Why the Fight Against AIDS Is Not Over

During my visit to Zimbabwe at the beginning of this year, I had the chance to meet people infected with HIV and their families. I will never forget the old woman I met in Lower Gweru in rural Zimbabwe. She showed me her house and I met several young children from her family. The woman explained that she and her husband were the only adult survivors after all her children had died of AIDS.

Now she was caring for 16 grandchildren. The oldest, who was 13, had already tested HIV positive and was under treatment with anti-retroviral (ARV) drugs. She was very grateful for the support she got and the treatment provided for her children by Doctors Without Borders (MSF), but it was by far not all she needed.

At the time of my visit, the world was talking about the cholera outbreak in Zimbabwe. Although that outbreak was the largest ever recorded, in terms of human loss it lagged far behind the real medical problem of the country. Within the space of just two weeks, more people died of AIDS than during the whole six months of the cholera outbreak. Every day, 400 people in Zimbabwe die of the disease.

Dire Situation

Despite great gains in the treatment of AIDS, the situation of the vast majority of people infected with HIV in the world remains dire. The latest data on HIV/AIDS shows a small reduction in the number of new infections and deaths, but 2 million people still die of the disease every year -- thousands every day. For every person put on HIV treatment, there are three new infections. In the six worst-affected countries -- Swaziland, Botswana, Lesotho, Zimbabwe, Namibia and South Africa -- AIDS is the leading cause of death.

Doctors Without Borders has been treating people with anti-retroviral drugs against HIV/AIDS since the year 2000. We currently have more than 140,000 patients in over 30 countries receiving the life-prolonging treatment. Today more than 4 million people around the world have access to anti-retroviral therapies -- but more than 6 million are still in need of urgent treatment.

At the moment, it is clear that donors are starting to question the need for further efforts in the area of HIV funding. Initial reports suggest that countries are under pressure to cut back their spending on ARV therapy in order to reduce costs. The Global Fund, one of the major funding mechanisms for HIV/AIDS treatment, needs new funds to provide for new projects beyond 2010.

Additional problems also exist regarding HIV drugs, which are essential to treating the disease. Here we are facing a crisis that has the potential to overturn the current successes in HIV treatment. After a long period of decline, prices for medicines to treat HIV are increasing again, because doctors today need newer drugs to treat HIV/AIDS.

There are two reasons for the need to switch treatments. First, the virus develops resistance to existing drugs over time. Secondly, the side effects of some drugs can become unbearable.

These newer treatments are much more likely to be patented or subject to patent disputes, which means that there will be no cheap generic versions in the near future. The resulting dramatic increase in drug prices is a major threat to the sustainability of HIV treatment programs.

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