most vulnerable to HIV infection. We’ve also given people with HIV access to health care. For the last 15 years, low-income people with HIV have been eligible for Medicaid in Massachusetts without having to wait for a diagnosis of AIDS. And our state’s landmark health care reform law in 2006 extended affordable health care to virtually everyone else in the state, which has made a critical difference in reducing viral load and ensuring better health outcomes.
More broadly, we see signs of progress with the increase in the life expectancy of those who have been diagnosed with HIV in the United States. In 1996 the life expectancy was 10.5 years; by 2005 it had increased to 22.5 years. And this is the story globally as well. Utilizing a fairly macabre example, New York Times columnist Nicholas Kristoff reported this month that coffin makers in Lesotho, South Africa are seeing their business dry up thanks to a dramatic decline in AIDS deaths as more of those living with HIV have access to life-saving medications.
Some of the critical discussions we expect to see come out of the conference include the impact of US health care reform law on HIV care/treatment. By 2014, for example, thanks to the Affordable Care Act, every low-income person living with HIV will be eligible for Medicaid. Other topics for discussion will include HIV prevention technologies/treatments such as PrEP (pre-exposure prophylaxis, in which HIV drugs are given to uninfected persons to reduce their risk of becoming infected); microbicides; HIV vaccines; and experimental HIV drugs in development, including a few that are now awaiting FDA approval; and research into curing HIV, an area of growing optimism in the past few years. Along with these discussions will come debate around who will be able to access these technologies and who will pay for them.
Meanwhile, we expect discussion around the objectives outlined in President Obama’s National HIV/AIDS Strategy, which was released in 2010, the same year Congress lifted its ban prohibiting people with HIV from visiting or immigrating to the US and which made the US location of this year’s conference possible. Can they be met? Or will the funding required to fulfill these objectives fall short? And speaking of funding, we can be sure to hear a frank discussion of the impact of changes in HIV/AIDS funding – including the redistribution of existing funding to different regions within the U.S. on HIV prevention and treatment efforts and changes in global funding.
The end of AIDS is within our grasp. Over three decades, AIDS service organizations have built a sophisticated model of care for HIV, one of the most complicated — and expensive — chronic diseases confronting the health care system today. These social supports, combined with ever-improving drug treatments that target the virus more efficiently and with fewer side effects, ensure better health care outcomes today than we’ve seen at any point during the last 30 years.
The critical question we now face is will do what it takes to get the job done? We look forward to hearing what the best and the brightest working to end HIV/AIDS have to say during the 2012 International AIDS Conference.