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AIDS on decline, millions still waiting for drugs

LONDON — When the AIDS epidemic erupted nearly three decades ago, experts feared it would be impossible to stop the disease’s spread or to provide enough of the costly drugs needed to treat it. Today, the number of new cases has leveled off and deaths are at their lowest since peaking in 2005.

Substantial challenges remain: Millions of people still need treatment. Scientists haven’t yet developed a vaccine to prevent it. And the rate of new HIV infections has held steady. At the end of 2011, there were about 34 million people living with HIV, roughly the same number as the year before.

All that amid a global financial crisis that has meant cutbacks in donations and less enthusiasm for expensive programs that require years of commitment.

As thousands gather in Washington for the International AIDS Conference this week, health officials describe the progress made in getting AIDS drugs to poor countries as remarkable. “Ten years ago, we knew nothing about delivering (AIDS drugs) to Africa,” said Nathan Ford, an AIDS expert at Medecins Sans Frontieres (Doctors Without Borders).

Last year, more than 8 million people in poor countries were being treated. But that is only about half of the nearly 15 million eligible patients worldwide.

“We need a new wave of innovation to redefine how we provide care,” Ford said. He said the doctors group is testing treatment programs in Mozambique where stable patients don’t need to see a doctor or nurse to get their medicines.

While revised guidelines mean more people in poor countries are now eligible for drugs, Ford isn’t convinced a surge of new patients will overwhelm the health system, as some critics have warned. “Doctors and nurses will just be giving pills to people rather than performing life-saving interventions,” he said.

Still, once people start taking AIDS drugs, they must stay on the regimen for life. Many such programs in developing countries are paid for by donors.

“The treatment is lifesaving, but the costs of it are potentially crippling,” said Deirdre Hollingsworth, an AIDS expert at Imperial College London. She said the world would eventually reach a turning point when investing in treatment will mean fewer people would get infected. But she couldn’t predict when that might happen.

She said there had been huge successes in recent years, but it might be too optimistic to get to “zero new HIV infections,” as United Nations officials have pledged. “I don’t think that will happen in my lifetime,” she said. “Elimination is too challenging.”

Online:

International AIDS Conference: http://www.aids2012.org/

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