Combination HIV prevention – fully implemented and supported by governments, communities and scientists – is necessary for the international community to achieve its HIV prevention goals. This call comes from Dr Peter Piot and Michael Bartos (Joint United Nations Programme on HIV AIDS, Geneva, Switzerland) and colleagues in the sixth of six papers in The Lancet series on HIV Prevention.
After 25 years of research on HIV and Aids, the international community has learned much about the transmission and prevention of the disease. However, every day, the world sees 7000 new infections. There have been several programs targeting HIV prevention, yet many have been underfunded, have not had sufficient coverage, or have not been targeted to the most needy populations. In order to overcome the political, cultural, and logistic barriers to effective HIV prevention, say the authors, there must be confident and unified leadership. There must be additional support for programs educating young people, policies for injecting drug users, and other proven interventions, such as those directed towards sexual minorities.
Not only must international institutions, national governments, and community activists work hand-in-hand to raise HIV prevention demand, but workplaces, schools, communities, and places of worship must also provide support. The authors call for a link between treatment activists, entrepreneurs, women’s and youth activists, and the coalition of people dedicated to HIV prevention and the people living with HIV/AIDS. They want to continue the pursuit for a HIV vaccine and invest in HIV-preventing technologies as well as managerial, technical, and implementation capacity for national authorities working on HIV/AIDS.
“If combination prevention is intensified as rapidly as possible from today, then some 12 million fewer HIV infections will occur if incidence at today’s levels remains constant, and the annual number of new infections in 2015 will have reduced by two-thirds,” say the authors. HIV prevention will cost US $11.6 billion by 2010 and $15.3 billion by 2015, according to UNAIDS estimates, as programs become more universally accessible.
Piot and colleagues conclude: “None of the successes in HIV prevention over the past quarter of a century have been easily won. They have required taboos to be broken, pleasures foregone, resources reallocated. We must have the courage to press ahead, because if we fail the challenge of HIV prevention, HIV/AIDS will relentlessly undermine human progress. An energised HIV-prevention movement, marching hand-in-hand with the movement to make access to treatment universal, is a goal truly worth the effort it will take.”
Coming to terms with complexity: A call to action for HIV prevention
Peter Piot et al.
The Lancet (2008).
Written by: Peter M Crosta