World AIDS Day at 20

Today is the 20th annual World AIDS Day, and World Health Organization Director-General Margaret Chan reflects on what the global community has achieved over the past two decades:

Civil society brought the disease â and the needs of those affected â to the forefront of world attention. Attitudes changed. Treatments were developed. Clinical schedules were streamlined and standardized. Funds were found. Prices dropped. Partnerships were formed, and presidents and prime ministers launched emergency plans.

The response to AIDS also reaffirmed some of the most important values and principles of public health. The AIDS epidemic showed the relevance of equity and universal access in a substantial way. With the advent of antiretroviral therapy, an ability to access medicines and services became equivalent to an ability to survive for many millions of people. The epidemic focused attention on the broad social determinants of health, the vital role of prevention, and the need for people-centred care. In so doing, it helped pave the way for a renewal of primary health care.

She goes on to state that leadership, empowerment (especially for women and girls), and strengthening of health systems are essential for meeting the substantial challenges we still face.

CDC describes some of the challenges: worldwide, 33 million people are living with HIV, and 7,500 new infections occur daily. In the US, 1.1 million people are living with HIV, and approximately one in five persons living with HIV in this country is unaware of his or her infection. The agency urges people to get tested; visit hivtest.org for testing locations.

The Center for American Progress compiles some additional statistics that emphasize how far the U.S. still has to go on AIDS:

AIDS is the number one killer for black women between the ages of 25 and 34.
Black women are now almost 15 times as likely to be infected with HIV and 23 times more likely to be diagnosed with AIDS as white women.
The HIV rate in Washington, D.C., our nationâs capital, is 1 in 20âthe same as the overall rate in sub-Saharan Africa...
African Americans, who make up only 12 percent of the U.S. population, now make up more than 45 percent of new infections...
Only 4 percent of the current share of HIV/AIDS domestic funding is devoted to prevention programs.

CAP calls for a National AIDS Strategy that includes more funding for the Minority AIDS Initiative to address the disproportionate effect of AIDS on communities of color, and programs based on public-health principles (i.e., no abstinence-only sex education).

Over the past two decades, we've learned a lot about how to prevent the spread of HIV and how to treat the disease. Now we need to do a better job of applying that knowledge.