Domestic Strategy for Combating HIV/AIDS in U.S. Should Mirror PEPFAR, Opinion Piece Says

President Bush's "efforts to reduce HIV infection and mortality rates through the President's Emergency Plan for AIDS Relief have made the first real dent in Africa's HIV/AIDS plight," and the program's success "should illustrate for the next administration the benefits that would come from creating a similar program to battle the rise of HIV infections in America's inner cities," Robert Gallo, director of the University of Maryland's Institute of Human Virology, writes in a Washington Post opinion piece. According to Gallo, although PEPFAR has extended antiretroviral treatment to more than 1.7 million people around the world and helped HIV-positive women give birth to nearly 200,000 HIV-negative infants, in 2008, "some places in the United States, chiefly poor urban areas, are home to the same rising HIV/AIDS statistics as those of some Third World countries."

Gallo writes that in light of recent CDC data about HIV/AIDS in the U.S., a "PEPFAR plan for America's inner cities would help to neutralize and diminish the number of people contracting HIV and the number dying of AIDS." He adds, "It would provide access to prescribed care and medical therapies so patients with HIV can live a normal lifespan." Furthermore, an "effort to help these Americans, among our country's poorest, could also strengthen U.S. international relations, sending a message to the world that America recognizes that it is not different from other countries and that we, too, have an HIV/AIDS pandemic."

According to Gallo, a domestic strategy for HIV/AIDS similar to PEPFAR also would assist in the construction of clinical infrastructures for diagnosis and treatment in inner cities. He writes, "Federal and state officials have already allocated enormous sums to fight bioterrorism. But in the past seven years, more Americans have been the victims of HIV/AIDS than have been affected or killed by any bioterrorist attack." Gallo adds that education "is the key to managing and preventing HIV infection" and that the U.S. "needs a program that can teach people about prevention and early detection." He writes, "As long as adverse socioeconomic conditions prevail, those living in HIV/AIDS 'hot spots' without education about the disease and facing other life challenges -- such as mental illness, drug abuse, homelessness and lack of health insurance -- will be at risk even if we do develop an AIDS vaccine."

Regardless of when such a vaccine is developed, Gallo writes that "we must actively address the growing HIV/AIDS pandemic in the United States." He adds, "When an AIDS vaccine does become available, a program to reduce HIV infection in inner cities would ensure that our nation is educated and positioned to readily distribute the medicine, helping to put an end to this terrible disease. In the meantime, the program would help stabilize a growing HIV pandemic and stop the spread of HIV."

Gallo writes, "Unless we develop a program to fight HIV infection in America's inner cities, our urban centers will continue to face an even more daunting pandemic." He concludes, "To improve the health of millions of Americans and reduce HIV infection rates, the next administration should craft and implement a PEPFAR plan targeting our inner cities" (Gallo, Washington Post, 11/16).