THE BLOG

Curing HIV in One Baby, Preventing HIV in Many...

07/03/2013 00:41 GMT | Updated 06/05/2013 10:12 BST

Researchers from the US claim to have "functionally cured" a new born Mississippi baby of HIV - this is excellent news for the child and her family, and a welcome development revealing more clues to scientists working on HIV cure research.

On International Women's Day we should reflect on the wider implications of this extraordinary headline-grabbing case. There is a hidden story here that is just as telling: the excitement of scientific discovery, the pragmatism of public health, and the urgency of raising more money.

It is very rare for a child to be born with HIV in the US, or other developed countries. This is a story of the health service failing a woman and her child - and then (remarkably) delivering a near miracle. The story of health services failing women is not so remarkable elsewhere. Every day over 900 children are born with HIV - almost all of them in 22 countries, 21 in Africa.

Without intervention, about one in three children born to HIV-infected mothers acquire HIV, which is why in 2010 an estimated 330,000 children were born with HIV. By contrast, UNAIDS tells us, that mother-to-child transmission of HIV has been largely eliminated in high-income countries through testing, counseling, access to medicines, family planning and safe feeding.

It should be very rare for a baby to need 18 months of three drugs from birth - as the Mississippi infant received. The UN's Global Plan to Eliminate New HIV Infections Amongst Children and Keep their Mothers Alive sets out a clear and compelling road map to end new HIV infections in children and boost the health of women living with HIV; and prioritises the 22 countries where 90% of children live. The plan charts a direction of what can be achieved by 2015, with the scientific evidence and knowledge we already have.

The Mississippi mother - for whatever reason - did not get the health care she needed during pregnancy. If she had done - and if those hundreds of thousands of African women could - she would have been counseled about HIV and encouraged to test. When the test came back HIV-positive she would be encouraged to start with the three drugs: to boost her own health and stop HIV reaching her baby. Hopefully she would be supported by a Mentor Mother - another woman living with HIV who has already lived through this. During delivery she would get more HIV medicines, perhaps a caesarean section, and her infant would be given a much shorter course of medicine. The mother would then carry on with the medicine to give her the best hope of a long and healthy life. This is the standard protocol - recommended by WHO - that we have known about for a long time.

So why are babies still born with HIV? The answer is not science but money.

The Replenishment for the Global Fund To Fight AIDS, Tuberculosis and Malaria falls due this year. The Global Fund's new Executive Director Mark Dybul says this is the year when we can really start to defeat the three diseases. But that will only happen if the global community pays up so the Fund can get money out to the most important programmes.

The price tag is expected to be in the region of US$12-15billion. Historically the US and the UK government have been massive supporters of the Fund - it is essential for their support to continue and for others to now step up.

2013 is also the first time the UK government hosts the G8 since the milestone meeting in Gleneagles in 2005.

Gleneagles made a landmark agreement (which I helped to negotiate) to achieve "Universal Access to HIV prevention, treatment, care and support by 2010" that led to 5.4 million more people on AIDS treatment - and changed the ambition of many countries to believe that they really could deliver on AIDS. The UK has other priorities for this G8, but it would be a desperately missed opportunity if they did not use their influence to make sure the Global Fund has all the money it needs. The UK used the G8 as a game changer on AIDS last time round - will it have the courage to be just as bold again?

As the Mississippi case - and especially the 900 babies born with HIV every day - remind us, women and girls shoulder an unfair burden of the HIV epidemic. Yet over the past three decades I have worked on this, many of the vital struggles around stigma, discrimination, sexism and marginalisation have simply not moved. It's not that we don't know what to do - it's that we don't get the money behind what we know works.

Of course we want a cure for HIV or a vaccine. But as scientists walk those long roads it is time to step up and deliver justice now to the 17 million women who currently live with HIV, and to do all we can to prevent more women, girls and children becoming infected. Justice is reminding ourselves that - as the fortunate ones living in rich countries - we have within our power the ability to turn the corner of the AIDS crisis. What we need is simple: money and political will.