Funding must support optimism surrounding HIV prevention, treatment

The goal of an "AIDS-free generation" "requires an ambitious implementation-science agenda that improves efficiency and effectiveness and incorporates strategies for overcoming the stigma and discrimination that continue to limit the uptake and utilization of [treatment, prevention and care] services," AIDS 2012 Co-Chair Diane Havlir of the University of California-San Francisco School of Medicine and Chris Beyrer of the Johns Hopkins Center for AIDS Research write in a New England Journal of Medicine opinion piece. They note that "[r]esearch efforts on HIV vaccines will also probably be key, and the field has been reinvigorated" by recent study results. "A combination approach to prevention that includes HIV treatment can generate tremendous gains in the short term by curtailing new HIV infections, but ending the AIDS epidemic will probably require a vaccine, a cure, or both," they write.

"The scientific opportunities and optimism at this moment in HIV research are not matched, however, by the available resources," they continue, adding, "This lack of funding is the major point of divergence between optimism and pessimism." Havlir and Beyrer state, "The global fiscal realities are compounded by what we would argue are artificial debates that pit AIDS against other global health needs." They note that HIV research informs other areas of medicine and investments in HIV programs have secondary social, economic, and development benefits. "Markedly expanding high-quality treatment programs, taking new prevention tools to scale, and maximizing the potential of antiretroviral therapies for prevention will be difficult and costly, but failure to capitalize on the scientific advances of this critical period could be devastating," they continue. "The response to HIV, perhaps better than efforts against any other epidemic, encapsulates what can be accomplished when scientists, policymakers, the private sector, and the community mobilize toward a common goal," they write, adding "the most important part of the story is about to be written" (7/18).