The beginning of the end of AIDS Center for Strategic amp International Studies Washington DC March 22 2012 Thomas R Frieden MD MPH Director Centers for Disease Control and Prevention ID: 201950
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Slide1
Creating an AIDS-Free GenerationThe beginning of the end of AIDS
Center for Strategic & International StudiesWashington, DCMarch 22, 2012
Thomas R.
Frieden
, MD, MPH
Director
Centers for Disease Control and PreventionSlide2
2012 is a tipping point for the global HIV epidemic
Increasing coverage, decreasing costsRecognition of global shared responsibility and accountabilityNew evidence thatTreatment is preventionPMTCT and voluntary male medical circumcision can be scaled up for population reach and impactInfection rates and deaths can be driven downSlide3
CDC provides assistancethroughout the world
CDC Direct Assignees
Global Disease
Detection Centers
DoD
Collaborations
CDC Influenza
International Assignees
CDC Global AIDS
Program
CDC Malaria
Assignees
CDC Field Epidemiology
Training Program (FETP)
Global Immunizations
Assignees
Nearly 400 assignees in 50+ countries
1,500 host country national staffSlide4
Global
Sub-Saharan Africa
1990
1993
1996
1999
2002
2005
2008
5
3210Number (millions)4Source: UNAIDS/WHOHIV incidence is decreasingNumber of people newly infected with HIV,globally and in Sub-Saharan Africa, 1990-2008Slide5
2.5
2.0
1.5
0.5
1.0
3.0
0
Number
(millions)
1996
199820002002200420062008199719992001200320052007HIV-related mortality is also decliningNumber of AIDS-related deaths, globally and inSub-Saharan Africa, 1996-2008Source: UNAIDS/WHOGlobalSub-Saharan AfricaSlide6
U.S. government calls for anAIDS-free
generationAIDS-free generationVirtually no children born with HIV infectionAdults living with HIV don’t develop AIDSAccelerated declines in HIV incidence
Combination prevention
Antiretroviral treatment as prevention
Prevention of mother-to-child transmission (PMTCT)
Voluntary medical male circumcision
Correct & consistent condom useSlide7
National HIV/AIDS Strategy for the United StatesReduce new HIV infectionsIncrease access to care and improve health outcomes for people living with HIV
Reduce HIV-related disparities andhealth inequitiesAchieve a more coordinatednational response to the HIV epidemicSlide8
New CDC approach to HIV preventionin the U.S.Funding to places most in need, for populations most in need, for programs that work
Funding determined by number of people living with HIVSupports innovative demonstration programs by Health Departments75% of proposed activities in 4 program areasHIV testing and linkage to care
Comprehensive HIV Prevention with
Positives
Condom distribution
Initiatives to promote prevention and accountability, particularly viral loadSlide9
Effective prevention interventionsCoverage of these evidence-based interventions remains limited
Intervention
Efficacy
Coverage
PMTCT
With effective PMTCT programs, HIV transmission can be reduced to 2-4%
48%
Antiretroviral Treatment as Prevention
96% reduction in HIV transmission
47%
Male Circumcision>60% efficacy4.6%(14 priority countries)HIV Vaccine?31% efficacyVaginal Microbicide 39% efficacy; 54% among high adherers Pre-Exposure ProphylaxisTrial #1: MSM (44% efficacy; 74% among high adherers)Trial #2: High-risk women (no evidence of efficacy)Slide10
Adult male circumcision provides long-lasting protection against HIV infectionRakai, UgandaSlide11
PEPFAR has driven down costs of HIV treatmentSlide12
Modeling combination prevention and reductions in HIV incidenceIncidence in Swaziland in 2014 by scenario
ART = antiretroviral treatmentMC = male circumcisionSlide13
Sustainable public health progressCDC helps develop local capacity domestically & globally
Guidance, technical assistance, direct fundsApplied epidemiologyUS direct hires and host country national staffLabs systems and qualityHealth securitySlide14Slide15
Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333Phone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov