Secretary Clinton’s speech on November 8 at the National Institute for Health represents an historic commitment of the Obama Administration towards further scaling up the global HIV/AIDS response. The commitment builds on the bipartisan consensus behind the President’s Emergency Plan for AIDS Relief (PEPFAR) launched by the George W. Bush Administration. For Secretary Clinton, the world has a “historic opportunity…to change the course of this pandemic and usher in an AIDS-free generation”.
Secretary Clinton confirmed the commitment of the Obama Administration to supporting evidence-based approaches, stating that “we need to let science guide our efforts.” She focused on three important biomedical interventions within combination prevention – prevention of mother-to-child transmission (PMTCT), voluntary medical male circumcision (VMMC), and treatment as prevention. However, she also noted the importance of behavioural and structural interventions which are crucial components for an effective and sustainable HIV response.
Ending stigma and discrimination
The Alliance particularly welcomes Secretary Clinton’s call to address social and legal barriers to the HIV response. She stated that successful HIV responses depends on “ending stigma [and] reducing discrimination”, particularly against women and girls, and abolishing discriminatory legislation, such as “laws that make people criminals simply because of their sexual orientation”. These crucial changes reflect key commitments of the Political Declaration on HIV/AIDS agreed at the U.N. General Assembly High Level Meeting on AIDS in June 2011. Secretary Clinton also highlighted the importance of supporting a response to HIV that is well integrated with TB, malaria, child and maternal health.
Secretary Clinton noted that the United States is the largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria and had made its first multi-year pledge in October 2010. She highlighted that the Global Fund has the responsibility to continue to reform and donors have the responsibility to increase their contributions. She also noted that the Global Fund is working to weed out fraud and corruption where it exists, calling on donors not to punish the Global Fund for its transparency, stating that “the system is working.”
A key opportunity to turn evidence into action
“With World AIDS Day 2011 (1 December) approaching, now is a key opportunity for governments and donors to show their commitment to turning evidence of what works into action; scaling up interventions that we know will have impact and reach those at highest risk and most affected by HIV” stated Dr. Alvaro Bermejo, Executive Director of the International HIV/AIDS Alliance. Dr. Bermejo also serves as the representative of Developed Country NGOs on the Board of the Global Fund.
Secretary Clinton’s speech follows the publication of the investment framework for HIV/AIDS in The Lancet in June 2011. The investment framework demonstrates how increased investments in high-impact programme activities would make it possible to start to turn the tide of new HIV infections and bring an end to AIDS.
“Secretary Clinton has outlined how investment in what works now can bend the curve of the epidemic and start reducing the costs of the response in only 5 years” Dr Bermejo stated, adding that “the key question is whether other key donors and governments, such as the U.K., other European Union members and Australia will show the same political leadership to transform the way things are done at a country level and make a real impact on ending AIDS. This should include technical assistance and funding to scale up the programmes that we know work, both in generalised epidemics and concentrated epidemics.”
Alliance U.S. Director Jason Taylor Wright added, “The U.S. Government has done more than any other institution to fight global HIV/AIDS through PEPFAR and the Global Fund. Secretary Clinton’s speech provides the context for President Obama to issue a call on global leaders to work with him to take the decisive actions needed to bring an end to AIDS.”