Wednesday, May 1, 2013

The AIDS-Free Generation

The Berlin Patient. The VISCONTI cohort. A baby in Mississippi. None of these represent the wide-reaching HIV cure that we’ve spent decades looking for, but they do get us a little bit closer to one.

We now have a cure for HIV. But it’s not the magic bullet we had hoped for.

In the 30 years since HIV was discovered, governments and philanthropists, hoping to find a cure, have poured billions of dollars into research on the virus and its impact on the body. In the process, scientists and activists knocked this former death sentence down to a chronic disease. The year before the approval of combination antiretroviral therapy (ART), HIV killed more people between 25 and 44 than any other disease; two years later, deaths almost halved. Today, whether in New York or Nigeria, people on ART live with nearly-normal immune systems and only traces of the virus in their body. Given the efficacy of these medicines, do we even need the magic bullet?

If we could treat everyone who had HIV, then maybe not. But only eight million of the nearly 15 million sufficiently immune compromised to necessitate medication were on antiretrovirals in 2012, according to UNAIDS, the Joint United Nations Programme on HIV/AIDS. Medication only works if taken every day and geographic isolation and social disadvantage complicate consistent delivery of drugs to many of these people. In total, about 34 million people around the world have HIV and, each year, that numbers grows: in 2012, 1.7 million people with HIV died and 2.5 million were newly infected. Even the United States’ domestic HIV policy fails to protect its citizens’ health; here at home, 50,000 people are newly infected—which adds 30,000 net HIV cases—each year (PDF).

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