Introducing the first formal strategy to tackle the global AIDS epidemic, U.S. Secretary of State Hillary Clinton unveiled the PEPFAR Blueprint today, saying the plan would not have been possible without science, and that science will carry it forward.
Clinton was joined by U.S. Global AIDS Ambassador Eric Goosby, South African AIDS treatment advocate Florence Ngobeni-Allen, UNAIDS Director Michel Sidibe, and African Union Chair Dr. Nkosazana Dlamini-Zuma. Speaking before an audience of scientists, policy makers, advocates for AIDS treatment, prevention and research, Clinton said the work that the plan would carry out “represents our very best values in practice.”
The Blueprint, as well as her declaration a year ago setting the goal of acheiving “an AIDS-free generation,” was sparked by new research that confirmed effective means of reducing HIV transmission — through treatment of those infected, through prevention of mother to child transmission, through circumcision, through pre-exposure antiretroviral use — could greatly lower HIV incidence. The Blueprint goes beyond those, however, targeting tuberculosis, the leading killer of people with HIV, setting a course for coordinated treatment efforts that would address both diseases. In addition to following accelerated scenarios of extending treatment, the plan promises to promote immediate universal access to antiretroviral treatment for all HIV-positive people diagnosed with tuberculosis and access to screening and TB preventive tuberculosis therapy for people diagnosed with HIV.
It expands interventions, with a focus on populations largely neglected during PEPFAR’s work of the last decade: people making their livings in commercial sex work, injecting drug users, men who have sex with men, and intensifies work to reduce the risks of women, improving access to family planning and reproductive health services, Clinton said.
Laying out four “roadmaps” — for expanding treatment and prevention interventions, reaching populations of greatest risk and promoting sustainability, creating a shared response, and using science to guide the efforts, the 64-page document and an additional fact sheet use existing country data to show what the plan can accomplish.
The immediate aim, to reach the “tipping point” at which numbers of new infections is surpassed by the numbers put on life-saving and preventive treatment, will be the first step towards achieving an AIDS-free generation, Clinton said.
Clinton defines an AIDS-free generation as one in which no child is born with HIV, the odds of acquiring it are substantially reduced, and those infected with HIV receive treatment to prevent becoming sick with AIDS, the product of an infected, untreated, damaged immune system.
Clinton was introduced by Florence Ngobeni-Allen, a South African woman who lost first her husband and then her child in 1996, in the process discovering they all had HIV.
“Little did we know that today, it would be a different story,” Ngobeni-Allen said. The years since haven’t lessened the pain of watching her daughter die, she said, her voice breaking. “In a few months I lost everything. I lost my world.”
She has gone on to work with the Elizabeth Glaser Pediatric Foundation, to become an HIV educator, and to remarry and give birth to two healthy sons, she said.
She thanked President Barack Obama, who she called “our president,” and Clinton: “We’ll never forget you for fighting for us,” and she urged the rest of the audience not to give up: “It’s not the end, it’s the beginning.”
Clinton, in turn, said the plan carried with it an obligation to put it into action.
“We set the goal, we know it’s possible, now we have to deliver,” Clinton said. “That may sound obvious, but it isn’t. The history of global health is littered with grand plans that never played out.”