Australia: The end of AIDS?

prep-400x210Australia’s top HIV/AIDS epidemiologists, scientists and community sector representatives have marked extraordinary progress against AIDS and declared that it is now possible to virtually eliminate HIV infections in Australia with appropriate investment in research, community-led health promotion and access to new HIV prevention technologies, such as PrEP.

While HIV was traditionally the precursor to AIDS, advances in the effectiveness of HIV medicines and access to them means very few Australians who are able to access HIV therapies now progress to AIDS.

The announcement marks the culmination of a thirty-three year response, spanning science, medicine and community outreach and activism. While noting the progress against AIDS, the elusive goal of ending new HIV infections remains an enduring challenge. More than 1000 new infections occur each year. New technologies, if appropriately supported and monitored, have the potential to achieve virtual elimination of new HIV infections by 2020.

Australia’s national surveillance of HIV/AIDS is led by the Kirby Institute at UNSW Australia.

“Australia has made tremendous progress both in treating and preventing HIV and preventing it from progressing to AIDS”

Professor Grulich, Head, HIV Epidemiology and Prevention Program at the Kirby Institute, said.

“While we continue to see a number of people diagnosed late with HIV, some of whom have  AIDS-type symptoms, the AIDS public health threat has morphed into an HIV prevention challenge. We continue to see more than 1000 new HIV diagnoses a year in Australia.

“In fact, with new prevention tools such as pre-exposure prophylaxis (PrEP) Australia has a real chance of both consolidating our tremendous progress against AIDS and reaching the ambitious goal of virtual elimination of HIV transmission by 2020,” Professor Grulich added.

According to Darryl O’Donnell, Chief Executive Officer of the Australian Federation of AIDS Organisations (AFAO), “Australia’s progress against AIDS is tremendous. We will never again in our communities have the horror of so many loved ones dying. We don’t have to worry that HIV will inevitably lead to illness and death. Good access to treatment and testing and a community-led approach is critical to maintaining Australia’s effective response to HIV.

“But the job isn’t done. Too many people are still being diagnosed with HIV, and often they’re being diagnosed much later than we’d like. The virtual elimination of new HIV infections requires long-term investment in the organisations that have responded to the needs of HIV in our affected communities for thirty years. These are the community organisations that have supported gay men and communicated honestly about new research into treatment and prevention. Successive governments have invested in the HIV/AIDS response since the early 1980s. Australia’s success in fighting AIDS is globally recognised. Now we must go the next step and end new HIV infections.”

According to Mr Cipri Martinez, President of the National Association of People Living with HIV Australia (NAPWHA), “the virtual elimination of AIDS cases in Australia is an important milestone, but a crucial element to ending HIV in Australia is to encourage the uptake of anti-retroviral medicine so that HIV positive people can become undetectable and un-infectious to others. The most successful community responses will include early combination prevention, testing and treating strategies.

“Getting to zero new HIV infections in Australia means redoubling our efforts with vulnerable communities including, women, non-community attached gay men and people from non-English speaking backgrounds. These people are most likely to be diagnosed and treated late and can sometimes develop AIDS-defining conditions. Those few individuals can be confident that in most cases their symptoms can be quickly and easily addressed with effective treatments.

“The only way we can reduce the number of HIV infections to zero by 2020 in our region is by focusing intense advocacy and resources on those people most at risk of new HIV infections, especially young gay men and people who inject drugs,” said Martinez

Professor Sharon Lewin, Director of the Doherty Institute stated:

“I am especially pleased that we are also working on an effective cure for HIV infection. At the forthcoming International AIDS Conference to be held in Durban, South Africa in the week of 17 July 2016, we will be informed of the latest scientific and medical developments in HIV treatments and research for an HIV vaccine and cure”.

According to Mr Bill Bowtell AO, Executive Director of the Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria, “we cannot end HIV in Australia until we eliminate AIDS and HIV in the world. In recent years, we have seen stunning declines in global deaths from AIDS, and a sustained fall in new HIV infection rates, but globally, millions are still dying from untreated AIDS, and being infected by HIV.

“We must continue progress towards expanding access to HIV treatments by supporting the Global Fund, which is the key financing mechanism for fighting HIV/AIDS. This year, the Global Fund will be asking donors including Australia, to increase their support for the Global Fund to enable the great gains against HIV/AIDS to be sustained and improved,” said Mr Bowtell. “I hope that the new Australian government will respond generously to the Global Fund’s appeal for increased funding to protect the world from HIV, malaria and tuberculosis.”

There are around 1,000 people diagnosed with HIV diagnosed each year in Australia. Within the Asia-Pacific region, 180,000 people died from AIDS-related illness last year. Of the five million people in the Asia-Pacific who are living with HIV, only two million are on anti-retroviral treatment.

The decline of AIDS in Australia can be attributed to many factors, including:

  • A world-leading universal healthcare system where access to HIV care and treatment has been determined by clinical need and where affected individuals have been treated free of stigma or discrimination
  • An effective community response engaging key populations such as gay men, sex workers, people who inject drugs, with education programs designed to encourage and normalise HIV testing, inform early identification of HIV before the onset of AIDS, and support a healthy culture of ‘safe sex’ and ‘harm minimisation’.
  • Increasingly well-tolerated and effective treatments for HIV infection, combined with a secure ongoing supply which is easily and affordably accessible to individuals, ensuring that HIV can be quickly suppressed and AIDS stopped from developing.
  • Innovative new treatments such as PrEP, a well- tolerated  anti-retroviral treatment that, taken daily, provides almost complete protection from HIV infection. PrEP has been approved for use in Australia and is being made available in trials.

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