As we prepare to mark World AIDS Day tomorrow, the U.S. government this week announced a blueprint for achieving an AIDS-free generation. The plan to confront AIDS globally outlines goals and objectives that take into account groundbreaking scientific advances in HIV care, treatment, and prevention — many of which would not have been possible without federally funded research supported by Maryland-based institutions and scientists.
These advances in our knowledge of how to treat and prevent HIV infection could be game-changing in our fight against the pandemic, but time to act on this new U.S. blueprint will be short. Our window of opportunity is closing rapidly, threatened by drastic cuts in federal funding scheduled to take effect in January.
Without a strong U.S. commitment to fund continued research and provide the resources needed to deliver lifesaving HIV care, services, and treatment globally and here at home, more lives will be lost, harming communities and public health. Ultimately, the ambitious goal of finally turning the tide against AIDS, more than 30 years into this pandemic, will be in peril.
The science is clear: Identifying people who are infected with HIV and starting them on treatment saves lives. Treatment also drastically reduces transmission: by 96 percent among heterosexual couples in which one partner is infected and the other is not, according to 2011 results from a landmark clinical trial supported by the Bethesda-based National Institutes of Health.
Tragically, the anticipated reductions in federal funding could cut off lifesaving treatment for an estimated 273,000 people globally, potentially leading to 62,000 more AIDS-related deaths and 122,500 more orphans. Approximately 111,000 fewer HIV-infected pregnant women worldwide could receive medications to prevent their babies from becoming infected, leading to more than 21,000 infected infants.
In the U.S., nearly 16,000 people could lose access to lifesaving HIV drugs from the AIDS Drug Assistance Program, which provides HIV medications to patients who cannot afford them. A majority of clinics supported by the federal Ryan White Program, which provide HIV care to the poor and the uninsured, and which are already overwhelmed by growing patient loads and stagnant funding, would be forced to reduce services and cut staffing levels.
The cuts would also threaten the hard-earned progress achieved domestically through the National HIV/AIDS Strategy and expected with the Patient Protection and Affordable Care Act. Fully funding and implementing health reform across all states, including the Medicaid expansion, will be crucial in expanding access to effective HIV care and treatment for those who need it but cannot afford it and do not qualify for current safety-net programs.
The secondary benefits to the economies of Maryland and the nation are also at risk: Nearly 500 bioscience companies and 50 research-intensive federal institutes are based in Maryland, and the state ranks second in the country in federal funding for global health research and development. The life sciences sector supported nearly 72,000 Maryland jobs in 2010, with earnings 76 percent higher than the state average. Nationwide, NIH-funded research supported an estimated 432,000 jobs in fiscal 2011.
Maryland is fortunate to have representatives in Congress who are committed to improving global health and to the fight against HIV/AIDS domestically and around the world. We look forward to their continued leadership on these issues as lawmakers adopt what we hope is a balanced approach to the nation's budget challenges, one that protects investments in research and public and global health.
We still have much work to do to end AIDS: More than 50,000 new infections occur each year in the U.S., where 1.1 million people are living with HIV. Nearly 20 percent of those who are infected, including an estimated 9,000 Maryland residents, are unaware of their HIV status. Globally, nearly 3 million people are newly infected with HIV each year, and only a third who live in poor countries and need treatment have access to it.
Guided by the scientific evidence and continued research, we have the capability to begin to finally end the HIV/AIDS epidemic globally and domestically. We need an ongoing U.S. commitment to provide the necessary leadership, resources and funding to finish what we have started.
Dr. Michael Horberg is chairman of the HIV Medicine Association (HIVMA) and executive director of research with the Mid-Atlantic Permanente Medical Group in Rockville. Dr. Joel Gallant is HIVMA chairman-elect and professor of medicine and epidemiology in the Division of Infectious Diseases at the Johns Hopkins University School of Medicine.Copyright © 2014, The Baltimore Sun