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International AIDS Conference Day Two: Hillary Clinton envisions AIDS-free generation

U.S. Secretary of State Hillary Clinton brought more than 7,000 people to their feet today with her memories of the millions lost to AIDS and her vision to bring about an AIDS-free generation.

Speaking for the first time at the International AIDS Conference, Clinton laid out an ambitious domestic and global agenda. It includes:

  • funding to bring 600,000 more people into treatment, in addition to the 4 million already receiving antiretroviral drugs through the U.S. President's Plan for AIDS Relief (PEPFAR);
  • providing more HIV-positive pregnant women with therapy so their unborn children remain virus-free, with a goal of reaching 1.5 million by next year and reducing transmission to zero by 2015;
  • investing more in circumcision programs, which have been shown to reduce chances of viral transmission by more than 60 percent. The U.S. will contribute $40 million this year to help 500,000 South African men undergo circumcision, Clinton said.

Clinton said she remembered her first visit to the AIDS quilt on the mall in downtown Washington, D.C. with her husband, President Bill Clinton, in 1996. She recognized the names of many friends in the commemorative art work.

"When we saw how enormous the quilt was, covering acres and acres of ground, it was devastating. And it kept growing. Too many people kept dying... We are here today because we want to stop adding names," she told the audience in somber tones. "Today, let us restore our faith so we may reach that goal of an AIDS-free generation and honor all those who have been lost."

Though Clinton acknowledged that the U.S. has been criticized in the past for not doing enough, today it remains the largest single funder of global AIDS, committing 59 percent of the $7.6 billion spent by governments in 2011, according to a new report by UNAIDS. U.S. funding slid in 2009 and 2010 but has since returned to 2008 levels, the report indicated.

Clinton, who was recognized by UNAIDS director Michel Sidibe as "one of the most committed visionaries to change," said U.S. strategy has shifted from emergency mode to one of building sustainable health care systems around the world.

"We have had to fundamentally change the way we - and our global partners - do business," she said. "That has required some difficult conversations, like talk about government corruption and delivery of drugs."

On the domestic front, the Obama administration inaugurated the first comprehensive national AIDS program in July 2010 to fight an epidemic which affects some 1.1 million Americans. Some 20 percent of those infected don't know it, and only 62 percent are linked to care, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease. And only 28 percent are receiving therapy that is effective enough to keep the virus in check, Fauci said. So throughout the United States, and particularly in hot spots like Washington, D.C., "there still needs more resources and smarter strategies," Clinton said.

Ruthann Richter is a Scope contributor and writer in the medical school’s communication office. She is attending the International AIDS Conference in Washington, D.C. and is posting periodic updates on the happenings there. You can see all of her updates in our HIV/AIDS category.

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