Kaiser Family Foundation/CSIS forum reviews AIDS 2010, looks ahead to AIDS 2012

Last month's 18th International AIDS Conference-AIDS 2010 in Vienna, Austria, will be remembered as the first since the global economic downturn, the growing recognition of treatment as part of prevention and a focus on the importance of human rights, HIV/AIDS experts said Thursday during a panel discussion in Washington, D.C. A webcast of the event is available online.

The forum, sponsored by the Kaiser Family Foundation and the Center for Strategic and International Studies (CSIS), examined progress and challenges highlighted at AIDS 2010, all while looking ahead to AIDS 2012, which will be held in Washington, D.C.

Jennifer Kates, vice president and director of global health and HIV policy at Kaiser, opened the forum with findings of a joint Kaiser/UNAIDS report released at AIDS 2010, which found overall donor support for global HIV/AIDS programs flatlined in 2009. Kates also noted the UNAIDS estimate that $7.7 billion was needed to fill the HIV/AIDS funding gap.

Kates said of funding discussions at AIDS 2010, "Ultimately, the bottom line was that there's more that's needed. Where is it going to come from and how and how quickly, given the economic crisis and given some of the other pressures, was a big topic of conversation."

Despite this tension, Lisa Carty, deputy director and senior adviser at the CSIS Global Health Policy Center, warned of splintering among HIV/AIDS groups in the face of economic challenges. "It would be a tragedy to return to the old debates of prevention versus treatment or to return to the rivalries that pit one organization against the other. It's short-sighted and counterproductive when the public conversation on HIV devolves into destructive rancor, as sometimes happened in Vienna," Carty said.

Scientific studies presented at AIDS 2010 represented promise in efforts to control HIV/AIDS through prevention, noted two other panelists - Principal Deputy U.S. Global AIDS Coordinator Deborah von Zinkernagel and Johns Hopkins Bloomberg School of Public Health Professor Chris Beyrer.

The Vienna conference marked not only "the return of basic science," but also served "as a landmark" in attempts to focus on the connection between science and human rights in the fight against HIV/AIDS, Beyrer said. Pointing to findings that an ARV-containing vaginal gel used by women before and after sex reduced their rates of HIV infection by nearly 40 percent represented not only a major scientific finding, but one which could ultimately empower women.

Von Zinkernagel noted the recognition by PEPFAR that the use of sterile needle and syringe exchange programs and medication-assisted treatment can help reduce HIV transmission among injection drug users (IDUs). In July, PEPFAR released revised guidelines (.pdf) on its IDU harm reduction policies. Von Zinkernagel and Beyrer also commented on the Vienna Declaration, which calls for a rethinking of international drug policies to incorporate greater scientific evidence and increased access to HIV prevention, treatment and care for IDUs.

Jeffrey Crowley, director of the U.S. Office of National AIDS Policy, discussed the Obama administration's new U.S. National HIV/AIDS strategy announced just before AIDS 2010 as well as the key role the U.S. will play as host to AIDS 2012. "In this country, we're not always good at acknowledging what we have to learn from other countries but I do think we'll all benefit from a rich dialogue" during AIDS 2012 in the United States, he said.

Phill Wilson, executive director of the Black AIDS Institute, outlined the HIV/AIDS epidemic in the U.S., and noted the vital role community leaders must play in HIV policy.

Stephen Morrison, senior vice president and director of the CSIS Global Health Policy Center concluded the meeting with a look ahead to AIDS 2012 when the conference will "return to U.S. soil for the first time in 22 years." Because the U.S. will be in the middle of an election year during the next conference, "Washington in the 2012 context is a great opportunity to shape American opinion and global opinion. It's a great opportunity to reach other Americans outside of global health who matter to opinion-makers and have them engaged in new and different ways," Morrison said (Evans, 8/5).

BBC Examines U.S. HIV/AIDS Funding

The BBC examines U.S. funding for global HIV/AIDS efforts through PEPFAR and President Barack Obama's Global Health Initiative. The video piece includes comments from White House Health Policy Advisor Ezekiel Emanuel, who discusses the White House's commitment to HIV/AIDS programs as well as the broader aims of the GHI. The video also includes interviews with Matthew Kavanagh of Global Access Project, Peter Mugyenyi of the Joint Clinical Research Center in Kampala, Uganda, who express concern over U.S. funding for HIV/AIDS and comments from HIV-positive patients, who were turned away after seeking HIV drugs at a clinic in Uganda (Morris, 8/4).

IOM Panel Outlines Plans For 2 Year Evaluation Of PEPFAR

Nature's "The Great Beyond" blog reports on the recent Institute of Medicine meeting in Washington, D.C., where a panel of experts "la[id] out an important element of the global fight against AIDS: the plan to assess the President's Emergency Plan For AIDS Relief (PEPFAR)."

"Over the next two years, the congressionally-mandated evaluation will look at qualitative and quantitative data from the 120 countries that receive PEPFAR money," the blog writes, adding that the committee will release the results of the evaluation to Congress in 2012. "In particular, they hope to examine how efficient PEPFAR is and determine whether it remains an appropriate response to the international HIV crisis," according to the blog. The blog also notes, "The five-member panel explicitly stated that it was not their prerogative to evaluate the amount of money allocated to PEPFAR, only its effect" (Mann, 8/4).