As communities around the globe mark World AIDS Day December 1, HIV infection rates in some parts of the world are surging, and remaining "stubbornly steady" in many other regions. At the same time, more effective prevention strategies and progress toward an HIV vaccine are generating new hope for what U.S. Secretary of State Hillary Clinton recently called "an AIDS-free generation."
“The goal of an AIDS-free generation may be ambitious, but it is possible,” said Clinton.
Speaking at a Washington forum, she called on global health experts, scientists, and advocates to redouble their efforts.
The stakes are high. AIDS - a disease associated with the Human Immuno-deficiency Virus - HIV - has killed 30 million people over the past three decades. Another 34 million people around the world are currently living with HIV infections.
Scientists working to control the epidemic say the fight against AIDS is difficult because the virus that causes it is complex - and tenacious.
“The fact is that once you are infected with HIV, it incorporates into your genetic material. The virus has a trick that it kind of permanently attaches itself to our genetic material. And that means that it’s very difficult to get rid of," said Rick King, vice-president of vaccine design at the International AIDS Vaccine Initiative, a public-private partnership.
King said an effective vaccine against HIV could be ready within five years, though hurdles remain.
“Millions of viruses are circulating at one time and they are different enough that a vaccine needs to take those differences into account. We need to find vaccines that will block all those thousands of circulating strains,” said King.
A recent UN report says better prevention and drug treatment programs are reducing AIDS-related deaths and global HIV infection rates. But in some regions, said UNAIDS executive director Michel Sidibe, the data show the epidemic is surging.
"I think the most serious areas remain Eastern Europe and Central Asia, where the report is showing that in 10 years, we have an increase by 250 percent in the number of new infections," said Sidibe.
Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said there's a simple explanation for such disparities: high-risk human behavior.
"Injection-drug use, the use of selling sex for drugs - it's all a perfect incubation pot for the spread of HIV. So it isn’t an even, well-distributed incidence, prevalence, deaths, etcetera. Some countries are up and some countries are down,” said Fauci.
Sidibe said South Africa is a good example of a nation trying to get its AIDS epidemic under control:
"[They] tested more than 14 million people and reduced the price of a drug by 52 percent and increased the number of people on treatment," said Sidibe.
While public health experts applaud the progress made in controlling HIV/AIDS, they say more support from donor countries and better use of resources by host nations will be needed to end the epidemic and meet the goal of an AIDS-free generation.