By Charlene Porter
Washington File Staff Writer

Washington – The combined efforts of a U.S.-backed global AIDS program and other international initiatives are bringing on a “tipping point” in the battle to quell the HIV/AIDS epidemic, according to the top U.S. HIV/AIDS official.

“[It is] the point at which we are seeing the epidemic wane, the point at which we are finally gaining ground on this epidemic,” said Dr. Mark Dybul, the acting global AIDS coordinator (GAC), who is responsible for overseeing the U.S. effort to assist other nations to fight the disease. (See related article.)

Dybul spoke in a digital videoconference with reporters in Canada, in the run-up to the opening of the XVI International AIDS Conference in Toronto August 13-18.

The President’s Emergency Plan for AIDS Relief (PEPFAR) is the key program for delivery of U.S. assistance to nations struggling to combat the disease. In the two years since PEPFAR began, 120 nations have received U.S support from the five-year, $15 billion initiative, the largest commitment to address a single disease ever made by a single nation, according to the GAC office.

PEPFAR particularly targets 15 nations, which suffer some of the world’s worst HIV prevalence rates. (See related article.)

Since 2004, PEPFAR has provided anti-retroviral drug treatment (ARVs) to 561,000 people suffering from AIDS in the 15 target countries. Globally, international initiatives in which the United States is a partner have begun providing drug treatment to 1.3 million people, Dybul said.

The United States has supported prevention against mother-to-child HIV transmission during more than 4.5 million pregnancies. Through September 30, 2005, PEPFAR supported care for nearly 3 million people, including care for over 1.2 million orphans and vulnerable children.

PEPFAR also has facilitated prevention counseling on more than 13 million occasions. That effort is part of a comprehensive prevention approach designed to achieve an “AIDS free generation,” Dybul said.

A Kenyan prevention program teaches teens that “you can actually abstain [from sexual activity] and it’s cool,” said Alice Wambugu, of the NimeChill campaign which is receiving PEPFAR backing. Wambugu, in Nairobi, Kenya, participated in the videoconference along with representatives of other nongovernmental organizations working against AIDS in Kenya with PEPFAR support.

A Uganda-developed prevention strategy known as “ABC” – abstinence, be faithful, condom use – has received significant attention, but Dybul said, the U.S. prevention scheme is more far-reaching than recognized and includes prevention of both sexual and mother-to-child transmission.

“We also support - significantly - efforts … for safe blood, safe medical injections and underlying issues such as, alcohol, intravenous drug use and gender inequality that contribute to HIV spread,” Dybul said.

Although some critics of PEPAR initiatives have said that the use of condoms should receive greater emphasis, Dybul responded, “The data are clear that you need all three components.”

Dispelling the suggestion that the U.S. backed programs disfavor or discourage condom use, Dybul said PEPFAR has supported more than 475 million condom purchases in 2006, almost triple the number in 2001.

For additional information, see a fact sheet on the State Department Web site.

For more on U.S. efforts to combat the epidemic, see HIV/AIDS.