Although HIV statistics remain painfully high, for the  time scientists have begun to discuss the prospect of an AIDS-free generation. At the 19th International AIDS conference in Washington, DC, 25,000 activists,  policymakers, and people living with HIV/AIDS convened to discuss the conference’s theme, “Turning the Tide Together.”

But turning this rhetoric into reality is a challenge—and not just for the community of researchers. Beneath the surface, 1.7 million individual lives are lost to AIDS every year, and many are those of young women: HIV is the leading cause of death among women of reproductive age. Women between the ages of 15 and 24 who live in SubSaharan Africa are eight times more likely to live with HIV than men the same age, and 76 percent of all HIV-positive women live there. In response to these statistics, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the US National Institutes of Health, claims that what is needed is the will —political, organizational, and individual—to implement scientific breakthroughs.

Because of enduring poverty, prejudice, power imbalances, and a dearth of resources, HIV-infected persons in developing countries, especially women in Sub-Saharan Africa, are denied access to advances in science and affordable AIDS prevention and treatments. Increased funding and investment in AIDS research alone will not alleviate the disproportionate suffering and deaths resulting from contracting HIV by people in devel- oping nations, particularly women. A concerted effort among the key players in the global health community—governments, foundations, international organizations, non-governmental agencies, drug companies, activists, researchers, and religious organizations—must occur in strategic global and local partnerships to decisively and comprehensively fight prejudice and poverty, increase awareness, and improve education. It is possible to turn the tide and eradicate AIDS, but it will take more than scientific breakthroughs.


The drop in annual AIDS-related fatalities from 2.3 million in 2005 to 1.7 million today is attributed to an increased number of people on anti-retroviral therapy (ART) drugs, first available nearly two decades ago. This, in combination with prevention, has resulted in a declining rate of infections. Targeted prevention includes condoms, drug treatment, male circumcision, and the end of mother-to-child transmission. Treatment costs less than US$200 annually, a substantial drop from US$10,000 less than two decades ago. ART drugs have been shown to stop the spread of HIV from person to person by suppressing the virus to undetectable levels. For this reason, it is crucial that all HIV-infected persons undergo treatment.

Marginalization, power imbalances, and insidious cultural gender norms leave large populations of women disproportionally more vulnerable to HIV infection than men. In Rwanda, for example, women who have been coerced into sex are 89 percent more likely to contract HIV. Food insecu- rity is an even more tangible leading contributor to this gender disparity. A study conducted in Botswana and Swaziland concludes that the women who sell sex for resources—victims of food insecurity—have 70 percent increased odds of having unprotected sex. In Asia-Pacific, sex work is the leading cause of HIV infection. Gen- der equality and empowerment must play a fundamental role in the effort to end AIDS: women, particularly in regions of Africa and the Caribbean, must have the resources to achieve economic independence and social equality. Above all, this includes eq- uitable education and comprehensive maternal and sexual health services. Seventy-four percent of young men around the world know condoms are effective in preventing HIV infection, compared to only 49 percent of young women. These and similar statistics illustrate a model of health disparity that confronts the global health community today.


Evidence shows that treatment is prevention. A highly cited study reveals that early treatment intervention results in a 96 percent decrease in the risk of HIV transmission. Since a successful vaccine is not near on the horizon, an unparalleled effort must be made to stop the spread of the virus. In addition to scaling up efforts to ensure universal drug therapy for patients, state and non-state actors must strengthen maternal health services to ensure that every pregnant woman infected with HIV is treated: the prevention of mother-to-child transmission should be a matter of human rights.

A targeted effort to treat every HIV-infected person and a more strategic approach to investment depends on the successful coordination of efforts among key players in the global health community. The ineffective organization and allocation of responsibilities among these global health actors is a current impediment to a full-fledged effort to eradicate the disease. Over 34 million people live with HIV today: eight million in poorer parts of the world are on treatment, but over seven million are not. Such a disparity does not have a place in the 21st century. The executive director of UNAIDS, Michel Sidibe?, concluded the 2012 AIDS Conference with a call to action: the opportunity to end AIDS “will evaporate if we do not act.”


The US President’s Emergency Plan for AIDS Relief (PEPFAR) represents the largest financial commitment by a single nation to fight the global HIV/AIDS epidemic. Nevertheless, President Obama’s budget proposal for the fiscal year of 2013 cuts US$563 million from PEPFAR, amounting to three percent of the current global HIV/AIDS budget. Today, a lack of commitment from governments stems from economic uncertainty: however, this cannot be used to justify delayed or abated efforts to eradicate an epidemic that claims a life every fifteen seconds. The high drug costs, limited treatment availability, scant funding, and low prospects of success that plagued global health in previous decades no longer apply. The 21st century has ushered in a golden age for global health. Treatment efficacy has reached new heights: now is the time to end AIDS.