The world is "poised to control HIV," says Ambassador Deborah L. Birx, the coordinator of U.S. government activities to combat HIV/AIDS.
Ambassador Deborah L. Birx has one of the most important jobs in the world. She oversees the U.S. initiative to end AIDS — the largest commitment by any nation to combat a single disease in history.
Birx heads the President’s Emergency Plan for AIDS Relief (PEPFAR), created in 2003 to deliver lifesaving services in countries hardest hit by HIV/AIDS.
“Before PEPFAR began, an HIV diagnosis was a death sentence in many countries,” she said. “Today, 15 years later, PEPFAR has saved over 14 million lives, and we’re closer than ever to ending the epidemic as a public-health threat.”
A hospital in Kenya that works with PEPFAR. Kenya is one of 13 “high-burdened countries” with the potential to control HIV by 2020.
Birx began her career with the U.S. Department of Defense in 1985 as a military-trained clinician in immunology, focusing on HIV/AIDS vaccine research. The then-Colonel Birx helped lead one of the most influential HIV vaccine trials from 2003–2006, a trial that confirmed that a future vaccine could prevent HIV infection.
On the 15th anniversary of PEPFAR, Birx shared her insights about the global fight to end AIDS.
Our Question: What do you believe are the three most important lessons PEPFAR has learned in the global fight against AIDS?
Birx: We’ve learned so many lessons that it’s hard to pick three. But if I have to choose, I’d say:
If you want to be successful, people must always come first. If you don’t treat people with respect and create a culture of compassion and accountability, you won’t reach your goals.
Data, data, data. To fix a problem, you have to understand all of the intricacies, track if what you’re doing is working, and be agile enough to adjust your course quickly if another approach would have a greater impact.
Never be deterred from doing something hard if it’s worth doing. As Nelson Mandela so wisely said: “It always seems impossible until it’s done.” Working together with our partners, PEPFAR has achieved many things that once seemed impossible.
Since PEPFAR was created, more than 2.2 million babies have been born HIV-free who otherwise might have been infected.
Our questions: You’ve been U.S. Global AIDS Coordinator for four years now. What do you consider your “proudest moments,” and why?
Birx: I’m incredibly proud of, and deeply humbled by, the millions of men, women and children around the world whom we serve. Each of them has taken the courageous step to know their HIV status, to access lifesaving treatment if they are HIV-positive, and to stay on that treatment both for their own health and to protect their partners and families. At the end of the day, they are the reason that PEPFAR succeeds.
SA: What do you think will be PEPFAR’s future challenges and successes over the next 15 years?
Birx: Our main challenge now is to build on these incredible accomplishments by accelerating the pace of our progress. For the first time in modern history, we have the tools to control a pandemic without a vaccine or a cure, laying the groundwork for eventually eliminating HIV.
Up to 13 high-HIV-burden countries are poised to achieve epidemic control by 2020 with PEPFAR support. These efforts will create the road map to reach epidemic control in the more than 50 countries that PEPFAR supports. If we successfully and sustainably control the epidemic, we’ll be poised to eliminate HIV once we have a vaccine or a cure.
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