This blog post by Nils Daulaire, assistant secretary for global affairs at the U.S. Department of Health and Human Services, was published on the AIDS.gov website on December 2. There are no republication restrictions for use by U.S. embassies.
Living a Healthy and Full HIV-Positive Life
By Nils Daulaire, M.D., M.P.H.
The Department of Health and Human Services (HHS) honors World AIDS Day 2013 and celebrates the improved wellbeing of millions of people around the world living healthy and full HIV-positive lives. As the care and treatment of people living with HIV/AIDS has expanded so has the number of people living long HIV-positive lives. As of 2012, nearly 10 million people throughout the world were receiving antiretroviral therapy, vastly improving their quality of life and reducing the number of early deaths due to the disease. And recent changes to the World Health Organization’s treatment guidelines are expected to substantially increase the number of people qualifying for treatment.
Widespread access to HIV medications and treatments, principally through PEPFAR and the Global Fund, has changed the course of HIV infection from an acute and deadly infection to a chronic disease requiring long-term care management. While this means a diagnosis is no longer a death sentence, it also means health systems now need to be prepared to address the long-term care needs of those living — sometimes for decades — with HIV.
Health systems strengthening has been a key part of the global response to HIV/AIDS from the beginning. We realized early on that more robust systems were needed in many countries to deliver high-quality HIV treatment. Programs have also brought greater attention to the importance of addressing the health needs of populations beyond just access to medication as a key part of HIV prevention and care. For example, on a recent trip to Vietnam, HHS Secretary Kathleen Sebelius visited health care facilities providing HIV/AIDS prevention, treatment and services to high-risk populations, particularly injection drug users. A key part of the clinic’s work was counseling to address addiction and mental health issues. To target these needs, HHS’s Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) introduced Methadone Maintenance Treatment as a way to provide substance abuse treatment and prevent HIV infection. Keeping people on treatment required ensuring they have the support needed to stay active and make healthy choices.
As the number of people on treatment expands, and with it increasing their life expectancies, we must ask ourselves: How can we best ensure that systems are in place to help people manage this disease and its associated health complications in the decades to come? How can we support HIV-positive mothers raise HIV-free children? How can we support HIV-positive children as they grow up? What are the challenges for adults aging with HIV?
These are not new questions, but we still need better answers. The United States will continue to work with partner governments and organizations to promote and support the future of HIV/AIDS treatment and care. Our successes come from close multilateral and bilateral partnerships, as well as our collaboration with non-governmental organizations, the public and private sector, and faith-based organizations. We share the responsibility with all of our partners to make an AIDS free-generation a reality, just as we share the responsibility that all people – whether HIV positive or not – have access to the supports and services they need to live healthy and fulfilling lives.
(Mr. Nils Daulaire is the assistant secretary for global affairs, U.S. Department of Health and Human Services.)