Skip to main content

World AIDS Day 25 years on: It's time to stop saying 'AIDS in Africa'

By Erin Hohlfelder, health campaigner, Special to CNN
November 29, 2013 -- Updated 1232 GMT (2032 HKT)
HIV positive children take part in a club supported by Prince Harry's Sentebale charity on February 23, 2013 in Lesotho.
HIV positive children take part in a club supported by Prince Harry's Sentebale charity on February 23, 2013 in Lesotho.
STORY HIGHLIGHTS
  • 25 years on from the first World AIDS Day, much progress has been made in fight against AIDS
  • Erin Hohlfelder says 16 African countries have passed the "beginning of end of AIDS" tipping point
  • "Treatment now works better, and costs less, allowing people with AIDS to live long, productive lives"
  • But Hohlfelder says we must not allow complacency to set in; there is still much to be done

Editor's note: Erin Hohlfelder is the Global Health Policy Director at The ONE Campaign, where she specializes in infectious diseases, maternal and child health, and global health financing mechanisms. She has conducted research in Kenya on holistic care for female AIDS orphans. The opinions in this commentary are solely hers.

(CNN) -- Travel back in time with me to 1988: Guns N' Roses was blasting onto the music scene, Dustin Hoffman turned in an award-winning performance in Rain Man, and Nike coined the now-famous tag line, "Just Do It." But the year also brought a cultural touchstone with much deeper significance: the first World AIDS Day.

The importance of such a day -- to be held annually on December 1st -- could not be understated, particularly at a time when the disease was still widely misunderstood, and a diagnosis often meant a death sentence.

Twenty-five years on, it is difficult to imagine a world without World AIDS Day (or without AIDS, for that matter).

But in the quarter century since the first World AIDS Day, much has changed—so much so, in fact, that leaders have begun to call for "the beginning of the end of AIDS," a global tipping point when the number of people newly infected with HIV is surpassed by the number of people newly offered treatment.

A new study released by The ONE Campaign this week demonstrates just how far we've come, and suggests that if current rates of progress continue, the world will reach "the beginning of the end of AIDS" as early as 2015.

AIDS researchers look for a cure
On GPS, Bono on U.S. fight against HIV
Does condom use ad promote adultery?

Reaching this milestone would have been unimaginable just a few years ago, and is testament to the immense global effort and impressive new science that has emerged, particularly in the last decade.

That acceleration has also been fueled by the simple fact that AIDS treatment now works better, and costs far less. In 1988, the only drug available to treat HIV/AIDS was AZT; it was not hugely effective, and it cost as much as a car. Today, for the price of an iPhone -- less than a dollar a day -- combination antiretroviral treatment allows HIV-positive individuals to not only stay alive, but live long and productive lives.

The progress we've made also means that the language we use to describe the AIDS pandemic needs a refresh. In particular, ONE's report stresses that it's time to retire the phrase "AIDS in Africa." Of course, this doesn't mean the disease has disappeared from the continent, but it does mean that African countries have made widely divergent progress, and that a one-size-fits-all approach no longer makes sense.

In fact, 16 African countries have already achieved the beginning of the end of AIDS. Countries like Ghana, Zambia, and Malawi are leading the way, deftly combining their own domestic health financing and planning with donor aid to achieve real impact. Political leadership has also been important in elevating HIV/AIDS as a priority issue on the national agenda, supported (and sometimes pushed) by dynamic civil society organizations on the ground.

It's important that we celebrate all of this progress, and honor those who have worked so hard to make it happen. But the work is far from over, and in many ways, the AIDS fight today is struggling precisely because of its own success. Because it is no longer perceived as an emergency, but rather a chronic and manageable disease, the fight has lost some of its political momentum and funding has not grown to match the global need.

UNAIDS estimates that the funding needed to fight AIDS is still at least $3-5 billion short each year. With a few exceptions, donor funding for AIDS has stalled. Compounding this problem, only six African governments are meeting their commitments to spend 15% of their national budgets on health. These trends must be reversed -- and quickly -- in order to accelerate progress.

Baby cured of HIV
Face of childhood HIV: It's not easy
Nigeria is second in people with AIDS

Insufficient money is not the only thing holding back the global AIDS response. Although treatment programs have grown massively -- they now reach nearly 10 million people around the world -- too many people are still being left behind.

In the coming years, the world must do a better job at adapting treatment and prevention programs to reach those most at-risk, including LGBT populations, drug users, and sex workers. Doing so will, in some cases, require a sea-change in how these populations are treated.

On a political level, leaders can do more to ensure that the HIV/AIDS responses in their countries are more equitable and free of stigma, as the first lady of Zambia, Christine Kaseba-Saba, recently did in a statement rejecting homophobia.

Equally important, donors must make sure that their resources are appropriately targeting these at-risk groups and tailored to match the unique nature of local and national epidemics.

Each World AIDS Day forces the world into a moment of reflection and accountability. On this 25th anniversary, we have much progress to celebrate, but we cannot allow complacency to set in before we're even halfway home.

As we close in on a global tipping point and look to defeat AIDS within our lifetimes, we must pick up the pace. We have the tools to defeat the epidemic, but we need reinvigorated political will and new resources from the public and private sectors.

The message this year should be: Let's work harder, together, to make the beginning of the end of AIDS a reality. Or, to borrow from Nike's 1988 ad: "Just do it."

The opinions in this commentary are solely those of Erin Hohlfelder.

ADVERTISEMENT
Part of complete coverage on
August 27, 2014 -- Updated 1626 GMT (0026 HKT)
The death of Douglas McAuthur McCain, the first American killed fighting for ISIS, highlights the pull of Syria's war for Western jihadists, writes Peter Bergen.
August 26, 2014 -- Updated 2242 GMT (0642 HKT)
Former ambassador to Syria Robert Ford says the West should be helping moderates in the Syrian armed opposition end the al-Assad regime and form a government to focus on driving ISIS out
August 27, 2014 -- Updated 1321 GMT (2121 HKT)
Ruben Navarrette says a great country does not deport thousands of vulnerable, unaccompanied minors who fled in fear for their lives
August 27, 2014 -- Updated 1319 GMT (2119 HKT)
Robert McIntyre says Congress is the culprit for letting Burger King pay lower taxes after merging with Tim Hortons.
August 26, 2014 -- Updated 2335 GMT (0735 HKT)
Wesley Clark says the U.S. can offer support to its Islamic friends in the region most threatened by ISIS, but it can't fight their war
August 27, 2014 -- Updated 1126 GMT (1926 HKT)
Jeff Yang says the tech sector's diversity numbers are embarrassing and the big players need to do more.
August 26, 2014 -- Updated 2053 GMT (0453 HKT)
America's painful struggle with racism has often brought great satisfaction to the country's rivals, critics, and foes. The killing of Michael Brown and its tumultuous aftermath has been a bonanza.
August 26, 2014 -- Updated 2019 GMT (0419 HKT)
Ed Bark says in this Emmy year, broadcasters CBS, ABC and PBS can all say they matched or exceeded HBO. These days that's no small feat
August 26, 2014 -- Updated 1919 GMT (0319 HKT)
Rick Martin says the death of Robin Williams brought back memories of his own battle facing down depression as a young man
August 26, 2014 -- Updated 1558 GMT (2358 HKT)
David Perry asks: What's the best way for police officers to handle people with psychiatric disabilities?
August 25, 2014 -- Updated 1950 GMT (0350 HKT)
Julian Zelizer says it's not crazy to think Mitt Romney would be able to end up at the top of the GOP ticket in 2016
August 25, 2014 -- Updated 2052 GMT (0452 HKT)
Roxanne Jones and her girlfriends would cheer from the sidelines for the boys playing Little League. But they really wanted to play. Now Mo'ne Davis shows the world that girls really can throw.
August 25, 2014 -- Updated 1629 GMT (0029 HKT)
Peter Bergen and Emily Schneider say a YouTube video apparently posted by ISIS seems to show that the group has a surveillance drone, highlighting a new reality: Terrorist groups have technology once only used by states
August 25, 2014 -- Updated 2104 GMT (0504 HKT)
Kimberly Norwood is a black mom who lives in an affluent neighborhood not far from Ferguson, but she has the same fears for her children as people in that troubled town do
August 22, 2014 -- Updated 2145 GMT (0545 HKT)
It apparently has worked for France, say Peter Bergen and Emily Schneider, but carries uncomfortable risks. When it comes to kidnappings, nations face grim options.
August 26, 2014 -- Updated 1727 GMT (0127 HKT)
John Bare says the Ice Bucket Challenge signals a new kind of activism and peer-to-peer fund-raising.
August 22, 2014 -- Updated 1231 GMT (2031 HKT)
James Dawes says calling ISIS evil over and over again could very well make it harder to stop them.
August 24, 2014 -- Updated 0105 GMT (0905 HKT)
As the inquiry into the shooting of Michael Brown continues, critics question the prosecutor's impartiality.
August 22, 2014 -- Updated 2247 GMT (0647 HKT)
Newt Gingrich says it's troubling that a vicious group like ISIS can recruit so many young men from Britain.
August 21, 2014 -- Updated 1450 GMT (2250 HKT)
David Weinberger says Twitter and other social networks have been vested with a responsibility, and a trust, they did not ask for.
August 22, 2014 -- Updated 1103 GMT (1903 HKT)
John Inazu says the slogan "We are Ferguson" is meant to express empathy and solidarity. It's not true: Not all of us live in those circumstances. But we all made them.
August 22, 2014 -- Updated 1223 GMT (2023 HKT)
Retired Lt. Gen. Mark Hertling says he learned that the territory ISIS wants to control is amazingly complex.
August 20, 2014 -- Updated 1951 GMT (0351 HKT)
Cerue Garlo says Liberia is desperate for help amid a Ebola outbreak that has touched every aspect of life.
August 21, 2014 -- Updated 1742 GMT (0142 HKT)
Eric Liu says Republicans who want to restrict voting may win now, but the party will suffer in the long term.
August 21, 2014 -- Updated 1538 GMT (2338 HKT)
Jay Parini: Jesus, Pope and now researchers agree: Wealth decreases our ability to sympathize with the poor.
August 21, 2014 -- Updated 1200 GMT (2000 HKT)
Judy Melinek offers a medical examiner's perspective on what happens when police kill people like Michael Brown.
August 19, 2014 -- Updated 2203 GMT (0603 HKT)
It used to be billy clubs, fire hoses and snarling German shepherds. Now it's armored personnel carriers and flash-bang grenades, writes Kara Dansky.
August 20, 2014 -- Updated 1727 GMT (0127 HKT)
Maria Haberfeld: People who are unfamiliar with police work can reasonably ask, why was an unarmed man shot so many times, and why was deadly force used at all?
ADVERTISEMENT