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A generation to whom AIDS is history

“If you’re not getting excited about this, please raise your hand and I will send somebody to check your pulse!” smiled Hillary Clinton, the US secretary of state, as she ordered a blueprint for an “AIDS-free generation” by this World AIDS Day (December 1), perfectly aware of the dream goal and date she was setting up at the 19th International AIDS Conference in Washington, DC this July.

“Now, I’ve heard a few voices from people raising questions about America’s commitment to an AIDS-free generation, wondering whether we are really serious about achieving it.” But the applause from thousands of delegates, activists and people living with HIV reaffirmed their faith in her as she pledged US support to “fight for the resources necessary to achieve this historic milestone”.

Metro scanned the convention to find answers to questions and the tools that would help create a generation free of AIDS.

What is an “AIDS-free generation”?

It’s a generation in which no one will be born with HIV. As people in that generation age, they will be at a far lower risk of becoming infected than they are today. And finally, if they do acquire HIV, they will get treatment that keeps them healthy and prevents them from developing AIDS and passing on the virus.

What is the progress so far?

Since Clinton declared last November that “we can create an AIDS-Free Generation”, the US President’s Emergency Plan for AIDS Relief (PEPFAR) and other agencies across the US government have heeded the call and are focusing on “combination prevention”. It means using condoms, counselling, testing and special emphasis on three core areas — treatment as prevention, voluntary medical male circumcision and stopping mother-to-child transmission of HIV. Since December, PEPFAR has managed to expand its funding and reach nearly 4.5 million people, on track with the US President’s goal of treating 6 million people by the end of 2013.

What are the hurdles?

As Clinton rightly sai:, “I know that creating an AIDS-free generation takes more than the right tools”. It would require addressing the critical needs of people living with HIV, groups at high risk of contracting the virus.

What is the deadline for getting HIV and AIDS cases down to zero?

The deadline for the blueprint outlining the goals and objectives for achieving an “AIDS-free generation” has been set for World AIDS Day 2012, observed on December 1. The due date for the beginning of the end of AIDS using the “recent scientific breakthroughs” is 2015.

Why was the 19th International AIDS Conference important?

The conference returned to the US for the first time since 1990. With 24,000 attendees from 183 countries, celebs and leaders taking the lead, it was all about a positive boost to the AIDS battle.

Bill Gates to Bill Clinton, Elton John to Whoopi Goldberg, activists to survivors, talked on everything from science, advocacy and faith to vulnerable populations, funding and challenges at the world’s largest AIDS convention.

Eric Goosby, US global AIDS co-ordinator leading all international HIV/AIDS efforts, summed up the message loud and clear: “The science is here, the knowledge is here. We have no more excuses but to look for ways to put this knowledge into programmes and move towards an AIDS-free generation.”

What percentage of their budget are US donors and funding bodies planning to allocate for organisational development in India?

“We cannot continue to be the ministry of health for other countries or oversee and manage programmes effectively, forever,” said Goosby. The governments of many developing countries are also “unwilling” to put their own resources in services “that a donor is already paying for or could pay for”, he felt. “We’re happy to support you in this effort but you need to invest in your people as well, like the Americans have. It’s important for people to know that the government values their people enough to invest in them.”

How to ensure that the money received from donors is used for the right purpose?

Goosby feels that the real check is “civil society” or a “feedback group” in areas where the services are being put up, with a voice that can tell people who are managing whether these services are working or the needs are being met.

How can young urban adults be made more AIDS-aware?

By not making the topic “boring”, is what Gregory Pappas, senior deputy director, District of Columbia department of health, would advise. “You have to do it in a popular way. Get Bollywood-type actors and singers to talk to young people and get the message across. It could also be weaved into stories or Bollywood movies or a song about the cause to get youngsters to connect.”

If integrated sexual and reproductive health is the current concern in HIV/AIDS, is it possible today for HIV-positive people to have a sexual life, get married and keep their child safe?

Yes. When HIV-positive, the best thing to do is disclose your status to your partner. Florence from Johannesburg, who lost her husband and five-month-old daughter to AIDS 15 years ago, decided to undergo antiretroviral treatment before she decided to remarry and give birth to two AIDS-free babies six years ago. She was at the conference to offer her side of the story and show people that “there is life after HIV”. Florence married an HIV-negative person “but had to educate him so our families could come together and support each other”.

What are the recent scientific breakthroughs that people can bank on?

Although developing a vaccine and a cure still remains a challenge, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, pointed out the “extraordinary advances in basic and clinical research in HIV/AIDS” made over three decades. “It includes the development of nearly 30 approved antiretroviral drugs. Used in combination, these medications can dramatically improve an individual’s health and longevity.” PEPFAR also announced Labs for Life, a collaboration to help strengthen healthcare and laboratory systems in the developing world along with the US department of health and human services. Labs for Life is expected to expand outside Uganda, Kenya, Ethiopia and Mozambique in Africa to India.

“The ultimate tool will be a vaccine. Scientists are making great progress,” said Microsoft founder Bill Gates on Day 2 of the conference. “We also need prevention tools. Male circumcision is really the best one we have got right now, we need to roll that out more effectively. There is a ring, a dapivirine ring that I am very excited about... and so, only by having a number of these new tools and eventually a vaccine, can we really seriously talk about moving towards the end.”