The next 25 years: The need for a long-term view

摘要

When I first joined the Editorial Board on AIDS, I assumed that the journal would have a relatively short life, as with so many others. I implicitly thought that this new epidemic would be a matter of at the most a couple of decades, and that the end was already in sight (as we hear again today). Thirty years into the epidemic, it is clear I was wrong. Following the discovery of HIV as the cause of AIDS, there was great optimism that a vaccine would become available that optimism was reinforced by the discovery of'highly active antiretroviral therapy' in 1996, opening perspectives of eliminating HIV. The global response was-rightly-framed as an emergency response (the E in PEPFAR). Thanks to unprecedented global solidarity and strong national and community mobilization, HIV incidence and HIV-related mortality are declining, with the notable exceptions of the former Soviet republics and old and new epidemics in MSM. The demonstration that early antiretroviral treatment is highly effective in reducing HIV transmission in discordant couples has led to renewed optimism that the end of AIDS is in sight, and that HIV, according to some models, can even be eliminated in the foreseeable future.