The Future of Global HIV Treatment and Prevention

The CSIS Global Health Policy Center and the International AIDS Society hosted Dr. Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases, who gave a presentation on the current status of HIV treatment and prevention. The presentation was followed by a roundtable discussion featuring Dr. Diane Havlir, Chief of the HIV/AIDS Division at the University of California, San Francisco, Dr. Elly Katabira, Professor of Medicine at the School of Medicine at Makerere University and IAS President-Elect, and Dr. Phillip Nieburg, Senior Associate at the CSIS Global Health Policy Center.

Dr. Fauci highlighted important research that has impacted treatment strategies, such as data on the benefits of initiating antiretroviral treatment (ARTs) earlier in the course of the HIV disease (starting treatment for persons with a cell count less than 350 CD4+ T cells/mm3). In terms of prevention, he emphasized the many proven prevention modalities that are known to be effective, such as prevention of mother to child transmission (PMTCT). Fauci also mentioned that he believed a plausible strategy for addressing the HIV/AIDS situation will not be an “all or none” phenomenon, rather, the strategy would need to be a synergistic approach between getting HIV transmission rates down through universal voluntary testing with immediate ARV therapy (the ‘test and treat’ method) and other interventions, such as the use of microbicides. In his closing remarks, Fauci spoke on the future course of HIV vaccinology. He stated that if an HIV vaccine were to be developed, it could never be a free-standing preventive modality such as the polio or small pox vaccine, but would have to be incorporated into a comprehensive HIV prevention modality.

During the roundtable discussion that followed, Diane Havlir spoke about the impact that investments in HIV/AIDS interventions have on other diseases, citing examples of how the scaling up of ARTs have resulted in reductions in TB transmission rates. Elli Katabira emphasized how African countries, who bear the brunt of the HIV/AIDS pandemic, need to renew their own strategies in providing HIV/AIDS services. Phil Nieburg spoke about the importance in having a public discussion when making policy decisions, and the importance in expanding the resource base in order to ensure that the growing need for ARTs would not draw funds away from any prevention programs in place.

Closing remarks were provided by Julio Montaner, current President of IAS, who spoke about the secondary gains from prevention interventions and the importance in convincing policy makers to do the “right thing” and invest in ARTs. He said that “we have failed to put this package together in a clear way, properly outlining the cost-effectiveness of ARTs as a public health intervention.” Montaner closed the event expressing his appreciation to the American people for the contribution that they have made to the fight against HIV/AIDS.

View photos from the event below:

Special thanks to Marie Ridoff for authoring this post.

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