My Hopeful Wishlist for HIV/AIDS’ Long, Tragic, and Complicated Saga

by Margaret Anderson, COO, FasterCures

An estimated one in 20 adults in Washington, DC is infected with HIV. With the highest rate of new AIDS cases in the country, at 11 times the national average, our nation’s capital is setting records that we’d rather not see. It is against this backdrop that I attended the last Institutional Review Board (IRB) meeting of the Whitman-Walker Clinic recently. This local IRB is being closed for cost-savings purposes, as using a centralized IRB will save resources. Resources are currently in short supply for Whitman-Walker, one of the preeminent HIV/AIDS clinics in the country.

The economic downturn has hit the clinic hard, as has AIDS fatigue, coupled with extremely high demand for HIV services in the District. I first began volunteering at the clinic doing paperwork for the support group programs, then I began leading support groups for men with HIV. After 10 years, I moved over to the IRB which met my need for involvement that was one step removed from direct services and the burnout that I’d faced in that role. In the course of my support group work, we lost so many to HIV, all before the current therapies had come on the market and changed the face of HIV/AIDS.

Despite the medical successes in finding treatments for HIV, there is still so much work that needs attention. The trajectory of the HIV/AIDS story is truly stunning from a research standpoint, and yet anti-HIV therapy is a lifetime commitment. Dr. Jeffrey Laurence of amfAR wrote in a November 2008 piece about how for every person that gets on treatment, two to three new people get infected. “We need a cure for AIDS. We can’t treat our way out of this epidemic,” he wrote.

The advent of a new year calls for lists. Here’s what’s on mine:

• We need adequate levels of basic and translational research in HIV/AIDS so we can eradicate HIV.
• We need to be able to get proven therapies into the hands of those who should be on therapy, help them adhere to the treatment, and get these paid for, so that those who should initiate anti-HIV therapy actually do.
• And finally, research needs to be continued at valuable sites like Whitman-Walker that are on the front lines of the epidemic.

HIV/AIDS in the U.S. has woven a long, tragic, and complicated saga. There has been some hope though. We’ve seen the research and drug development system move swiftly and change when need be. Yet, even when there are medicines on the shelf we need to keep on searching for treatments and cures.