Can We Eradicate HIV/AIDS?

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We talk about a world without AIDS, and AIDS free generation, and terminologies like that. I do believe that that is conceivable, it isn't a question of can we do, I'm certain we can, question is, will be. This is still a major pandemic, if you look at the history of it ranks within the very short-list of historically devastating pandemics of mankind. If you go from the very beginning, it's been at least 70 plus million people have been infected over 35 million of whom have died. There're 1.3 million deaths per year, and 2.3 new infections, million new infections per year. In the United States alone, there's 50, 000 new infections each year, and the tragedy of it is it's been at that level for almost two decades, which means we've reached some kind of war in being able to get it to go down. So there are so many things about HIV/AIDS that are still challenges, and yet we have within our own capability, but we're with a role to actually put an end to it.

I think there are two things, there's implementation breakthroughs. I think you get to an AIDS free generation by implementing the prevention, combination prevention, as well as the therapies that we already have. There's an absolutely extra ordinary observation that was made in a clinical trial which we sponsered, at NIA, a step was conducted at multiple different centers which is called Treatment as Prevention, which tells you that if you treat an HIV infected person and bring down their level of virus to below detectable level,

you dramatically diminished by 95 plus percent the likelihood that they're going to transmit their infection to someone else. So, just on the basis of treatment alone, if you could in a perfect world go out and actively, and aggressively, voluntarily test, link to care, get people on treatment, and keep them on treatment, and you brought the level of virus to below detectable level and the overwhelming majority of people who were infected, that alone could essentially put an end to AIDS pandemic.

Now logistically, that's not an easy thing to do, because the healthcare system in many of these countries doesn't make it easy to identify linked to care, and put in care, these people who are infected. If you super impose upon that, what started off as simple low tech prevention modalities like behavioral change, the use of condoms, needle exchange, and add to that the medically related prevention, like prevention of mother to child transmission by treating the mother during pregnancy, after pregnancy, during breastfeeding.

We've made the incidence of transmission from a mother to child under the proper circumstances go down to less than 1%. Then you have things like circumcision, medically, supervised adult male circumcision which dramatically decreases the acquisition. I mentioned three best prevention, we have pre-exposure propalocess, we've tropical microbocides, you put all of those combinations together, and you super impose that with the treatment.

If we implemented this on a global scale, we could see an AIDS free generation. I bring up the issue of a vaccine because human nature being what it is, you may get the courage to go down, but history has taught us that when you have diseases, be they Tuberculosis or Malaria, once you start to see things going the right direction, there's an unfortunate withdrawal of support for continuing it because you think you've got that problem covered, whereas if we had an AIDS vaccine, we could put the final nail on the coffin of HIV/AIDS by not only getting it down to below a pandemic level, but keeping it there.

Time frame of when that occurs depends completely on our global commitment to make it happen. If we have this as a top, top global priority, and I don't mean we, not only just the United States, but the global community, this can be done, I think within a reasonable amount of time, certainly in my lifetime.