With funding, an end to the HIV/AIDS epidemic is in sight [Commentary]

Thanks to the incredible combined power of treatments like anti-retroviral drugs (ARVs) and widespread use of harm-reduction services, mortality rates and new infections of HIV/AIDS are finally beginning to decline worldwide. The end of the epidemic is firmly in sight, but we must stay the course. The bottom line is: If we fully fund HIV/AIDS treatment at home and abroad, we will end the epidemic within 10 years.

In spite of numerous positive developments, global funding for HIV treatment and prevention is in crisis. The flagship U.S. program to fight AIDS internationally, PEPFAR (President's Emergency Plan for AIDS Relief), has faced almost $600 million in funding cuts since 2011, and it is being forced to cut services. It is tragic — and deadly — that this comes at a time when the tide of the AIDS epidemic is turning, and the goal of ending the epidemic is in sight.


Here in Maryland we are at the epicenter of the debate to fully fund this fight. That is because Maryland Sen. Barbara Mikulski chairs the Senate Appropriations Committee, which largely controls the federal government's AIDS budget. Recently, House Republicans voted in favor maintaining last year's funding. However, Senator Mikulski and the Appropriations Committee voted to cut global AIDS funding by $300 million. Now these two bills must be reconciled into one. This means that the next step in global AIDS funding is largely in Senator Mikulski's hands.

Senator Mikulski has a tremendous track record of commitment to ending the AIDS epidemic and doing the right thing when it comes to funding global AIDS relief work. She has consistently stepped up when asked to ensure that global and domestic AIDS programs are adequately funded. Now, we need her to step up again.


One of the authors of this piece, Eric Filemyr — a member of the Baltimore Student Harm Reduction Coalition (BSHRC) and a recent graduate of Johns Hopkins Bloomberg School of Public Health — served two years in the Peace Corps in the southern African country of Namibia beginning in 2011. There, he heard stories of every weekend bringing another funeral. In the decade between 1991 and 2001, life expectancy in Namibia dropped by more than 10 years (from 59 to 48 years for men, and 63 to 50 years for women), almost entirely due to HIV.

While Namibia still had one of the highest HIV prevalences in the world in 2011, the tide was turning. New infections were declining, and life expectancy had rebounded. This is thanks to global AIDS money from PEPFAR and the prevention activities and ARVs it pays for. For example, the entire Peace Corps health program in Namibia is funded by PEPFAR dollars.

Despite these remarkable gains, there is still great need. Infections continue, and many children are being raised by their grandparents or siblings because their parents have died of AIDS. HIV/AIDS is still the leading cause of death in Namibia. Cutting global AIDS funding means that literally hundreds of thousands of HIV/AIDS patients will not receive the life-sustaining modern ARV medications they need to survive. Yet, if this treatment receives adequate funding, it will lead to an end the AIDS epidemic by limiting the spread of the virus.

As the chairwoman of the Senate Appropriations Committee, Senator Mikulski has the power to secure these essential, life-saving funds. People around the world need Senator Mikulski to do what we, compassionate voters living in her state, are asking her to do: restore the $300 million cut from global AIDS funding.

As International AIDS Conference, one of the world's largest scientific gatherings, continues this week in Melbourne, Australia, we at BSHRC, along with hundreds of other organizations in Maryland and around the world, ask her to restore funding, save lives, and help end the global AIDS epidemic.

Eric Filemyr, Melanie Reese and Stephanie Sparrow are members of the Baltimore Student Harm Reduction Coalition, a diverse group committed to a range of principles and practices designed to reduce the harmful consequences and stigmas associated with substance use, sex and other activities that may contribute to poor health outcomes. Their respective emails are, and

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