The XIX International AIDS Conference (AIDS 2012) is the largest meeting of individuals from around the world working to end the HIV/AIDS pandemic. In this video interview, Dr. Howard Koh, Assistant Secretary for Health at the U.S. Department of Health and Human Services talks with Ambassador Eric Goosby, U.S. Global AIDS Coordinator, about how the diversity of individuals participating in AIDS 2012 are essential in helping realize an AIDS free-generation.

“I think that the unique thing about this meeting is the equal levels of discourse between these groups that normally don’t have an opportunity to talk and meet with each other,” said Ambassador Goosby.

Ambassador Goosby has been on the front-lines of the epidemic since the beginning, treating some of the first patients in San Francisco when AIDS first emerged.  Today, he is leading all U.S. government international HIV/AIDS efforts through the President’s Emergency Plan for AIDS Relief (PEPFAR). For more information on PEPFAR’s involvement in AIDS 2012, including announcements related to new and ongoing initiatives, visit http://www.pepfar.gov/.

The following video highlights this conversation. Visit USG@AIDS2012 to learn more about the conference.

Key fact sheets from PEPFAR:

• Using Science to Save Lives: Latest PEPFAR Results (PDF)
• Making Smart Investments to Increase Impact and Efficiency and Save More Lives (PDF)
• PEPFAR Supporting Country Ownership: Key to a Sustainable Response (PDF)
• Orphans and Vulnerable Children: Saving Children, Investing in Our Future (PDF)
• Combination Prevention Overview (PDF)
• U.S. Support for the Global Fund: A Key Vehicle for Meeting Shared Responsibility (PDF)

Dr. Kevin M. DeCock

More than 20,000 people of all backgrounds – scientists, activists, policy-makers, people living with HIV and others – will soon  arrive in  Washington DC for the XIX International AIDS Conference  , to be held at the Walter E. Washington Convention Center from July 22 to 27, 2012.  This is the first time in 22 years that the Conference has been held in the United States.  Previous U.S. visa restrictions on people living with HIV have been lifted, opening the way for the conference to be held in the United States for the first time since 1990. These International AIDS Conferences have served as milestones in the history of the HIV/AIDS pandemic.  The first was held in Atlanta, home of the Centers for Disease Control and Prevention (CDC), in 1985. Dr.  Jim Curran, head of CDC’s HIV/AIDS activities in the early years, commented later on CDC’s pride in organizing this event,  and  that only 1,000 people came (compared with more than 20,000 expected in 2012). Each of the 17 conferences since has had its own character and influence, but several have stood out as visible markers along our journey in the pandemic.

The conference in Berlin in 1993 may represent the nadir in our collective mood about HIV/AIDS.  Epidemiology described HIV/AIDS emerging in new areas of the world; East and parts of Central and West Africa were aflame with AIDS, political commitment was lacking, and research offered no solutions.   Results of the Concorde trial, sponsored by the UK Medical Research Council, showed that zidovudine monotherapy had no long term benefit.  I had the privilege of delivering a plenary lecture on HIV-associated tuberculosis, perhaps the first time that the association of these two major infections had been highlighted at a major meeting.  Multidrug-resistant tuberculosis was causing a public health emergency in New York City, and the implications of HIV-associated tuberculosis globally were only just beginning to be perceived, with no end in sight.

The contrast between Berlin in 1993 and Vancouver in 1996 could not have been greater.  The International AIDS Conference in Vancouver is synonymous with the introduction of highly active antiretroviral therapy (HAART), now just referred to as ART.  Elegant studies and trials showed that viral load predicted disease progression, that combination ART lowered viral load, and that lowering of viral load resulted in improved survival of HIV-infected persons.  Delegates were stunned by presentations of individual case histories of patients dying of AIDS who were rescued by ART, colorfully referred to as “the Lazarus effect”.  I delivered  a plenary presentation  summarizing the clinical track of the conference and noted perhaps the only perplexing aspect of the proceedings,  that the conference theme of “One World, One Hope” hardly applied to the real universe that in reality was one of “worlds apart”.   The scientific advance of ART was restricted to high-income countries.

How different our world is today.  When the International Conference on AIDS was held in Durban in 2000, who could have imagined the achievements we take for granted in 2012?  Durban was important because it brought home to delegates and decision makers the reality of HIV/AIDS in Africa, most severe by then in the southern part of the continent.  Durban unquestionably resulted in political pressures and    processes that culminated in the creation of the Global Fund, PEPFAR, and the World Health Organization’s “3×5” initiative that aimed to have 3 million persons on ART by end-2005.

Who in Durban could have dreamt that within a decade almost 7 million people worldwide, most of them in sub-Saharan Africa, would have accessed ART?  Just as importantly, the Durban conference heralded a golden age in global health that extended beyond HIV/AIDS and increased funding for malaria and neglected tropical diseases, and refocused attention to maternal and child health.  In addition, necessary attention was brought to bear on the overall need to strengthen health systems.

And now  to Washington in 2012.  The economic situation in the world is discouraging, the Euro is wobbling, and there is an overall reticence to seeing the bright side of life.  And yet, how much has been achieved!  How much more can be done, even if resources are not growing as they were some years ago!  Biomedical science has delivered extraordinary results in showing that HIV treatment is prevention, that prevention of mother-to-child transmission of HIV is possible everywhere (and including through breast feeding), and that male circumcision is a once-only, effective intervention with huge potential to prevent heterosexual acquisition of HIV in men.  Behavioral science remains critically important, including guiding us on how to use these gifts more effectively.

The global community combating HIV/AIDS is positioned to make major advances against this epidemic, and we must not squander these opportunities.  On behalf of  CDC’s Center for Global Health, I want to welcome attendees of the XIX  International AIDS conference to  Washington.

Editor’s Note: For information on the US Government’s activities at the conference please visit USG@AIDS2012.

Nelson L. Michael

When the HIV epidemic first emerged in the 1980s, the U.S. government immediately recognized the threat the disease could pose to U.S. and Allied Service Members. In this age of global deployments, HIV not only continues to pose a threat to Service Members, but it can also compromise the stability of a nation where the disease is prevalent and endanger worldwide security.

Early in the epidemic, the U.S. military emerged as a leader in the field of HIV research when its researchers developed the first HIV disease staging system, published evidence of the then-controversial notion that HIV could be transmitted heterosexually, described over half of the circulating variants of HIV, and developed the criteria for Western blot positivity—the first supplemental confirmatory test for HIV.

Fast-forward to 2009; the U.S. Army announced the results of RV144, the first HIV vaccine regimen to show some ability to protect people against this devastating disease. This landmark study showed a vaccine efficacy of 31.2% at the end of the study at 42 months, but interestingly there was a higher early protective effect of 60% 12 months into the study.

For the last two years, the U.S. Military HIV Research Program at the Walter Reed Army Institute of Research (WRAIR) has been part of a public private partnership called the P5, which is building on this success to advance and ultimately license similar vaccine candidates that have the potential to achieve a broad public health impact. The collaborators are planning future efficacy studies using an improved vaccine regimen with an extra vaccine boost at 12 months to improve and prolong the level of protection seen in the RV144 study.

This progress in vaccine science was enabled by strong collaborative leadership from the WRAIR and the U.S. National Institutes of Allergy and Infectious Diseases (NIAID), along with partners from the Thai and U.S. governments, private companies, non-profit organizations and more than 16,000 volunteers. By leveraging resources and capabilities, we have been able to achieve together what no one organization or country could do alone.

As we approach the AIDS 2012  conference, HIV scientists and global leaders are talking about the end of AIDS. Recently, great advances have been made in preventing HIV through the use of new strategies such as adult male circumcision in Africa and AIDS therapeutics as prophylaxis. However, these new prevention strategies have their limitations, and it will take a combination of prevention methods, including a vaccine, to truly end the pandemic. The U.S. military—working with U.S. and international collaborators—vigorously pursues this goal to protect U.S. troops and the global community so that we may one day achieve an AIDS-free generation.

Editor’s Note: For information on the US Government’s activities at the conference, please visit USG@AIDS2012.

Carrie Hessler-Radelet

For over 50 years, more than 200,000 Peace Corps Volunteers in 139 countries have worked to make communities around the world healthier and stronger. Volunteers work on projects ranging from sanitation, to malaria, maternal health, and HIV prevention—often impacting an entire community, village, or school at a time.

Today, a major area of Volunteer service is the health sector, which is second only to Peace Corps’ work in education. With the Peace Corps serving as an implementing agency of the President’s Emergency Plan for AIDS Relief (PEPFAR), a growing number of Volunteers conduct activities in HIV/AIDS prevention, care, and support. Last year alone, 52 percent of all Peace Corps Volunteers engaged in such work in communities overseas.  In 2013, through the Global Health Service Partnership, we look forward to placing doctors and nurses as adjunct faculty in training institutions in Africa.

As so many of us know, HIV/AIDS has no borders or boundaries. It can affect communities at every level of our global family. For the Peace Corps, we know that the epidemic has an impact beyond just our work in health.

That is why Volunteers working in other areas like agriculture, business development, environment, and youth development also contribute to our global response to the epidemic. Every day, our Volunteers find sustainable and creative ways to fight this epidemic.

A Peace Corps Volunteer joins his community on an AIDS march in Kenya.

It is estimated that of the 30 million people who are HIV positive today, two thirds live in Sub-Saharan Africa.  For this reason, every Volunteer serving in Africa, regardless of primary assignment, is trained in HIV/AIDS prevention and awareness. Every day, in countless communities around the world, Volunteers contribute in diverse ways by:

• Helping parents to improve their livelihoods for their families by improving access to clean water, introducing new farming and food generation techniques, and demonstrating safer ways to use cook stoves.
• Creating and implementing innovative HIV prevention content and curricula into English and science lessons.
• Partnering with local community groups to support orphans, vulnerable children, and people living with AIDS.
• Teaching new mothers simple techniques for pasteurizing milk and monitoring baby nutrition and weight.
• Leading camps for young women, “Girls Leading Our World” (GLOW), and helping teach them to be healthy, safe, and strong in their communities.

So many of today’s inequalities, such as poverty, hunger, and HIV/AIDS, still loom large in much of our world. But, even as we face new challenges, we must continue to work together to make sure we can achieve an AIDS-free generation. .

Please visit www.peacecorps.gov/aids2012 for more information about Volunteer projects and about Peace Corps activities taking place in conjunction with the AIDS2012 conference.

Editor’s Note: For information on the US Government’s activities at the conference please visit USG@AIDS2012.

The XIX International AIDS Conference , known as AIDS 2012, will take place July 22-27, 2012 in Washington, DC. Anticipating the conference, yesterday I spoke at the Brookings Institution on some of the lessons learned from the first decade of the President’s Emergency Plan for AIDS Relief (PEPFAR) that can inform future efforts on AIDS and global health.

I noted that in order to be wholly successful in our fight against AIDS, and achieve our collective goal of an AIDS-free generation, we need to focus on three specific areas of improvement: recognizing PEPFAR as a foundation for other global health successes; promoting country ownership; and fostering a shared responsibility for the global response. It is because of PEPFAR’s work that today many countries are in a better position to save more lives and create a stronger, more secure world.

The AIDS 2012 conference is now just one month away. Thanks to the Obama Administration, for the first time in more than 20 years, this meeting is taking place in the United States. America’s contribution has been imperative to the fight against HIV/AIDS. Through PEPFAR, as of last year, the United States supported nearly four million people on treatment. Additionally, PEPFAR programs supported drugs to prevent mother-to-child transmission for 660,000 HIV-positive pregnant women. Because of this effort, an estimated 200,000 infant infections were averted in 2011 alone.

The last 10 years have taught us what must be done to end this epidemic and achieve an AIDS-free generation, and I have great hope that we will get it done. This is the moment to seize this hope, and together we will turn the tide.

To read the transcript or watch the video of the event, please visit www.PEPFAR.gov.

Editor’s Note: With less than a month away from the XIX International AIDS Conference, we are reposting the following blog post to raise awareness around the U.S. global response to HIV/AIDS.

For the first time in over 20 years, the biannual International AIDS Conference will take place on American soil. From July 22-27, AIDS 2012 will convene scientists, health professionals, policy makers and those affected by AIDS in Washington, D.C. to assess progress to date and identify next steps in the global response.

The conference theme, Turning the Tide Together, underscores the pivotal moment in which AIDS 2012 is taking place. Recent scientific advances in HIV treatment and biomedical prevention, coupled with continued progress in scaling up key interventions in developing countries, have led to renewed hope and optimism across the globe.

In November 2011, Secretary of State Hillary Rodham Clinton announced the United States’ goal of creating an AIDS-free generation. President Barack Obama put this commitment into action on World AIDS Day with a plan to expand U.S. support for treatment to 6 million people globally.

Since AIDS was identified 30 years ago, the U.S. has played a leading role in achieving scientific progress, and in translating science into programs. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), with bipartisan support from Congress and a strong commitment by President Obama, has put that science into action to save the lives of millions in the developing world. It is truly an honor to be leading PEPFAR and working closely with our implementing agencies — including the US Agency for International Development, the Centers for Disease Control and Prevention, the Department of Defense and Peace Corps — to reach millions across the globe.

Evidence-based science is driving our efforts. The United States is supporting a combination of high-impact strategies that are changing the course of the epidemic. These include efforts to keep newborn children from being infected with HIV, voluntary male medical circumcision, and expanded access to antiretroviral treatment to save lives and prevent new exposure to HIV. When used in combination with each other, condoms, behavioral efforts, and other prevention tools, these interventions offer an historic opportunity to drive down the worldwide rate of new infections. Our latest results show that this is continuing to work.

In 2011, PEPFAR supported antiretroviral treatment for more than 3.9 million people. PEPFAR programs supported HIV counseling for 40 million people, and care for 13 million people, including 4.1 million orphans and vulnerable children. Last year alone, PEPFAR tested over 9 million pregnant women for HIV, reaching over 660,000 HIV-positive mothers with services to keep them alive and prevent transmission to their children. As a result, 200,000 babies were born free of HIV.

AIDS 2012 will be an opportunity to look back at the progress we have made and consider where the science will lead us to next. The conference will also be a critical venue to increase the global response to this shared responsibility, including through the Global Fund. The President has made it clear that continued strong leadership from the United States, along with heightened commitment by other partners, will allow us to seize the opportunity for dramatic progress toward an AIDS-free generation.

Mr. Buckingham moderates the Global Health Service Partnership panel at the National Press Club. Joining him on the podium is Ambassador at Large Eric Goosby from the Office of the Global AIDS Coordinator (OGAC), Global Health Service Corps’ Board Chair Dr. Fitzhugh Mullan and Executive Director, Dr. Vanessa Kerry, and Peace Corps Director Aaron Williams.

In a major lecture delivered on December 13, 2011, U.S. Global AIDS Coordinator Ambassador Eric Goosby described vital ways that United States health care professionals are working in developing nations to train more doctors, nurses and midwives and to support medical research.

He concluded, “When I talk about doing development differently, these programs focused on laboratories, physicians and nurses are prime examples of what I mean. They build on Africa’s greatest resource of all—its people. They are fostering indigenous capacity to strengthen health systems in a sustainable manner.”

Another big step forward in “doing development differently” took place on March 13 when Dr. Goosby joined with Peace Corps Director Aaron Williams and others to launch the Global Health Service Partnership (GHSP).

“The Partnership is an innovative approach to address the need for more, and better-prepared, health care professionals in countries hard-hit by HIV/AIDS,” said Dr. Goosby.

The partnership is formed with Global Health Service Corps — a nonprofit co-founded by Dr. Vanessa Kerry, its Executive Director and a Mass General physician, to raise awareness of GHSP among qualified professionals and to provide technical support to the program, its volunteers, and the teaching institutions overseas.

Peace Corps will work alongside PEPFAR country teams to engage Ministries of Health and of Education to identify priority training institutions to increase capacity and strengthen the quality and sustainability of medical, nursing and midwifery education and clinical practices.

The program will begin by placing 10 to 12 health professionals in Tanzania, Malawi and Uganda. Participants will serve one-year assignments through Peace Corps Response, a program that offers high-impact, short-term assignments for qualified Americans.

Although this partnership is an exciting innovation for the Peace Corps, the commitment to health which it reflects finds deep roots in our history, as Director Williams described at the launch on March 13:

“From the moment John F. Kennedy first publicly suggested even the idea of a peace corps, before it even had a name, health care was in our DNA.  Issuing an impromptu challenge to students during a 2 a.m. campaign stopover at the University of Michigan, he asked, ‘How many of you, who are going to be doctors, are willing to spend your days in Ghana?’

“Kennedy established the Peace Corps by executive order on March 1, 1961.  In announcing the order before TV cameras, he departed from the written announcement before him to once again affirm that volunteer nurses and doctors were to be a vital part of the story:  ’We are going to put particular emphasis,’ he said, ‘on… men and women who have skills in teaching, agriculture, and in health.’”

Director Williams observed, “this partnership…brings us full circle to that vision; but conforms it to the priority on sustainability.”

The partnership will take on fuller definition this summer, when invited physicians and nurses from academic health centers and other centers of expertise in the United States and the three initial countries in the pilot program will gather in Washington, DC on July 21 to further plan the contours of its work.  The application process is expected to begin in September 2012, and the partnership expects to begin sending health care professionals abroad in the summer of 2013.

We look forward to seeing the first of these Volunteers take flight.

Rajiv Shah

Over thirty years ago, when the fight against HIV first began, the outlook for tackling the pandemic was bleak. Across the world, AIDS was seen as a death sentence. Within just a few years, it had devastated communities from the United States to South Africa.

But the world continued to fight, and the past three decades have seen tremendous progress in HIV research, prevention and treatment, thanks in large part to the leadership of the United States. Today, we can build on that strong legacy to answer President Obama and Secretary Clinton’s call for an AIDS-free generation.

The XIX International AIDS Conference (AIDS 2012) conference will be an opportunity to renew our commitment to this incredible goal. It also marks an historic moment, as the United States hosts the conference for the first time in over 20 years now that people living with HIV and AIDS are able to visit the U.S. to attend in-person.

We know that we have a long way to go to win the fight against HIV–especially for children.

Through the President’s Emergency Plan for AIDS Relief (PEPFAR)–the largest international commitment to a single disease by any individual country–the U.S. Agency for International Development (USAID) and other U.S. government agencies provide lifesaving HIV and AIDS services to millions of children, women, and families worldwide.

These investments in the global AIDS fight are paying off. Together with PEPFAR, our efforts have made a significant difference in promoting access to prevention of mother-to-child transmission (PMTCT) services, helping to cut new pediatric infections in half in the past decade. We’ve also helped support 9.8 million pregnant women with HIV testing and counseling and provided PMTCT services to more than 660,000 HIV-positive women. As a result, approximately 200,000 infants were born free of HIV.

That means that 200,000 more children have had the opportunity to live to celebrate their 5th birthday.

This milestone is an extraordinarily important one in the development of all children, and it is the impetus behind the Every Child Deserves a 5^th Birthday campaign–an awareness-raising effort that brings together dozens of partners and educates a broader community on how to save children’s lives.  The campaign also sets the stage for the Child Survival Call to Action in June.  Co-convened by the Governments of the United States, India and Ethiopia, and in close collaboration with UNICEF, the Call to Action will bring together public and private constituencies to chart the course towards the end of preventable child deaths–including deaths caused by AIDS or AIDS-related causes.

The Call to Action will also build on ongoing global efforts, including PEPFAR and UNAIDS’s global plan (PDF 785KB) to end virtually all new HIV infections in children in the next few years while keeping mothers alive and healthy.

Still, we need to do better in the fight against HIV and AIDS. Today, we know what works in the effort to save children’s lives and now, more than ever, we are in a position to virtually eliminate pediatric AIDS. Together, we can give all children the chance to celebrate their fifth birthday.

The HHS Office of Global Affairs will host an educational forum for Federal staff with Dr. Elly Katabira, President of the International AIDS Society  (IAS) and International Chair of the XIX International AIDS Conference  (AIDS 2012), on Friday, February 10, from 1:00–2:00 p.m. Dr. Katabira will discuss the historic nature of AIDS 2012 during the forum, “AIDS 2012 and Beyond.”

The biennial conference, which is convened by the IAS in partnership with international and local (U.S.) organizations, including the U.S. government, will take place in Washington, DC, from July 22-27, 2012. The forum will be live-streamed to the public at: http://videocast.nih.gov/live.asp?live=10999.

To stay up-to-date on U.S. Government conference activities, please visit the USG @ AIDS 2012 webpage.