Senior fellow Mead Over was quoted in a New York Times article on Hilary Clinton's goal of creating an 'AIDS-free generation'.
From the Article
Secretary of State Hillary Rodham Clinton on Tuesday called on the United States and other countries to use new scientific discoveries to create an “AIDS-free generation” in the world, but offered no clues about where the money would come from to finance that inspirational and costly vision.
Her speech was the first effort to publicly set such an ambitious goal, and administration officials scrambled to suggest ways that at least part of it might be paid for, including diplomatic pressure on governments in developing countries to spend more of their own money and political pressure on wealthy nations to contribute more.
The interventions she endorsed, based on successes in clinical trials in the last two years, include circumcision for men, multidrug cocktails for pregnant women, and getting drugs to patients as soon as they are first infected rather than years later when they fall sick.
It has taken eight years and tens of billions of dollars to get nearly seven million of the world’s sickest people on treatment. To treat all 34 million estimated to have the virus would be vastly more expensive. And, while about one million African men have been circumcised recently, mostly with American tax dollars, many more millions of men could benefit from the procedure.
The new focus on circumcision, mother-child transmission and “test-and-treat” actually represents the second major shift in policy since President George W. Bush announced in his 2003 State of the Union address what became the President’s Emergency Plan for AIDS Relief, or Pepfar.
Back then, the focus was on A,B,C — abstinence, being faithful and using condoms. Some money was earmarked for drugs, but there was always tension over whether to spend more on prevention or treatment.
Then, in its early days, the Obama administration sought to put greater emphasis on diseases that cost less to fight and on saving more lives. Measles shots, tetanus shots, clean birth kits, midwife training and other relatively inexpensive interventions — not programs aimed at AIDS treatment and prevention — were the core of Mr. Obama’s Global Health Initiative.
However, the president’s program has been criticized for lacking focus and has usually piggybacked on programs started to fight AIDS.
Groups that fight AIDS greeted Mrs. Clinton’s speech enthusiastically. Dr. Unni Karunakara, international president of Doctors Without Borders, called it “very encouraging to see the U.S. government wanting to turn the latest H.I.V. science into policies that will save lives while beginning to reverse the epidemic.”
Dr. Mark Dybul, the Bush administration’s last Pepfar administrator, who was abruptly dismissed by Mrs. Clinton when she took office, nonetheless attended the speech and praised it, saying it reminded him of the excitement he felt when Pepfar was launched.
At that time, lower prices for Indian generic drugs made treatment in Africa possible.
“And now the science has radically changed in the last 18 months,” he said.
Mead Over, an AIDS expert at the Center for Global Development, was more cautious.
While studies in subgroups like drug addicts or couples in which only one member is infected have concluded that immediate treatment lowers new infection rates, it has not been tested across whole cities or provinces in Africa. Mrs. Clinton mentioned plans to spend $60 million on trials to do that — the only time she put a price on anything.
"Her vision of an AIDS-free generation is ambitious, but we don’t have strong evidence yet that we can achieve that,” Dr. Over said.