World AIDS Day

Ambassador Nancy Bikoff Pettit
 December 1, 2017

In June 1981, the U.S. Centers for Disease Control and Prevention (CDC) published a report describing cases of a rare lung infection in five young, previously healthy, gay men in Los Angeles.  The report described other unusual infections in the men, indicating that their immune systems were not working.  The Associated Press and the Los Angeles Times published details of the report on the same day and the following day, the San Francisco Chronicle published the story.  Within days, doctors from across the United States flooded the CDC with reports of similar cases.

It has been 36 years since the first published reports by the CDC of what would come to be known as HIV/AIDS.  This disease has wrought enormous suffering and devastation and caused more than 35 million deaths, including nearly 400 Latvians who die each year from AIDS-related illnesses, according to the National Institutes for Health (NIH) and UNAIDS.  There are now 36.7 million people living with HIV worldwide, including 2.1 million innocent children under the age of 15.

Today, as we commemorate World AIDS Day here in Latvia and around the globe, we pause to honor those who have lost their lives to AIDS, recommit to those living with HIV, and celebrate the caregivers, families, friends, and communities that support them.  On this day, I want to share a message of hope and optimism.  Despite the grim statistics, our fight against HIV/AIDS and the struggle against the stigma surrounding it, we continue to make progress and provide hope to suffering individuals and their families.  As we mark World AIDS Day, let us recommit ourselves to ending HIV/AIDS as a public health threat.

The theme of World AIDS Day 2017 is “Increasing Impact Through Transparency, Accountability, and Partnerships.”  Ambassador Deborah L. Birx, M.D., U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, emphasized that this year’s theme reflects the United States government’s longstanding leadership in addressing HIV/AIDS both at home and abroad and how we are increasing our impact to move epidemics from crisis toward control.  As a world-renowned medical expert who spent a career of three decades focused on HIV/AIDS immunology, vaccine research, and global health, Ambassador Birx noted that we have a historic opportunity to accelerate progress toward ending the HIV/AIDS epidemic as a public health threat around the world.  I am pleased that this year’s theme also emphasizes the critical role of transparency, accountability, and partnerships in reaching our collective goals.  The United States stands with Latvia as it seeks to halt the advance of HIV/AIDS.

According to the NGO Baltic HIV Association, Latvia now has one of the highest rates of new HIV cases in the European Union – a distinction that no country seeks nor wants.  In 2016, Latvia overtook Estonia in the number of new HIV cases with the number of officially registered new HIV cases at 18.5 cases per 100,000 citizens.  According to the Center for Disease Prevention and Control (CDPC) of Latvia, as of January 2017 there were 6,972 people infected with HIV in the country, including 365 new cases in 2016.  Unfortunately, that statistic represents one person per day in Latvia becoming aware that he or she is infected with HIV.  To me, equally frightening is that experts estimate only 60 percent of people with HIV know their status – so, in reality, these figures are likely even higher.  The data also show that most new cases are still transmitted through sexual contact, but not as you would expect.  Contrary to stereotypes promulgated through various false narratives, some 38 percent of new HIV cases in Latvia occur through heterosexual contact and only 6.6 percent through homosexual contact.  This is a problem facing all of us – men, women, and children, not just specific minority groups, and certainly not only in Latvia.

Fortunately, there are several organizations in Latvia doing excellent and vital work to raise awareness, combat the spread of HIV/AIDs, and support HIV/AIDS patients.  For example, the patient support organizations DIA+LOGS, AGIHAS, and HIV.LV have been helping Latvians affected by HIV/AIDS to access services and improve their quality of life, and the organization BaltHIV serves as a regional resource center for HIV/AIDS.  The U.S. Embassy stands ready to promote and support the efforts of such organizations, and to build upon their important accomplishments.

Part of our responsibility in our united effort is to stand up to stigmas associated with this epidemic.  I am the first to admit that HIV-related stigma and discrimination still persist in the United States, as well as throughout the world.  These actions negatively affect the health and well-being of people living with HIV.  I encourage Americans and Latvians to help reduce this stigma and discrimination by offering your support to people living with HIV and speaking out to correct myths and stereotypes that you hear from others in your community.  I am haunted by the statistic that 2.1 million children around the world, including young Latvians, live with HIV.  We owe them our support to stand up to discrimination against anyone facing this terrible health epidemic.

The national HIV/AIDS strategic vision in the United States is to make our country a place where new HIV infections are rare and when they do occur, every person regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.

To shape that vision into reality, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) was introduced in 2003 as the U.S. Government’s initiative to help save the lives of those suffering from HIV/AIDS around the world.  This historic commitment is the largest by any nation to combat a single disease internationally, and PEPFAR investments (over $6 billion per year) also help alleviate suffering from other diseases, including tuberculosis and malaria, across the global health spectrum.  PEPFAR is driven by a shared responsibility among donor and partner nations and others to make smart investments to save lives.

With 1.2 million of our own citizens living with HIV, the United States focuses on a three-pronged approach to combating HIV and AIDS: prevention through education, early detection through testing, and treatment of the infection.  We have 28 agencies and offices representing 12 Federal Departments involved in our national HIV/AIDS strategy, including the U.S. Department of State.  In September, Secretary of State Rex Tillerson released the new PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020), which reaffirmed U.S. support for HIV/AIDS efforts in more than 50 countries, ensuring access to services by all populations, including the most vulnerable and at-risk groups.  As the largest bilateral donor to the global HIV/AIDS response, the United States is committed to eradicating this health epidemic.  Until that day, we will support our friends and partners as we work to provide the best treatment to those living with HIV, while also preventing new cases.

Today, thanks to remarkable achievements in biomedical science and public health, we have the tools to build a better future for individuals living with HIV and for those at risk of infection.  The greatest scientific accomplishment in HIV research has been the development of effective treatments that suppress the virus and prolong the lives of those living with HIV.  Over time, scientists have refined and optimized antiretroviral therapy, delivering safer, more effective drugs.  Today, a person living with HIV on antiretroviral therapy can expect to live a nearly normal lifespan.  We are hopeful that new approaches currently under exploration could expedite the end of the HIV/AIDS pandemic.

As Ambassador Birx noted, we are at an unprecedented moment in HIV/AIDS response.  For the first time in modern history, we have the tools to change the very course of a pandemic by controlling it, even without a vaccine or a cure.  Controlling the HIV/AIDS epidemic would lay the groundwork for preventing, eliminating, or eradicating it, which we hope will be possible through continued and future scientific breakthroughs for an effective HIV vaccine and cure.

We have 36.7 million reasons why the global community must come together, not only for one day to commemorate World AIDS Day, but every day to recommit ourselves to treating, preventing, and eradicating HIV/AIDS completely.  This is a struggle that begins right here – in our homes, in our communities, in the United States, and in Latvia.