HPH NOW, August 4, 2006, Progress Made with HIV/AIDS Epidemic but More Work Needed, says UNAIDS Executive Director Piot

Peter-Piot

Great progress has been made in the international fight against AIDS, with more people in developing countries receiving antiretroviral drugs than ever before and with prevention programs showing decreasing infection rates in many countries, said Peter Piot, Executive Director of UNAIDS, at a talk co-sponsored by the FXB Center for Health and Human Rights at HSPH, HMS Department of Social Medicine, and Harvard University Program on AIDS.

"Results are starting to come,'' Piot said during his July 20 lecture at the Armenise Amphitheatre. "I believe we are at the turning point. We are at the point where we need to move from crisis management and think of the long term.''

Piot noted that five years ago there were fewer than 200,000 people in developing countries benefiting from antiretroviral drugs. Today, there are more than 1.5 million HIV/AIDS patients on the drugs in a variety of developing countries around the world. Funding for AIDS drugs and programs is way up-$8.3 billion spent last year in developing countries, compared to just $292 million 10 years ago.

Prevention programs have caused infection rates to drop sharply in 10 countries, he noted.

"The last five years have seen more results in fighting AIDS than we saw in the previous 25 years,'' said Piot.

The good news has resulted from effective political activism, with presidents and prime ministers of many countries getting directly involved in the issue, he said.

But much work remains to be done, Piot said. "The key issue is to maintain AIDS on the political agenda,'' he said, to help ensure funding.

He warned that if complacency sets in-if people believe the problem is over-progress will grind to a halt.

There are still 65 million people infected with HIV, he noted. More than four million were infected in 2005 alone. In some countries in sub-Saharan Africa, including Zimbabwe and Botswana, 20 to 30 percent of adults are infected. Fifteen percent of women ages 15 to 24 are HIV-positive in certain countries.

The high infection rate in these countries is causing numerous problems, particularly with economic development, as the labor force is being wiped out, he said.

"For these countries, we need something like a Marshall Plan,'' he said.

AIDS must never be seen as just one of many health problems facing the world, he warned. "AIDS has become the make-or-break issue of our time,'' he said. "It is an unprecedented challenge.''

To meet that challenge over the long term, funding must continue to increase, he said. "The fact is that as people become more and more ill, the bill will get higher and higher,'' he said.

Piot estimated that $20 to 30 billion will be needed each year by the year 2010. "The rich countries can still give far more,'' he asserted.

And it will not be enough simply that more funding be made available, he said. "We must make sure the money reaches the people,'' he said.

Beyond making more drugs available, efforts must focus on helping poor countries retain health care workers, many of whom leave for jobs in developed nations where they get paid much higher wages and have better working conditions, he said.

Prevention efforts must include dealing with issues such as sexual violence, he noted, as most teenage girls are becoming infected not by teenage boys but by older men.

"That's the kind of thing we have to address,'' he noted.

—ML