There now is a considerable body of evidence to support the view that an effective HIV/AIDS strategy integrates prevention, treatment and human rights. In this chapter, we emphasize the importance of each of these aspects and draw upon the conclusions reached in previous chapters to map out the future of HIV/AIDS. While medicine and science have a crucial role to play in addressing pandemics, whether slow-moving (like HIV/AIDS) or fast-moving (like influenza), the social, legal, political, financial and economic ramifications of pandemics can not be ignored. Well-considered social, legal, political and financial strategies are essential in order to address any pandemic effectively.
The Importance of HIV/AIDS PreventionGlobal access to antiretroviral therapy for people living with HIV/AIDS has been scaled up significantly in recent years, from 8% in 2003 to 28% in 2006 (Global HIV Prevention Working Group 2007). Many developing countries now have universal access to treatment, including low-income countries, such as Rwanda (Perry 2007), and middle-income countries, such as Thailand and Brazil (see Chap. 2).vention, new infections will rise and millions more people will need treatment.The importance of prevention is illustrated dramatically in Fig. 9.1. Two middleincome countries started out at the same point in 1990 with respect to HIV/AIDS: Thailand and South Africa. However, the course of the epidemic in each has diverged to an extraordinary degree since then. and 2006 the annual number of new HIV infections in men under 30 who have sex with men increased by 32%. The significant factors behind the increase in new infections appear to be higher rates of drug use, optimism that AIDS is treatable and increasing stigma about HIV (Kershaw 2008)."AIDS is no longer just a disease, it is a human rights issue."Nelson Mandela, at the first 46664 concert held at Greenpoint Stadium, Cape Town (29 November 2003).301Low-and middle-income countries are not alone in needing a significant inseveral high-income countries in recent years. In New York City, between 2001However, prevention needs to be scaled up considerably in order to make univercrease in HIV prevention. As Table 9.1 shows, HIV infections have increased in sal access to treatment an affordable goal on a global scale. Without adequate pre-347 9.4 The Future of HIV/AIDS