Is the End of AIDS in Sight?

Six of the people who died on the Malaysian Airlines flight shot out of the air over Ukraine were AIDS researchers on their way to an international AIDS conference in Melbourne, Australia. They perhaps already knew that one of the themes of the conference would be to set sights on ending the AIDS epidemic by 2030, as reported by this week's Economist.

“End” is an elastic term, since there is no cure for HIV infection, nor is one in sight. But optimists think a combination of the tools available—particularly the antiretroviral (ARV) drugs which now keep around 13m people alive—could be enough to stop the virus spreading. In the parlance of epidemiologists, they believe they can arrive at R0<1 .="" average.="" course="" during="" each="" font="" her="" his="" in="" individual="" infected="" infection="" layman="" less="" lifetime="" means="" of="" on="" one="" or="" pass="" person="" s="" terms="" than="" that="" the="" to="" will="">

This would be nothing short of miraculous, when you consider that no one had heard of the disease a few short decades ago, but in the meantime it has killed millions, especially in sub-Saharan Africa. Using condoms, not sharing needles, and taking antiretroviral drugs all are helping to bring the disease under control, but the success in doing that runs the risk of diverting attention away from the work that still needs to be done--most of it related to lifestyle and the cost of drugs, rather than anything inherently medical.

The Post-2015 Development Agenda, intended to follow on from the United Nations’ Millennium Development Goals, which were set in 2000 and which explicitly mention AIDS as a problem to be dealt with, do not, at the moment, mention the disease directly. This worries many. Spending on prevention and treatment, about $19 billion a year in a combination of locally raised money and foreign aid, is thought unlikely to rise over the next few years. Those fighting AIDS must learn to do more with less.