We have accepted that there currently exists no cure to HIV/AIDS, simply antiretroviral drugs that can dramatically slow its effects. Along with these drugs, education, and lots of preventative measures against it, the proportion of the population living with HIV/AIDS should be minute. As residents of a developed nation where we can find doctors’ offices and hospitals on every other corner, we never think about what would happen if there was no healthcare facility nearby and we had no car to drive to the nearest one, or even a computer to look up its location. This is the major issue plaguing the fight against HIV/AIDS, and in rural areas where few resources are available, we are no closer to solving it.
The US President’s Emergency Plan for AIDS Relief (PEPFAR), launched in 2003, was founded for the purpose of reducing the prevalence of HIV/AIDS in 15 focus countries in Africa, Asia, and South and Central America. In 2008, the program shifted away from the focus country approach and opted to try a partner approach, training countries to become leaders in the fight against HIV/AIDS. However, PEPFAR remains preoccupied with the continued search for an HIV/AIDS cure and the propagation of its abstinence programs. It has not yet developed a better method for ensuring that people can get to a health facility to obtain antiretroviral drugs without fear of shame or having to wait a lengthy period of time for a PEPFAR worker to be in the area. In rural villages miles from the nearest city, there need to be permanent health facilities built where people can easily go for testing and treatment, along with a regular bus available for transport. HIV/AIDS programs such as PEPFAR would have far better success if they spent a smaller proportion of their funding on abstinence programs and more on the development of increased antiretroviral and testing availability. The installation of these health facilities would occur in partnership with communities so that they can later become capable of running them without the interference of a third party nation.
Let’s move away from Africa and into our home nation of the US, where we don’t perceive HIV/AIDS to be a significant problem. It is currently estimated that one third of US citizens suffering from HIV/AIDS do not receive treatment, simply because they cannot afford it. For people with insurance, especially with the recently Supreme Court upheld Affordable Care Act, getting access to antiretroviral drugs is easy. But unfortunately, people with insurance do not constitute the majority of people living with HIV/AIDS. In 2010, a US government agency estimated that less than 17% of people with HIV/AIDS do not have health insurance, because they do not receive it through their jobs, cannot afford private insurance, and make just too much to qualify for Medicaid. Medicaid, the most common source of coverage for Americans with HIV, has very restricted coverage. In other words, current healthcare policies within the United States itself do not facilitate easy access to HIV/AIDS treatment for the majority of people living with the disease. The United States currently spends approximately 29.7 billion dollars in HIV/AIDS programs as a whole, but yet less than half of that goes towards ensuring that people have access to treatment. It is time that we as an international community temporarily shift our focus away from abstinence programs and from finding what is believed to be a nonexistent cure for HIV/AIDS, and towards making those treatments that already exist more accessible to patients.
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