On Monday, US Secretary of State John Kerry signed an agreement with the African Union to help establish the African Centres for Disease Control and Prevention. Headquartered in Addis Ababa, Ethiopia, the African CDC will take on a role similar to the Centers for Disease Control and Prevention (CDC) in the United States, and work to prevent and respond to future disease outbreaks on the continent.
CGD Policy Blogs
On World AIDS Day in 2003, WHO and UNAIDS launched a campaign called the “3 by 5 initiative,” with the objective to “treat three million people with HIV by 2005.” At that time, AIDS treatment was still prohibitively expensive for poor countries, where only a few thousand people had access to treatment. Thanks to President Bush’s creation of the President's Emergency Plan for AIDS Relief (PEPFAR) program that same year, the number of people on antiretroviral therapy (ART) began to rise dramatically. While the total number of people on ART reached only one million in 2005, the objective to reach three million people was attained in 2007, and the numbers have continued to climb. The numbers have now surpassed 11 million in low- and middle-income countries and 13 million worldwide. (See bottom trend line in figure 1.)
It’s too early to know how large the economic impact of Ebola will be on West Africa and the world. Past experience, including the 2002-03 Severe Acute Respiratory Syndrome (SARS) epidemic, suggest it could be very large indeed, especially in the African countries that have been hardest hit. Fortunately, actions that the US and other donor countries take now could help not only to control the epidemic but also to minimize the economic fallout.
There’s no doubt that Treatment as Prevention (TasP) will receive continued emphasis at this year’s International Aids Conference (IAC), as advocates argue for aggressively expanding treatment from the 9 million worldwide currently on antiretrovirals (ARVs) to the 35 million people who are HIV infected. But at the TasP workshop in Vancouver last month the more challenging and novel topic was pre-exposure prophylaxis, or PrEP. A whole array of sessions on PrEP is already on the agenda for next week’s conference in Melbourne, and our bet is that PrEP will generate a lot of buzz – an approach with intriguing potential, but edgy downside possibilities.
UNAIDS recently convened a diverse group of experts to discuss how UNAIDS should go about estimating the post-2015 cost of the HIV/AIDS response. Participants opinions varied on most topics: whether estimates should assess the cost of treating all HIV infected people as soon as they are infected (the “Universal Test and Treat” option) or that of a less ambitious treatment policy; whether spending on poverty reduction and gender empowerment should be included in the cost estimates and, if so, on how to cost these “critical enablers.” But on one question, there appeared to be virtually unanimous agreement: donors and countries should increase the frequency, the granularity and the precision of HIV infection surveys.