Pessimism About Stopping the HIV Epidemic
For decades, we have not lacked for knowledge based solutions to stopping the HIV epidemic. We knew how to stop the epidemic by 1983 when we understood how AIDS was transmitted, even before the causal agent was discovered. Universal use of condoms would also stop the HIV epidemic. The problem has been implementation and behavior change.
I believe it will be decades before our new knowledge of how to stop the HIV epidemic, universal early and continued treatment, will be effective. The key barriers are government inaction, poor healthcare delivery systems, and behavioral change. In stark terms, that means fifty million more people are likely to die of HIV infection that need not. I base my opinion on more than thirty years of work and observation of the human response to the infection. Sad to say, I believe that even my prediction is optimistic.
Below is an excerpt from an article in the journal Nature.
How to Beat HIV
Scientists have the tools to end the epidemic. They just need better ways to use them.
On the shores of Lake Victoria, Kenyan fishermen spread out their nets on the sand to dry their catch in the sun. At a clutch of tents next to the beach, healthcare workers are casting a very different kind of net, one that could help to capture the best approach to eradicating HIV.
The tents draw a steady stream of visitors because the fishermen and their families, as well as farmers, students, and others from the surrounding communities, have heard that they can get vitamin A, condoms, and medicines for worms and malaria there. At the same time, they are offered various screening tests — including one for HIV. The hope is that, along with taking advantage of the other medical services, they will agree to be tested and, if necessary, treated for the sexually transmitted virus.
Here in Kenya’s Nyanza Province, which has the country’s highest rate of HIV infection, this community is part of a groundbreaking study designed to explain a troubling conundrum. Interventions to prevent HIV transmission that work in trial settings — such as rapid on the spot HIV tests coupled with effective treatments — often fail to make as much of a dent in the epidemic as they should. The current trial, known as Sustainable East Africa Research in Community Health (SEARCH), has enrolled more than 335,000 people in Kenya and Uganda and is at the forefront of a shift in thinking about how best to deal with HIV. In the past, there was a sense that stopping the HIV/AIDS epidemic would require some radically new biomedical intervention, such as a cure or a vaccine. The growing consensus, however, is that the tools needed to stamp out HIV already exist if they could just be used in the right way.
Click here to read the rest of the article.