World AIDS Day

December 1, 2016

Dear Colleagues,

World AIDS Day 2016 arrives today on a current of optimism that reflects the remarkable progress we’ve made against one of the biggest threats to people’s health in our lifetime. And yet, World AIDS Day also forces us to acknowledge that much work – and many challenges remain – before our ultimate goal is realized, a world where HIV is eliminated as a public health threat.

The progress is promising – such that talk of an AIDS free generation is within our reach. The hard and complicated work we’ve done has paid off to the extent that the United Nations proclaimed earlier this year that ending AIDS by 2030 is both a realistic and reachable goal. The expanded use and availability of antiretroviral therapy (ART) have been effective.  ART is providing an opportunity for more than 18 million people worldwide to live with hope, health and a sense of normalcy. The intensive efforts to eliminate mother-to-child transmission of HIV have yielded remarkable results. According to new data from UNAIDS, antiretrovirals have averted an estimated 1.6 million new HIV infections among children since 2000.

The results of new Population-based HIV Impact Assessments in Malawi, Zimbabwe, and Zambia are further cause for celebration. They suggest these countries are making tremendous progress towards achieving epidemic control:  confirming reductions in incidence, measuring high population viral load suppression, and demonstrating that persons who report knowing they are HIV-infected are likely to be accessing treatment with successful viral load suppression. Read more about these findings in PEPFAR’s press release and fact sheet.

Combined, the advances have been so demonstrably effective that HIV is increasingly seen as a manageable chronic disease. But that circumstance, while positive, has triggered a new set of challenges that demand attention and answers. For example, with more people than ever before on HIV treatment, the need for ongoing vigilance against drug resistance is critical.

On this World AIDS Day, it’s worth remembering that gaps exist and that the advances and good news are not uniform.

While we’ve met our global goal of treating 15 million people, the facts show that we need to treat at least 15 million more who so far are not getting the therapy they need. Despite unquestionable advances driven by science and sheer determination, more than 1 million people die each year from AIDS. There are still 37 million people living with HIV.

And that is perhaps the most important message of today – that despite the successes and admirable achievements, we are far from finished. We must remain steadfast in our determination to defeat HIV. We cannot rest or relax until this epidemic is ended. The facts and the challenges are right in front of us.

In July, the United Nations documented a “prevention gap” where HIV rates have declined by 50 percent or more over the last decade in some countries “while many others have not made measurable progress or experienced worrying increases in new HIV infections.”

We have a roadmap. In the near term our focus is on three important milestones to be met by 2020:

• Ninety percent of people with HIV diagnosed
• Ninety percent of those diagnosed on antiretroviral therapy
• Ninety percent of those on antiretroviral therapy virally suppressed

As always, CDC will be on the frontlines, working side-by-side with ministries of health, partners, and community organizations in 50 countries to put into action and sustain novel approaches to help achieve these global goals.

CDC will continue our actions where we have made important contributions, such as expanding access to state-of-the-art HIV tests to identify babies with HIV in the critical first 6 weeks of life, devising new ways to reach undiagnosed persons with HIV testing, and piloting innovative approaches to help more people with HIV start and stay on treatment.

CDC is also working aggressively to prevent people from becoming infected with HIV in the first place, including continuing to expand access to pre-exposure prophylaxis and voluntary medical male circumcision. Promising and effective new approaches for preventing HIV such as pre-exposure prophylaxis are underutilized.

Stigma still exists and can also resurge without active, concerted efforts to keep it at bay. We must continue working aggressively and with a clear focus to prevent its resurgence and continue to combat it.

With continued leadership and commitment from CDC and the global community, our global goals can be achieved. There is no doubt on this point because the record so far shows how hard work and clear, creative, industrious thinking can attack a problem that once seemed overwhelming.

Of all the messages and themes of World AIDS Day 2016, the most important is that today highlights a clear, indisputable record that will provide energy, determination and momentum necessary to ending HIV once and for all. This is not easy work. Essential, meaningful, important work never is. But the path, with its unmistakable end, is clearly before us so on this World AIDS Day 2016, let us recommit ourselves to the goal we are working together to achieve.

Sincerely,

/Rebecca Martin/
Rebecca Martin, PhD
Director, Center for Global Health
Centers for Disease Control and Prevention
www.cdc.gov/global

/Shannon Hader/
Shannon Hader, MD, MPH
Director, Division of Global HIV & TB
Center for Global Health
Centers for Disease Control and Prevention
www.cdc.gov/globalhivtb