HIV and AIDS in 2030: A Choice Between Two Futures
HIV and AIDS in 2030: A Choice Between Two Futures

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HIV and AIDS in 2030: A Choice Between Two Futures

The AIDS Epidemic Is Not Over

Many people think that the AIDS epidemic is over, that advances in science and medicine have solved the problem, that we don’t need to worry about it anymore.  But the reality is that the war against AIDS is not yet over.  The scientific and medical advances have been remarkable, but we still need to make sure that everyone who needs the medication can get it.  So we could win the war against AIDS.  The question is whether the world has the collective will to do so.  If the answer is no, then the results will be catastrophic, with millions of people needlessly dying.

2030 will be the year of reckoning for the AIDS epidemic, marking the first half century one of the worst epidemics in the history of the world.  The 28th International AIDS Conference, which will be held in July 2030, is likely to be a focal point of world attention.  The conference may be held in Durban, South Africa, just as earlier conferences have been held in Durban marking other key points in the global response to AIDS.  The conference will probably include a panel of leaders looking back on the fifty-year history of HIV and AIDS.  But what will the panelists say?

If HIV and AIDS have made a strong resurgence in the 2020’s, the panelists will focus on what went wrong.  Perhaps the panel will be called How We Lost the War Against AIDS.  The panelists will look at charts that show rates of new infections and deaths, first rising, then falling, then rising again. They will see that more than twelve million people have been needlessly infected with HIV, and more than eight million people have needlessly died. They will look at charts showing treatment coverage, and they will look at charts showing the financial investments that were made and not made. They will remember the great progress made in the 2000’s and 2010’s. But they will focus their discussion on what went wrong, what led to the tragic resurgence of the AIDS epidemic. The panel will identify the mistakes that were made and the opportunities that were missed. It will be a very sober discussion, because they will know that the catastrophe could have been avoided.

But in a different future, a future in which HIV and AIDS are no longer threats to public health, the panel will have a joyous tone.  Perhaps the panel will be called How We Won the War Against AIDS.  These panelists will also look at charts of new infections,  and deaths, treatment coverage, and financial investments, but their charts will all show steady progress toward the end of AIDS.  They will look at the key events and key decisions that kept the global progress going, even during times that were politically or socially challenging.  They will identify the mistakes that were avoided and the opportunities that were seized. And they will celebrate!

Curiously, or perhaps not so curiously, the two groups of panelists will say very similar things. They will both talk about the importance of global political will and global commitment.  They will talk about the complexities of the social issues that affect so much of the AIDS epidemic.  And they will talk about the very significant effect that religion had on the epidemic, sometimes in a positive way and sometimes in a negative way.

Although the two groups of panelists will say similar things, they will say them with very different tones.  On one panel, they will say them with regret, recognizing challenges that were not overcome.  They will face accusatory questions from the audience, spoken with grief and anger.  The panelists will share a sense of collective guilt that the world didn’t do what it could have done.

On the other panel, they will say the same things with satisfaction, describing the challenges that had been overcome.  They will hear congratulatory comments from the audience, spoken with joy and gratitude. The panelists will share a sense of collective pride that the world had accomplished what some thought would be impossible.  

But, of course, it is now only the year 2019. We don’t yet know what the panelists will say, because we don’t yet know what future we will give to them.We don’t yet know whether we will win or lose the war against AIDS.If we persevere, we can still win. If we do not persevere, we will surely lose.

The choice between these two futures is ours to make, and we must make it now.

David Barstow