DURBAN, South Africa – When Bill Gates came to Durban Wednesday for a discussion of progress with physician scientists researching the next HIV responses, the Microsoft founder recounted his first visit to South Africa in 1997, when his focus was still on his business and, he says, “closing the digital divide.” The divide he discovered instead in Soweto, between those with access to doctors, nurses, diagnostic tests, vaccines against preventable illnesses, and medicines for treatable illnesses led to dedicating his family foundation to global health, particularly HIV and tuberculosis. Attention to and progress against both diseases over the years since, through international efforts that include ones supported through the Bill & Melinda Gates Foundation has been dramatic, he observed, but he added, “It’s important to see the magnitude of the task that remains in front of us.”
Recent declines in incidence, he noted, are leveling off, while rising incidence is now being seen in some countries. And, he warned, by 2030, the number of young adults that make up the age group most at risk for HIV infection will be three times the number in 1990.
Medical circumcision, he pointed out, “is the single most powerful one time intervention that we have,” and a prevention tool more widely embraced than any other, including pre-exposure prophylactic use of antiretroviral medicine — or PrEP.
The new tools necessary to end HIV as a global public health threat, he said, including long-term antiretroviral treatments, and a vaccine, will require continued significant investment, he said. “The payoff,” he added, “will be dramatic.”