Optimism Despite Grave Challenges on World AIDS Day

Amid many discouraging signs, there are signs of progress in combating HIV and AIDS

Today is the 22nd annual World AIDS Day, a moment of international awareness of the HIV and AIDS epidemic that plagues every corner of the world. The timing of this year's World AIDS Day--the same day that President Obama is set to announce a 30,000-plus troop increase in Afghanistan--is a stark reminder of the severity of the AIDS epidemic. In 2007, fighting in Afghanistan claimed the lives of 1,523 civilians and 232 troops. That same year, AIDS was responsible for 2 million deaths, including 270,000 children. Despite the grave challenges of combating AIDS, especially in places such as South Africa where conditions are poor and the infection rate is 12%, some experts find cause for optimism.

• Prevention, Not Treatment  Newsweek's Katie Paul explains that the Bush-era plan emphasized treatment over prevention, which mean "bypassing local governments to get as many people on treatment as possible, as quickly as possible. But while that has produced impressive results, the approach is far from sustainable." The new plan: "Shift more resources over to prevention efforts. Transfer programs to local ownership and put national governments on the hook for delivering services. Monitor and evaluate which programs are working, then report the results."

• Fighting AIDS By Farming  The Atlantic's James McWilliams looks to Rwanda. "[M]any of the country's HIV patients did not have access to ample food. HIV/AIDS drugs work most effectively when patients are eating a sound diet. They work poorly when patients are malnourished. Experts called this situation 'a nutrition gap.'" McWilliams describes how activists started local farming collectives for HIV-positive Rwandans, called the "nutrition through agriculture" initiative. He beams, "These are people with HIV/AIDS who were once marginalized as incapable of maximizing the productivity of Rwanda's agricultural resources. Today, they're people who are not only growing food--and preparing their own bodies to benefit from the wonders of modern medicine--they're making money by selling their surplus produce."

• 'Watershed' Improvements  U.S. News's E.J. Mundell calls 2009 "a watershed year in terms of advances in prevention and treatment." Mundell explains, "One big reason could be expanded access to antiretroviral drugs. A report released in October by the World Health Organization, UNICEF and UNAIDS found that 42 percent of people in the developing world who carry HIV now have access to life-extending medications. [...] Other nonprofit groups -- most notably the Clinton Foundation and the Gates Foundation -- have also led the charge, helping to broker price-reduction schemes with pharmaceutical companies for the cheap distribution of AIDS drugs in poorer nations."

• U.S. Political Will  The Huffington Post's Matthew Kavanagh asks, "Where is the $50 billion for global AIDS promised by President Obama, Vice President Biden, and Secretary Clinton when they were campaigning for our votes?" He lays out the opportunities. "The seeds of success are all there: strong, bold leadership, a belief in human rights and the capacity of wealthy nations to do good in the world, and a renewed commitment to global engagement. They have promised a Global Health Initiative centered around women. As the leading cause of death and disease among women, HIV has to be the place to start and Obama can signal a break from the Bush era by eliminating ideologically driven prevention programs that fail women."