Experts know how to control the global spread of the AIDS virus. What's missing is enough money and political will to apply proven tactics widely enough to change the course of the epidemic.
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On Thursday Secretary of State Hillary Clinton unveiled her promised "blueprint" for reaching an "AIDS-free generation" — meaning a time when virtually no child is born with the virus that causes AIDS and teenagers have much less risk of becoming infected. It lays out ways for containing the epidemic, like expanding the use of the most effective treatments and prevention methods, and focusing on groups most at risk of infection, like sex workers and people who inject drugs. But it failed to set firm goals for the percentage of people to be provided with treatments or the reduction in disease to be achieved. Nor does it offer a pledge of new money to help afflicted nations carry out the tasks.
Doing better on AIDS is not a pipe dream. In fact, the combined efforts of the American program to combat AIDS abroad, a global health fund based in Geneva, private donors and national governments have substantially slowed transmission of the disease. The United Nations AIDS program reported last month that the annual rate of new infections had been cut over the past decade by more than 50 percent in 25 low- and middle-income countries and by more than 70 percent in Malawi and Botswana, two of the countries with the highest prevalence of the virus.
These gains were achieved by strategies like providing drug treatments to infected people to reduce the risk that they will spread the virus, treating mothers with drugs during pregnancy and breast-feeding to prevent transmission to their babies, wider testing, circumcising males to protect them from infection, public education campaigns and counseling, and distributing condoms. Still, the number of new infections yearly, while coming down, remains stubbornly high — 2.5 million in 2011. Some 34 million people around the world are infected with the virus.
The fight against AIDS has yet to reach what Secretary Clinton calls a "tipping point," at which the annual increase in new patients being treated with AIDS drugs exceeds the number of people newly infected. Until it does, the global epidemic will continue to expand.
The blueprint was prepared by the President's Emergency Plan for AIDS Relief, a program created in 2003 by former President George W. Bush with bipartisan support from Congress. It suggests that a "robust scale-up" of high-impact prevention programs can put many countries "on the path" toward an AIDS-free generation within the next three to five years.
Middle-income countries where AIDS is prevalent have steadily increased their share of the annual total of more than $16 billion spent around the world fighting the disease, but the poorest countries still need help. Governments struggling to revive their economies will be hard pressed to increase money or resources, but this is an investment that the international community cannot put off.
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