War against AIDS at a crossroad; status quo won't do, panelists say

IDCE Director William Fisher is interviewed as a panelist at the Global Health Council’s aids2031 book launch on Jan. 13, at the Newseum in Washington, D.C.

Experts in the long battle against HIV/AIDS gathered in Tilton Hall on Jan. 19 to offer hope that the world now stands at the midpoint of the disease’s global march, with better days ahead. The speakers were on hand to discuss the findings of the aids2031 consortium, published in the new book “AIDS: Taking a Long-term View,” which asserts that the pandemic, first identified in 1981, can be sharply curtailed within the next three decades. The panel was hosted by William Fisher, director of Clark’s International Development, Community and Environment department and one of the book’s authors. Serving on the panel were Jeffrey L. Sturchio, president and CEO of the Global Health Council; Michael Isbell, an independent consultant specializing in public health policy, strategic advocacy planning and health-related communications; Jessica Ogden, director and owner of Ogden Health 7 Development Connections, and Rob Goble, research professor in the IDCE department at Clark.

Clark Voices: Clark’s IDCE department plays a key role in a global consortium’s landmark aids2031 program, helping to launch its final report: "AIDS: Taking a Long-term View." To watch part two of this video, click here. Global Health TV: To watch video of the book launch in Washington, click here.

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When the U.N. first embarked on the aids2031 project and sought a hub to coordinate teams of economists, epidemiologists, and biomedical, social, and political scientists from around the world, it selected Clark University to manage the coordinating unit, headed by Fisher and backed by grants totaling nearly $4 million. IDCE associate research professor Heidi Larson directed of the aids2031 project. She currently heads the Vaccine Programmes and Policy Group of the Institute for Global Health at Imperial College in London. As the three-year aids2031 project draws to a close, IDCE will continue the mission in a variety of ways here at Clark.

“AIDS: Taking a Long-term View” (Financial Times Press)

Fisher opened the panel discussion with a tally of disturbing statistics about the progression of AIDS/HIV, noting that since 1981 there have been 60 million HIV infections and 27 million deaths. Currently, 33 million people are living with HIV and 7,400 people are infected every day, he said. But the disease defies easy categorization by geography, social status or racial and ethnic identity. “The AIDS pandemic is really a set of radically different epidemics that vary from country to country and from region to region,” Fisher said. Ogden said that initially AIDS researchers focused on individualized behaviors when studying how the disease spread, but in recent years a new awareness has arisen of the social and other factors involved with the pandemic’s progression. According to Goble, “modeling” the epidemic is hard because it’s difficult to find reliable data about infection rates since the disease operates over a long period of time. Despite advances in science and technology, the world is “not very close” to finding an “easy fix” for the epidemic, and the key now is to find effective ways to bring diagnostic tools and testing to under-resourced areas. Early responses to AIDS were far from organized, Isbell noted. The fight against AIDS needs to enter a new phase, he said, utilizing a more strategic approach that places as much emphasis on quality, impact and sustainability as it does on access to treatments. “We need very simple diagnostic tools so that people on the front lines know if treatments are working or not,” Isbell said.

Participants in the aids2031 project, at Clark on Jan. 19, included (front row) Rob Goble, Nancy Goedhart, Ellen Foley, Octavia Taylor, Barbara Thomas-Slayter, and Hillary Tomlins; (back row) Jessica Ogden, Dave Bell, William Fisher, Jeff Sturchio, Anne Murenha, and Allison Kaminaga. (Photo by Champo Mapulanga ’13)

“AIDS isn’t over,” Sturchio told the crowd, noting an encroaching “AIDS fatigue” that’s creeping into the dialogue. Effective leadership continues to be a powerful weapon to combat the pandemic, he said. Sturchio pointed to the country of Botswana, whose president led a national mobilization effort against AIDS/HIV, which led to a dramatic reduction in infection rates. By contrast, the government of South Africa, whose rate of infection was not as bad as Botswana’s, took a sluggish approach and now claims more HIV-positive people than any other nation on earth. “Good politics is saving lives. Bad politics kills people,” Sturchio said. He stressed the importance of long-term thinking and an approach toward battling AIDS/HIV that involves many sectors — business, technology, politics, religion — as communities become empowered to drive change. Younger generations will be a necessary force to beat back the old stigmas against AIDS/HIV to promote change, Goble said. Isbell said that the fight against the pandemic carries with it a “passion, electricity and excitement” because it speaks to “how we relate to each other as human beings.” “You wouldn’t see someone with malaria speaking so passionately about that disease,” Ogden said. “[AIDS/HIV is] sex, it’s birth, it’s death, it’s relationships and it’s community.” Aids2031 has begun a process by challenging convention, conventional wisdom, assumptions, and long standing trends in the global aids response, Fisher said. “But this is only a beginning.  To make a lasting difference, to change the world, we need to do more than merely challenge convention.  Now we need to articulate and carry out the steps that will lead to significant, lasting, meaningful, and just change.”