It’s World AIDS Day, a day we’ve been marking for decades. Millions of people are still dying of AIDS every year, two people still getting infected every day for every person put on treatment.
But this year, it’s different.
“It’s night and day, at least when it comes to prevention,” said Dr. Stefano Bertozzi, director of HIV and tuberculosis programs at the Bill & Melinda Gates Foundation. “The landscape has shifted dramatically.”
Progess has been made in reducing the rate of new HIV infections through education, safe sex campaigns and the like. The world community has succeeded in getting more people on life-saving treatments. But the pandemic continues worldwide, with numbers (33 million infected, nearly 2 million dying every year) that are daunting if not mind-numbing.
World AIDS Day is often a sobering reminder of our failures, of the lack of an effective vaccine to prevent this deadly illness, of the inability still to get the life-saving drugs to many more — most, actually — of those who need them. It often feels like a day when we try to find something hopeful to say about pushing a rock up a hill.
But many, like Bertozzi, think we’ve entered a new era that may finally allow us to achieve major progress. The seismic change on the AIDS landscape he’s referring to concerns prevention and three scientific discoveries over the last year or so:
- The first-ever demonstration, in Thailand, of a vaccine that prevented against HIV infection. The Thai “prime-boost” vaccine, though not effective enough to be useful, nevertheless indicates an effective HIV vaccine is possible.
- A study, in South Africa, of a vaginal gel containing an anti-HIV drug that prevented infection in women. The CAPRISA trial showed that a microbicide gel can cut in half a women’s risk of HIV infection from sex with an infected partner.
- And just last week, researchers reported that a common drug used in HIV treatment, Truvada, can prevent infection in gay men who take it as a daily pre-exposure prophylactic.
It may be difficult for many to appreciate just how much of a difference these advances in prevention promise to make in the years ahead, Bertozzi said. An effective HIV vaccine is years away still, he acknowledged, but not that long ago many were despairing if it was even possible.
The two new “pre-exposure” preventive tools of a daily pill and a microbicide, Bertozzi says, are immensely promising as a means to help prevent further spread of HIV. The same drug, tenofovir, is used in both the pill and the gel, Bertozzi said, and remains expensive. But wider use often translates into lower costs, he noted, and together they could truly spark a prevention revolution.
“A lot has changed in the last year,” Bertozzi said. “It’s an exciting time for prevention research.”
Others are echoing his sentiments. In an article for the Huffington Post, three leaders in the fight against AIDS cite the same advances in prevention and ask “Can We Now Imagine a World Without AIDS?”
Much remains to be done yet, to advance the science and assure access to these new tools once they are fully proven out. But, as Bertozzi says, it’s a more hopeful landscape.