The Next AIDS Pandemic

Thousands of HIV/AIDS experts are gathered in Paris this week for their biennial world conference, and leaders are exhorting every one of them to fight for global financing and expand access to treatment, especially in Africa. But the world cannot treat its way out of AIDS, and without a revolutionary breakthrough in either vaccines or the entire model of HIV control, a massive second global wave of AIDS will come, perhaps within the next 10 years.

Three problems are driving the global fight against HIV into a new danger zone. First, new infections increasingly involve forms of the virus that are already resistant to the primary drugs used to treat and prevent HIV infection. Second, the world is fast approaching the limits of manufacturing capacity for anti-HIV first-line drugs, and the ceiling is far lower for second- and third-line treatments. And third, there aren’t sufficient financial resources applied to the AIDS problem now, and signals from major donors — especially the U.S. government — offer a grim future of diminished resources and greater demands on very poor countries to finance their own HIV fights without outside help.