Bill Gates says we're on track for a record HIV epidemic

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Ajay Verma/Reuters

The world has made enormous leaps in the fight against HIV/AIDS, to the extent that someone HIV-positive, with the right treatment, can expect to live as long as their healthy neighbor.

But as billionaire Bill Gates recently noted, without the proper funding, the virus could make a dangerous resurgence.

The Bill and Melinda Gates Foundation this week published the first-annual "Goalkeepers" report - an exhaustive document that identifies and tracks more than a dozen measures of global public health, including child mortality and family planning. The foundation plans to release a report every year until 2030, keeping tabs on the progress made on each metric along the way.

HIV infection is one of the first metrics listed in the 2017 "Goalkeepers" report. At last count, there were 36.7 million people worldwide living with the virus, roughly 1.8 million of whom were children under 15 years old. Today, the infection rate is about 0.14 people per 1,000 population, down from a high of 0.30 in the early 2000s.

global hiv deaths

Bill and Melinda Gates Foundation

But funding gains for HIV control are slowing down. People seem to be getting complacent with the progress that's been made over the last 15 years, Gates wrote, "and now there's talk of cuts." Models developed by the Gates Foundation in partnership with the Institute for Health Metrics and Evaluation show that a 10% cut in HIV treatment funding could lead to 5.6 million deaths by 2030.

Even if funding stays flat, HIV could seen an explosion of new cases, particularly in Africa, where the disease is most prevalent. The continent is currently home to 94 million people between 15 and 24 years old, the group most at risk for HIV. In the wake of the population boom over the last several years, that group is expected to balloon in size to 280 million.

"What that means is pretty clear," Gates wrote. "If we only do as well as we've been doing on prevention, the absolute number of people getting HIV will go up even beyond its previous peak."

The conclusion Gates draws is that treatment isn't the only solution. "I'm not advocating for a blank check for HIV treatment," he wrote, "because I don't think we need one." Instead, he sees prevention as the biggest factor in driving the infection rate as low as possible.

According to Gates, Kenya is the world leader in adopting preventive strategies. The East African country encourages safe-sex practices tested to reduce HIV risks. Additionally, Gates has called on scientists to keep investigating preventive drugs, including a vaccine. But such discoveries require funding for research and development.

"In the meantime, if we don't spend more to deliver the tools we have now, we'll have more cases," Gates wrote. "If we have more cases, we'll need to spend more on treatment, or people will die."
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