With opportunities to end the HIV pandemic demanding more resources and resolve than ever, a gathering of those in it for the long haul urge final sprint
The right things in the right places at the right time came together for Fortunata Kasege in 1997, when she came to the United States from her home in Tanzania, excited about prospects that included, along with schooling to become a journalist, her first child and marriage to her long-time sweetheart. Those prospects seemed to shatter like glass, as she tells it now, when she learned on her first prenatal visit that she had HIV. From everything she had known before, it meant that she would not live to realize any of her dreams, and that the life of the child she carried would be short and agonizing.
But she was in the right place, at the right time, when, more than a decade and a half into the global HIV pandemic the right things were available to save her life, and protect her child from the virus. That child is 18 now and applying to colleges. Kasege, now 40 years old, had another healthy child last year, who makes her laugh with delight.
“I reclaimed my dreams,” she said.
But, she reminded lawmakers and congressional staffers assembled on Capitol Hill Thursday, now more than three decades into the global HIV pandemic, “It is not the same everywhere in the world.”
The message Thursday was that it can be, and that HIV as a disease that threatens public health and shatters dreams can become part of history in the discernible future, with — and here is the catch — more commitment, more focus, more resources than ever before.
The challenges to sustaining those in the budget-constrained, politically divided, and resource-competing environment in which funding and policy decisions now are made brought people who have fought the pandemic for decades to the event sponsored by UNAIDS.
Dr. Anthony Fauci was there to present the data and the findings that leave “absolutely no excuse for every person diagnosed with HIV not to be on treatment,” and to note the success of Rwanda, surpassing, among many countries, the United States, in expanding access to effective treatment.
UNAIDS leader Dr. Michel Sidibe was there to celebrate the success of Cuba, which earlier this year became the first nation officially recognized to have eliminated parent to child transmission of HIV, and to remind policymakers: “We still have a journey to travel together. The success is significant, but very fragile . . . our journey will be about how to reach those people left behind.”
U.S. Global AIDS Coordinator Ambassador Deborah Birx was there to note that reaching those yet to be reached will demand not just funds but political will. She had just come from London, where with the Elton John AIDS Foundation the U.S. President’s Emergency Plan for AIDS Relief launched an initiative to provide grants to organizations working to meet HIV-related needs of sexual minorities in sub-Saharan Africa.
In turn, she said, affected countries will need to change policies, to allow for adoption of new World Health Organization guidelines calling for access to antiretroviral treatment upon diagnosis and six month drug supplies to save time and costs.
With 37 million people now living with HIV worldwide, and just 15 million getting the medicine they need, she emphasized, the alternative to accelerated responses to HIV will be an accelerated epidemic.
Sen. Ed Markey (D-Mass.) speaking at the same event, likened the gathering of speed and resolve needed to the final sprint of “Heartbreak Hill” that confronts runners 20 miles into the Boston Marathon.
With projections that accelerated efforts to expand HIV diagnosis, care, and effective treatment in the next five years could end the pandemic first recognized in 1981 in the 15 years, Markey explained, “We’re about 70 percent of the way there.”
That infamous incline facing runners in Boston who are about 70 percent done, is daunting to many, he said, “But those who make it there manage to get up it and reach the finish line.”