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The Next AIDS Pandemic
The Next AIDS PandemicForeign Policy, 7/26/17
Thousands of HIV/AIDS experts are gathered in Paris this week for their biennial world conference, and leaders are exhorting every one of them to fight for global financing and expand access to treatment, especially in Africa. But the world cannot treat its way out of AIDS, and without a revolutionary breakthrough in either vaccines or the entire model of HIV control, a massive second global wave of AIDS will come, perhaps within the next 10 years.
Three problems are driving the global fight against HIV into a new danger zone. First, new infections increasingly involve forms of the virus that are already resistant to the primary drugs used to treat and prevent HIV infection. Second, the world is fast approaching the limits of manufacturing capacity for anti-HIV first-line drugs, and the ceiling is far lower for second- and third-line treatments. And third, there aren’t sufficient financial resources applied to the AIDS problem now, and signals from major donors — especially the U.S. government — offer a grim future of diminished resources and greater demands on very poor countries to finance their own HIV fights without outside help.
The Joint United Nations Programme on HIV/AIDS, or UNAIDS, reckons 36.7 million people are living with HIV today: More than half of them are on drugs that, when used properly, hold the virus at bay, blocking progression to full-blown AIDS and decreasing the odds that they will pass the virus onto their sexual partners or via drug use. Thanks to that treatment, substantially paid for by U.S. taxpayers, death rates have plummeted from a 2005 annual high of nearly 2 million to about 1 million in 2016. But half of the HIV-positive world is still in need of those life-sparing medicines. And despite having 19.5 million people on the medicines, the new infection rates haven’t improved: Roughly 2 million more people are added every year to the HIV-positive population that need medication and can spread the virus to others.
Simple math illustrates the problem: If 36.7 million were living with HIV in 2016, and 2 million more become infected annually, by 2020 the pool will swell to 44.7 million, minus the annual death rate, bringing the total to 40.7 million. By 2030, if the world continues to muddle through using the same approach and funding to the HIV problem, there would be nearly 54 million people living with HIV — all of them in need of daily medications.
Three problems are driving the global fight against HIV into a new danger zone. First, new infections increasingly involve forms of the virus that are already resistant to the primary drugs used to treat and prevent HIV infection. Second, the world is fast approaching the limits of manufacturing capacity for anti-HIV first-line drugs, and the ceiling is far lower for second- and third-line treatments. And third, there aren’t sufficient financial resources applied to the AIDS problem now, and signals from major donors — especially the U.S. government — offer a grim future of diminished resources and greater demands on very poor countries to finance their own HIV fights without outside help.
The Joint United Nations Programme on HIV/AIDS, or UNAIDS, reckons 36.7 million people are living with HIV today: More than half of them are on drugs that, when used properly, hold the virus at bay, blocking progression to full-blown AIDS and decreasing the odds that they will pass the virus onto their sexual partners or via drug use. Thanks to that treatment, substantially paid for by U.S. taxpayers, death rates have plummeted from a 2005 annual high of nearly 2 million to about 1 million in 2016. But half of the HIV-positive world is still in need of those life-sparing medicines. And despite having 19.5 million people on the medicines, the new infection rates haven’t improved: Roughly 2 million more people are added every year to the HIV-positive population that need medication and can spread the virus to others.
Simple math illustrates the problem: If 36.7 million were living with HIV in 2016, and 2 million more become infected annually, by 2020 the pool will swell to 44.7 million, minus the annual death rate, bringing the total to 40.7 million. By 2030, if the world continues to muddle through using the same approach and funding to the HIV problem, there would be nearly 54 million people living with HIV — all of them in need of daily medications.
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