Ahead of World AIDS Day on December 1, a series of commentaries in this week’s issue of THE LANCET outline the current and future priorities in the global effort to curb the HIV/AIDS pandemic.
The first commentary is a call to action for a renewed public-health strategy to prevent sexually transmitted HIV. Against a background of twenty years of debate over the value of different behaviour-change approaches, authors Daniel Halperin (University of California San Francisco, USA) and colleagues outline evidence-based objectives for the various populations at risk: an emphasis on abstinence for young people not yet sexually active, the importance of fidelity and consistent condom use for people already sexually active; and programmes and policies aimed at reducing the number of sexual partners and promoting correct and consistent condom use in high-risk groups. The commentary is a consensus statement signed by over 140 HIV/AIDS experts from 36 countries, and includes such notable endorsers as Archbishop Desmond Tutu, President Museveni of Uganda, Special UN Envoy Stephen Lewis, and representatives from the World Bank, Global Fund for AIDS/TB/Malaria, and five UN agencies, the heads of the HIV-AIDS programs in several countries including Ethiopia, India, Jamaica and Uganda, as well as prominent technical, religious and other organizations working on HIV-AIDS. The commentary concludes: ‘The time has come to leave behind divisive polarisation and to move forward together in designing and implementing evidence-based prevention programmes to help reduce the millions of new infections occurring each year.’
With an estimated 5 million new HIV infections worldwide in 2003, the context in which people are vulnerable to HIV infection is discussed by Catherine Hankins (UNAIDS, Geneva, Switzerland). The commentary outlines how changing the social, legal, and economic environments in many populations—especially among women and children in developing countries—is critical if any future public-health interventions to reduce HIV transmission are to be successful.
Richard Lane | alfa
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