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Tue May 23, 2006 10:30 AM ET | By Patricia Reaney LONDON (Reuters) - A quarter of a century after the first cases were identified, public health experts are starting to see declines in HIV infections and momentum building in the battle against the epidemic. But Dr. Peter Piot, the executive director of UNAIDS that has spearheaded a 10-year battle against the global epidemic, said long-term commitment will be needed for decades or generations to come. "We are moving into a new area in the response to AIDS," he told Reuters. "I think 25 years later, after a series of failures, we've seen in the last few years a triple momentum. "We have political momentum, financial momentum and a momentum of results," he added. More than 40 million people are living with HIV/AIDS but declines in infection rates are being seen in some African countries where HIV/AIDS has had the greatest impact. Thailand and Uganda have been the rare success stories, but Piot said prevention efforts are now working in countries such as Kenya and Zimbabwe and that 1.5 million people in developing countries are receiving life-saving drugs at knock-down prices. The illness, which has been shrouded in shame, discrimination and stigma, has been declared a global catastrophe by the United Nations. Governments and businesses around the world have pledged funds and are working to raise awareness and fight HIV/AIDS. "Probably our major achievement, overall when I look back over 10 years, is that we have put AIDS on the mainstream agendas," Piot said. REDEFINING THE ISSUEWhen Piot, a Belgian infectious diseases expert and co-discoverer of the Ebola virus, heard the first reports of the mysterious illness, he never expected that 25 years later it would have killed more than 25 million people. "We naively thought we'll fix it in a few years. But we are here for decades, if not generations," Piot said. The development of antiretroviral therapy and the discussion of AIDS at a U.N. Security Council session in 2000 were turning points in the epidemic. "We redefined the issue," Piot said. "This is not only a disease, it is a threat to social and economic development. It is even a security threat." Initiatives with drug companies to reduce the price of treatments in poor countries changed the way health experts dealt with the epidemic. It also proved the drugs could be given in developing nations without sophisticated health systems. But Piot said bigger challenges remain. "We need to move from crisis management. Running after the epidemic to prevent it, to a long-term commitment. You can't deal with AIDS on the basis of one fiscal year at a time. We need predictable long-term funding," he said. The financial need is growing because more people will need treatment and will be on the drugs for decades. Piot said it was also crucial to address issues such as homophobia, sexual violence and inequality between the sexes, which contribution to making HIV/AIDS a long-term epidemic. His hope is that one day there will no longer be a need for UNAIDS but he doesn't see that happening in the near future. "We are in this for the long haul. Not as an institution but as an issue," he said. © Reuters 2006
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