HIV/AIDS has been around since the 1980s. It has baffled doctors and scientists as no cure for it has been found so far, despite decades of research. This Tuesday was the 1st of December, on which World AIDS Day is observed internationally.
This is another pandemic that resulted from the spread of a virus from animals to humans. HIV has infected more than 77 million people worldwide. Despite significant progress in treatments, it has killed over 35 million people — including 690,000 last year alone. Two-thirds of all new infections and deaths occur in Africa. Now, UNAIDS estimates that the Covid-19 pandemic may set back progress on HIV by a decade.
Life With HIV/AIDS Can Only Be Contained With ART
Science has been the backbone of the HIV response. Daily antiviral therapy has changed an HIV diagnosis from a death sentence. And today, those infected can expect to have a nearly normal life span.
However, it has been more than 30 years into the HIV pandemic. Over 13 million people still do not have access to the antiretroviral therapy (ART) and treatment they need daily. Factors ranging from new infections, limited access to health care, stigma, discrimination, persistent myths, fears about treatment and supply chain limitations have all contributed to preventing full control of — and access to treatment for — HIV.
Interventions that lead to a meaningful cure — allowing for people to safely stop antiviral drugs — are at least decades away. However, we must begin planning for it sooner than later. Once available, we must ensure a cure can be successfully delivered to those countries most burdened by the disease. And delivery must come at speed.
In addition to the lack of global access to lifesaving treatment, treatment is not perfect. And people living with HIV still suffer from stigma and discrimination — issues that will take time to overcome.
Over a 16-year period, the world spent approximately $560 billion on HIV. There are 1.7 million new infections per year. And every person living with HIV needs lifelong treatment. Hence, sustaining such massive investments is challenging.
How Close Are We To A Cure?
An HIV cure would mitigate the long-term health and economic consequences of the virus and eventually replace daily treatment. This would facilitate cost savings that could free health resources for other priority diseases. It could also catalyze pandemic control.
Most importantly, the scientific case for an HIV/AIDS cure has become increasingly stronger over the past decade. We know that a cure is possible thanks to the case reports of two men, Timothy Brown and Adam Castillejo, who were cured of HIV following a stem cell transplant.
Additionally, combined interventions that stimulate the immune system have led to cures in monkeys. Given the high bar for safety, evaluation of many interventions is now complete, allowing for clinical trials of combination cure strategies that are now underway. If an HIV cure is to have maximal impact, it must be affordable, deliverable, and acceptable in all countries hit hard by the virus.
With continued scientific advances, researchers have acknowledged that there will be successive generations of interventions leading to an HIV cure, starting with combined interventions to bolster the immune system and to reduce the pool of residual virus, and possibly even extending to genetic therapies in the future.