Towards the elimination of new HIV infections among children
Dr Margaret Chan
Director-General of the World Health Organization
Honourable ministers, distinguished delegates, ladies and gentlemen,
Finally, after struggling to control this devastating epidemic for more than three decades, we are in a position to outsmart the virus.
Over all this heartbreakingly long time, we have learned enough, invented enough to gain the upper hand.
For the first time, we are in a position to turn the epidemic around and celebrate its end.
But we must keep our eyes on the reality. Scientific breakthroughs have opened exciting opportunities for prevention as well as treatment. But these opportunities are tempered by the demands of sustainability, in a climate of financial austerity nearly everywhere.
Given these realities, we must make strategic choices firmly based on evidence, and we must look to innovation as never before. This is technical innovation, but also operational and programmatic innovation.
One of the most exciting opportunities, supported by a global plan, proof of feasibility, and the commitment of world leaders, is to ensure that every baby in the world is born HIV-free by 2015.
The technical innovations for doing so, proposed by WHO, include options for introducing the best and most appropriate drug regimens to prevent transmission of the virus.
Considerations for making policy choices include both immediate cost-effectiveness and long-term cost savings.
They also include operational feasibility.
What is the simplest way to achieve objectives without adding to the demands on programmes and staff, such as demands on procurement and stock management systems, or added prescribing complexities?
What I personally find most uplifting is the additional objective now being considered.
That is, to give pregnant women the fully suppressive triple therapy that is best for their own health, and not just the minimum medicines needed to prevent transmission of the virus to their infants.
That means prescribing the best medicines, regardless of CD4 counts, and continuing these medicines for the rest of the woman’s life.
The AIDS epidemic has always asked the international community to do the right thing. As we think about innovations that help eliminate infections in children, we once again have the technical option of doing the right thing.