论文部分内容阅读
The International AIDS Conference closed on July 27 in Washington, D.C. with a clear message that the end of the AIDS epidemic is possible with sustained financial, political and scientific commitment.
The event, under the theme of “turning the tide together,” drew nearly 24,000 participants from 183 countries, featuring 194 sessions covering science, community and leadership.
“It is a historic event,” said Dr. Diane Havlir of the University of California, San Francisco, who co-chaired the world’s largest AIDS meeting. “It’s, first of all, very significant that it is finally back here in the United States.”
The first International AIDS Conference was held in Atlanta, Georgia in 1985, and it was last held in the United States in San Francisco in 1990. U.S. restrictions on the entry of people living with HIV prohibited the conference’s return in the ensuing 20 years. In 2010, this ban was lifted by the Barack Obama administration.
Defining moment
Ahead of AIDS 2012, the Joint United Nations Programme on HIV/AIDS(UNAIDS), released a new report, titled Together We Will End AIDS, which outlined the recent gains made in achieving the global AIDS targets, including increases in HIV treatment coverage and domestic investments in low- and middle-income countries.
“It is now for a new AIDS agenda and new partnerships based on shared responsibility, mutual accountability and global solidarity,” said Michel Sidibe, UNAIDS Executive Director at the opening session on July 22.
Much of the weeklong conference was focused on how to get treatment to all people with HIV, and looking to achieve an end to the virus’epidemic spread. Most of the presenters, from senior government officials and heads of health institutes to civil society leaders and scientists, affirmed for the first time in the history of AIDS that an end to the epidemic is on the horizon.
“I didn’t have a lot of expectations when I came, but I now have to say the level (of the conference) is really high,” Denis Broun, Executive Director of UNITAID, a Genevabased international facility for the purchase of drugs against HIV/AIDS, malaria and tuberculosis, told Beijing Review, “I’m very happy to see a lot of positive news, a lot of new engagement and strategies at the conference.”
With the recent scientific progress on the treatment and prevention of HIV infection, AIDS mortality rates are declining globally. And efforts to eliminate mother-to-child transmission are progressing well, according to Science magazine.
Over 8 million people worldwide had access to life-saving treatment in low- and middle-income countries last year—an increase of 1.4 million over 2010, according to the latest UNAIDS report. Some 34.2 million people are living with the AIDS virus globally, including 2.5 million who became infected last year. And 1.7 million died in 2011. New infections and deaths dropped slightly last year. Since 2009, new infections in children have fallen by an estimated 24 percent. Some 330,000 children were newly infected in 2011, almost half the number at the peak of the epidemic in 2003.
“We are on scientifically solid ground when we say we can end the HIV/AIDS pandemic,” said Anthony Fauci, Director of the U.S. National Institute of Allergy and Infectious Diseases.
The optimism is due in part to recent discoveries that people living with HIV treated with antiretroviral therapy can prevent the virus from being transmitted to others—treatment-asprevention, as experts define. The drugs prevent the virus from replicating, reducing the level of active viruses in blood and other body fluids that are the usual vehicles for infection. And further research shows that good treatment can cut by 96 percent their chances of spreading the virus to sexual partners.
“We are at a defining moment,” Havlir said. “We know that starting the end of AIDS will not be easy. We need to keep sprinting in this marathon.”
AIDS-free generation
AIDS, the acquired immunodeficiency syndrome, was first recognized in the United States in 1981. Back in the 1980s, it was largely a disease of economically stable, white, gay men living in big cities on the west and east coasts. But today, HIV, the human immunodeficiency virus which causes AIDS, disproportionately infects African-American men who have sex with men, and the epicenter of the epidemic is in the poverty-stricken Deep South.
“In the richest nation on the planet, barely a quarter of people with HIV are in fully effective treatment. More than 70 percent are either not in treatment at all or suboptimal treatment,” Phill Wilson, President and CEO of the Los Angelesbased Black AIDS Institute, said at a plenary on July 23. “That’s bad for them and it’s bad for everyone else because when they are not on treatment, they are much, much more likely to spread the virus.” Wilson called on AIDS organizations to retool themselves and adapt to the new landscape.
“We want to get to the end of AIDS,” said Fauci, but how long it takes depends on how quickly the world can adopt those tools—including getting more of the millions of untreated people onto life-saving drugs that come with the bonus of keeping them from infecting others.
Testing-and-treatment is one of a series of factors that create a vast gap between HIV infection and control of the infection. The other challenge, which was also one of deep anxieties running through the entire meeting, is where the money will come from to keep the AIDS effort going forward, since “funding has stagnated since the 2008 financial crisis, and for many programs it has plummeted,”said Laurie Garrett, a senior fellow for global health of the New York City-headquartered Council on Foreign Relations.
“We now have a funding gap of $7 billion per year for HIV. This gap is killing people,”said Sidibe.
Domestic funding for HIV has exceeded international investments, according to the UNAIDS report. Low- and middle- income countries invested $8.6 billion for the response in 2011, an increase of 11 percent over 2010. International funding, however, remained flat at 2008 levels ($8.2 billion).
On July 23, U.S. Secretary of State Hillary Clinton announced a number of commitments to support AIDS prevention worldwide, including $80 million to help poor countries and an additional $15 million on research to identify the best HIV prevention tools to reach those key populations in different countries.“The United States is committed and will remain committed to achieving an AIDS-free generation,” she said.
As an echo to her, former U.S. President Bill Clinton, whose foundation funds HIV work, called for helping turn the tide against the HIV/AIDS epidemic at the closing plenary session. “We have you to thank for the progress that has been made and you to make us believe we can achieve an AIDS-free generation,” he said. “We just have to keep pushing the rocks up the hill.”
The Clinton Foundation started the Health Access Initiative in 2002 to increase affordable access to health care globally. The foundation’s efforts in the area have lowered the costs of treatment and increased access to life-saving medical technologies.
Active participation
Among the various sessions in AIDS 2012, a case study presentation about Methadone Maintenance Treatment (MMT) for AIDS attracted clinical professionals’ attention. Conducted by Han Lifeng with the Division of Global HIV/AIDS of the U.S. Centers for Disease Control and Prevention in China, the presentation provided a qualitative study of MMT among persons who inject drugs in three provinces in China.
At the end of 2011, the estimated number of people living with HIV in China stood at 780,000 people, according to the 2012 China AIDS Response Progress Report, issued by the Chinese Ministry of Health. HIV prevalence varies significantly between different population groups, with prevalence greatest amongst drug users.
MMT, which helps injection drug users reduce or stop injecting, has become one of the main actions taken in China to control the spread of HIV among drug users, according to the Chinese Center for Disease Control and Prevention (CDC). Since 2004, China has rapidly scaled up MMT from eight to 716 clinics with 332,996 cumulatively enrolled drug users by September 2011.
“China’s MMT is a successful AIDS treatment model in developing countries,”said Wu Zunyou, Director of the CDC National Center for AIDS/STD Control and Prevention.
The case study is also an important international cooperation program under the President’s Emergency Plan for AIDS Relief, a $15-billion effort launched in 2003 by former U.S. President George W. Bush. The plan received an additional $48 billion in funding in 2008.
“CDC is a wonderful research partner for us,” said Nora D. Volkow, Director of the U.S. National Institute on Drug Abuse. “We have a very strong collaboration and now are working on the implementation of two projects about injection drug user treatment.”
In recent years, China has continued to strengthen its HIV testing network and improve testing capacities. While continuing to roll out voluntary counseling and testing, it has actively promoted provider-initiated testing and counseling services, expanding coverage of HIV testing and counseling. In 2011, 14,571 medical treatment facilities at various levels across China carried out over 84.2 million HIV tests, finding 74,517 new cases of HIV.
Efforts to strengthen blood safety have been increased. In 2010, DNA testing was introduced in blood banks. By the end of 2011, more than 1.76 million blood samples had been tested, according to the Chinese Ministry of Health.
“China has made tremendous progress,”Sidibe told Beijing Review. “I’m very optimistic about China’s response.”
According to the UNAIDS report, Together We Will End AIDS, China is now one of the top five contributors to research, with $18.3 million invested in research on HIV vaccines in 2011.
(Reporting from Washington, D.C.)
The event, under the theme of “turning the tide together,” drew nearly 24,000 participants from 183 countries, featuring 194 sessions covering science, community and leadership.
“It is a historic event,” said Dr. Diane Havlir of the University of California, San Francisco, who co-chaired the world’s largest AIDS meeting. “It’s, first of all, very significant that it is finally back here in the United States.”
The first International AIDS Conference was held in Atlanta, Georgia in 1985, and it was last held in the United States in San Francisco in 1990. U.S. restrictions on the entry of people living with HIV prohibited the conference’s return in the ensuing 20 years. In 2010, this ban was lifted by the Barack Obama administration.
Defining moment
Ahead of AIDS 2012, the Joint United Nations Programme on HIV/AIDS(UNAIDS), released a new report, titled Together We Will End AIDS, which outlined the recent gains made in achieving the global AIDS targets, including increases in HIV treatment coverage and domestic investments in low- and middle-income countries.
“It is now for a new AIDS agenda and new partnerships based on shared responsibility, mutual accountability and global solidarity,” said Michel Sidibe, UNAIDS Executive Director at the opening session on July 22.
Much of the weeklong conference was focused on how to get treatment to all people with HIV, and looking to achieve an end to the virus’epidemic spread. Most of the presenters, from senior government officials and heads of health institutes to civil society leaders and scientists, affirmed for the first time in the history of AIDS that an end to the epidemic is on the horizon.
“I didn’t have a lot of expectations when I came, but I now have to say the level (of the conference) is really high,” Denis Broun, Executive Director of UNITAID, a Genevabased international facility for the purchase of drugs against HIV/AIDS, malaria and tuberculosis, told Beijing Review, “I’m very happy to see a lot of positive news, a lot of new engagement and strategies at the conference.”
With the recent scientific progress on the treatment and prevention of HIV infection, AIDS mortality rates are declining globally. And efforts to eliminate mother-to-child transmission are progressing well, according to Science magazine.
Over 8 million people worldwide had access to life-saving treatment in low- and middle-income countries last year—an increase of 1.4 million over 2010, according to the latest UNAIDS report. Some 34.2 million people are living with the AIDS virus globally, including 2.5 million who became infected last year. And 1.7 million died in 2011. New infections and deaths dropped slightly last year. Since 2009, new infections in children have fallen by an estimated 24 percent. Some 330,000 children were newly infected in 2011, almost half the number at the peak of the epidemic in 2003.
“We are on scientifically solid ground when we say we can end the HIV/AIDS pandemic,” said Anthony Fauci, Director of the U.S. National Institute of Allergy and Infectious Diseases.
The optimism is due in part to recent discoveries that people living with HIV treated with antiretroviral therapy can prevent the virus from being transmitted to others—treatment-asprevention, as experts define. The drugs prevent the virus from replicating, reducing the level of active viruses in blood and other body fluids that are the usual vehicles for infection. And further research shows that good treatment can cut by 96 percent their chances of spreading the virus to sexual partners.
“We are at a defining moment,” Havlir said. “We know that starting the end of AIDS will not be easy. We need to keep sprinting in this marathon.”
AIDS-free generation
AIDS, the acquired immunodeficiency syndrome, was first recognized in the United States in 1981. Back in the 1980s, it was largely a disease of economically stable, white, gay men living in big cities on the west and east coasts. But today, HIV, the human immunodeficiency virus which causes AIDS, disproportionately infects African-American men who have sex with men, and the epicenter of the epidemic is in the poverty-stricken Deep South.
“In the richest nation on the planet, barely a quarter of people with HIV are in fully effective treatment. More than 70 percent are either not in treatment at all or suboptimal treatment,” Phill Wilson, President and CEO of the Los Angelesbased Black AIDS Institute, said at a plenary on July 23. “That’s bad for them and it’s bad for everyone else because when they are not on treatment, they are much, much more likely to spread the virus.” Wilson called on AIDS organizations to retool themselves and adapt to the new landscape.
“We want to get to the end of AIDS,” said Fauci, but how long it takes depends on how quickly the world can adopt those tools—including getting more of the millions of untreated people onto life-saving drugs that come with the bonus of keeping them from infecting others.
Testing-and-treatment is one of a series of factors that create a vast gap between HIV infection and control of the infection. The other challenge, which was also one of deep anxieties running through the entire meeting, is where the money will come from to keep the AIDS effort going forward, since “funding has stagnated since the 2008 financial crisis, and for many programs it has plummeted,”said Laurie Garrett, a senior fellow for global health of the New York City-headquartered Council on Foreign Relations.
“We now have a funding gap of $7 billion per year for HIV. This gap is killing people,”said Sidibe.
Domestic funding for HIV has exceeded international investments, according to the UNAIDS report. Low- and middle- income countries invested $8.6 billion for the response in 2011, an increase of 11 percent over 2010. International funding, however, remained flat at 2008 levels ($8.2 billion).
On July 23, U.S. Secretary of State Hillary Clinton announced a number of commitments to support AIDS prevention worldwide, including $80 million to help poor countries and an additional $15 million on research to identify the best HIV prevention tools to reach those key populations in different countries.“The United States is committed and will remain committed to achieving an AIDS-free generation,” she said.
As an echo to her, former U.S. President Bill Clinton, whose foundation funds HIV work, called for helping turn the tide against the HIV/AIDS epidemic at the closing plenary session. “We have you to thank for the progress that has been made and you to make us believe we can achieve an AIDS-free generation,” he said. “We just have to keep pushing the rocks up the hill.”
The Clinton Foundation started the Health Access Initiative in 2002 to increase affordable access to health care globally. The foundation’s efforts in the area have lowered the costs of treatment and increased access to life-saving medical technologies.
Active participation
Among the various sessions in AIDS 2012, a case study presentation about Methadone Maintenance Treatment (MMT) for AIDS attracted clinical professionals’ attention. Conducted by Han Lifeng with the Division of Global HIV/AIDS of the U.S. Centers for Disease Control and Prevention in China, the presentation provided a qualitative study of MMT among persons who inject drugs in three provinces in China.
At the end of 2011, the estimated number of people living with HIV in China stood at 780,000 people, according to the 2012 China AIDS Response Progress Report, issued by the Chinese Ministry of Health. HIV prevalence varies significantly between different population groups, with prevalence greatest amongst drug users.
MMT, which helps injection drug users reduce or stop injecting, has become one of the main actions taken in China to control the spread of HIV among drug users, according to the Chinese Center for Disease Control and Prevention (CDC). Since 2004, China has rapidly scaled up MMT from eight to 716 clinics with 332,996 cumulatively enrolled drug users by September 2011.
“China’s MMT is a successful AIDS treatment model in developing countries,”said Wu Zunyou, Director of the CDC National Center for AIDS/STD Control and Prevention.
The case study is also an important international cooperation program under the President’s Emergency Plan for AIDS Relief, a $15-billion effort launched in 2003 by former U.S. President George W. Bush. The plan received an additional $48 billion in funding in 2008.
“CDC is a wonderful research partner for us,” said Nora D. Volkow, Director of the U.S. National Institute on Drug Abuse. “We have a very strong collaboration and now are working on the implementation of two projects about injection drug user treatment.”
In recent years, China has continued to strengthen its HIV testing network and improve testing capacities. While continuing to roll out voluntary counseling and testing, it has actively promoted provider-initiated testing and counseling services, expanding coverage of HIV testing and counseling. In 2011, 14,571 medical treatment facilities at various levels across China carried out over 84.2 million HIV tests, finding 74,517 new cases of HIV.
Efforts to strengthen blood safety have been increased. In 2010, DNA testing was introduced in blood banks. By the end of 2011, more than 1.76 million blood samples had been tested, according to the Chinese Ministry of Health.
“China has made tremendous progress,”Sidibe told Beijing Review. “I’m very optimistic about China’s response.”
According to the UNAIDS report, Together We Will End AIDS, China is now one of the top five contributors to research, with $18.3 million invested in research on HIV vaccines in 2011.
(Reporting from Washington, D.C.)