Centers

Wafaa El Sadr, MD, MPH, director of the International Center for AIDS Care and Treatment Programs (ICAP) at the Mailman School of Public Health, took part in a U.S. Congressional briefing on the value of U.S. investments in scientific research on HIV/AIDS. 

Discussions centered on the gains that have been made in the period since HIV first emerged and the dramatic change in making the disease more manageable. These accomplishments are due in large result of the 30-plus antiretroviral drugs (ARVs) developed through scientific inquiry over the last three decades.

The briefing on April 30th, entitled “AIDS Research at NIH: New Opportunities to Change the Course of the Epidemic,” was sponsored by the HIV Medicine Association, IDSA’s Center for Global Health Policy. On the program with Dr El-Sadr were Dr. Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases, and other physician-scientist experts.

Presenters spoke of the critical need to maintain and increase U.S. support to combat the HIV/AIDS epidemic. “There is a presumption in some quarters that we really have our arms around this and things are stable,” said Dr. Fauci. He cautions however, that with 2.7 million new infections each year, the epidemic is still spiraling.

According to Dr. El-Sadr, who is a Mailman School professor of Epidemiology and Medicine, an estimated three million lives have been saved with ARVs. “I call that a stunning success,” she said, but noted that there was still “unfinished business”. “We should be energized to continue this work,” said El-Sadr both in expanding access to treatment, finding new drugs, and researching new prevention tools.

A Continuing Emergency

Dr. El-Sadr pointed out that in parts of the U.S., including Washington D.C. and New York City, the prevalence of HIV in some subpopulations surpasses the rates in some African countries, but that the epidemic in the U.S. was a localized one, with African Americans disproportionately impacted. That requires targeted approaches to treatment and prevention to reach these underserved populations.

“We have to reconceptualize our approach to the epidemic emphasizing the need to look for more structural and socio-economic interventions as well as approaches that address reasons for vulnerability and risk,” she suggested. “But to do that, and be successful, requires more research.” Dr. El-Sadr points to a study supported by NIH that she’s involved with that is trying to identify women at risk for HIV in 10 communities in the US.  This study could eventually help determine what types of interventions might help mitigate that risk and protect such women.
Dr. El-Sadr also described the “test and link-to-care plus treat” research study currently under development which will determine the feasibility of such an approach. This NIH-funded study will focus on Washington, D.C., and the Bronx.

“This is the epitome of a complex study,” she said, “but it is the future of what HIV prevention will look like.”

In conclusion, Dr. El-Sadr said, “We have an emergency in this country and an emergency around the world. There is an urgent need to continue an ambitious, innovative, and courageous research agenda.”

See videos of Dr. El-Sadr's and Dr. Fauci's talk.