World leaders revisit a declaration to fight AIDS

By Kaitlin Keane

A decade ago, the international health community, prompted by activists including persons infected with HIV, came together to establish fundamental treatment and prevention goals that shaped the past decade's approach to curbing the AIDS epidemic. From that landmark meeting, the United Nations' first ever Special Session on HIV/AIDS, came a declaration calling for universal access to prevention, treatment and care.

Ten years later and just days after the 30th anniversary of the first reported cases of HIV/AIDS in the United States, the international community has again converged in New York for the second high level meeting on the disease — and debate continues to rage over the expected outcome of the meeting and the potential effects of the resulting declaration.

Prior to the completion of the three-day conference, discussion among the health community has focused on the language of the document expected to come out of the meeting. Partners In Health has worked with other organizations to keep concrete timeline and funding goals in the declaration, while cutting references influenced by moral and political ideas rather than evidence and human rights.  

Among the most pressing priorities are:

• Holding the international community accountable to time and funding goals by adding the goal of "15 by 15" — providing necessary treatment to 15 million HIV/AIDS patients by 2015. The goal, deemed overly ambitious by some first-world nations, would still treat less than 80 percent of the patients in need. 
• Advocating for "treatment as prevention," a strategy bolstered by results released last month from the HPTN 052 study, which confirmed the Partners In Health approach that putting patients on antiretroviral therapy early drastically reduces transmission. The results — a 96 percent reduction in transmission among the group given early treatment — should mean more funding directed at putting patients on treatment much earlier than has been standard practice for the last decade.
• Capitalizing on recent announcements of significant price reductions on antiretroviral drugs for HIV/AIDS patients in the developing world.
• Recognizing both the crucial link between AIDS-related deaths and tuberculosis — the leading killer of people living with HIV/AIDS — and the feasibility of saving lives lost to the fatal combination. One million lives could be saved by 2015 if world leaders commit to efforts to prevent and treat tuberculosis among people living with HIV/AIDS.

Dr. Wesler Lambert, who works with PIH’s sister organization in Haiti, Zanmi Lasante, is attending the meeting and said he was encouraged by the support professed for earlier ART from speakers and other attendees. There was also support for integration of HIV treatment into comprehensive health care alongside programs for nutrition and TB — a strategy that improves chances of success, he said.

As the high level meeting continues, Partners In Health strongly advocates for world leaders to adopt an integrated approach to HIV/AIDS support and care programs, including the accompaniment model that continues to prove successful in countries where community health workers care for the local patients and through which stronger health systems in resource-poor countries are developed to increase the capacity of existing healthcare systems to treat other diseases and conditions.