July 24, 2012 -- Researchers may be turning the corner on the AIDS epidemic -- but eliminating the disease completely will take more research and more money.
Such was the message of a series of high-profile talks at the International AIDS Conference in Washington, D.C.
More than 20,000 scientists, activists, politicians and people living with HIV are gathering this week at the conference, which has returned to the United States for the first time in 22 years around the theme "Turning the Tide Together."
"The U.S. is committed and will remain committed to achieving an AIDS-free generation," Secretary of State Hillary Clinton declared during a speech Monday morning.
From 1990 to 2009, such a gathering would have been impossible in this country, as people who were HIV positive were not allowed to enter the United States during this time -- making it the only medical condition explicitly listed under immigration as a reason to not be let into the country.
AIDS has claimed the lives of more than 30 million people since the epidemic began more than three decades ago. But there have been substantial signs of progress in recent years.
There were 500,000 fewer new HIV infections in 2011, compared to 2001. Additionally, the number of people in low- and middle-income countries receiving antiretroviral therapy increased from 400,000 people in 2003 to more than 8 million people in 2011.
And now scientists believe they finally have the scientific tools at hand to end the epidemic. The cornerstone of these tools is antiretroviral medications used in combination to both save the lives of those infected with HIV and prevent transmission. More advances recently proven effective include male circumcision and "pre-exposure prophylaxis," a daily pill to prevent HIV infection.
"We have a historic opportunity to -- with science on our side -- to make the achievement of an AIDS-free generation a reality," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Now, Fauci urged, "we must enhance what works and eliminate what does not, overcome legal and political barriers, and remove the stigma attached to HIV."
But what all of these solutions have in common is that they will cost money -- and in the current fiscal climate, garnering the additional funds necessary to scale up these innovations is a challenge. Technology magnate and philanthropist Bill Gates used his time at the meeting to call for improved efficiency in the use of our resources.
"The funding environment is very tough. Some days it feels like we are going to have to fight just to keep the funding at the levels it's at now," Gates said. "It's a human imperative that we be able to increase that number [of people treated] even if the dollars aren't going up as fast as we'd like."
In order to put these proven tools into action, Clinton pledged more than $150 million in new funding to fight AIDS. Of that, $80 million will be dedicated towards preventing mother-to-child transmission abroad, with the goal of eliminating it by the year 2015. Another $40 million is allotted for voluntary male circumcision in Africa to decrease risk of transmission of the virus.
Clinton pledged an additional $15 million to fund research on interventions, $20 million to bolster country-led efforts to expand HIV-related services, and $2 million towards civil society groups to reach key populations affected by HIV.
Another key to solving the AIDS problem is knocking down barriers to access, particularly when it comes to poorer populations that cannot afford expensive therapies.
Consumer advocacy organization Public Citizen today released a statement contending that the Obama administration's current negotiations around a "Trans-Pacific Partnership" free trade agreement are an obstacle to an AIDS-Free generation. They maintain that such a partnership would expand pharmaceutical monopoly power, and thereby maintain the high costs of HIV medications.
But what is truly needed, some say, is a greater effort to foster education and acceptance of those whose lives are affected by the pandemic. In a way, the return of the International AIDS Conference to the United States is a sobering reminder of the domestic epidemic, and particular its effect on the African American community.
"In the richest nation on the planet, barely a quarter of the people with HIV are on fully-effective treatment," according to Phil Wilson, president and CEO of the Black AIDS Institute. "Almost six in every 10 Black gay men in America will be HIV-positive by their 40th birthday."
Turning the tide, it appears, will take more than research and money, but a new mindset as well.
"The AIDS epidemic is not fueled by the virus," musician Elton John told the audience in a speech later in the day. "It is fueled by ignorance and hate.
"Everyone deserves compassion... Everyone deserves dignity... Everyone deserves love."
Dr. Liza A. McClellan and Dr. Andrew Myers contributed to this report.