500 days: Make them count

Five hundred days sounds like a long time, but compared with 15 years, it is the blink of an eye. And in fewer than 500 days we will reach Dec. 31, 2015, the target date of the Millennium Development Goals. It is a testament to the deceptive velocity of time that we so quickly find ourselves at the doorstep of that date adopted by the international community in 2000.

Improvements in the quality of human life around the world since 2000 have been unprecedented — both in terms of scale and pace.

On the front lines of the fight against HIV and AIDS, we have seen new infections fall 38 percent since 2001 and AIDS-related deaths plummet 35 percent from their peak in 2005. As of 2013, almost 13 million people living with HIV have access to antiretroviral therapy. Perhaps most encouragingly, new pediatric HIV infections have declined 58 percent since the Elizabeth Glaser Pediatric AIDS Foundation was founded more than 25 years ago, which means we are zeroing in on our goal of an AIDS-free generation.

In the course of those 25 years, EGPAF has reached 20 million women with lifesaving services to prevent them from passing HIV to their babies — in bustling metropolises like Dar es Salaam, Tanzania, and in remote villages like Ngegu, Kenya. In anticipation of the conclusion of the MDGs, UNAIDS issued a report in July setting the ambitious goal of ending the AIDS epidemic by 2030. The report stipulates that to do so, we must fill the gaps that now prevent more than 19 million people, including children, from knowing their HIV status and receiving lifesaving antiretroviral therapy.

Each day, almost 700 children become newly infected with HIV, more than 90 percent of whom contract the virus from their mothers during pregnancy, childbirth or breast-feeding. Only one-quarter of children living with HIV have access to treatment — without which nearly half will die before their second birthday, and 80 percent will die before age 5.

Children living with HIV are also left behind when it comes to advances in medical research and access to lifesaving medicines. They can’t be treated as miniature adults. They require medicines, care and support that are age-appropriate and effective for their specific needs.

Momentum to create new pediatric diagnostic tools and antiretroviral formulations is growing. Innovative treatments such as fixed-dosed combinations tailored for children, better tasting medications and even medications in powder or sprinkle form are in the pipeline. We cannot stop now.

To reach the moms and their babies who have been left behind, we must join forces as a global community. If there is one thing that the MDGs have taught us, it’s that the work of different global health sectors is intertwined. We can’t end the AIDS epidemic without also improving maternal health and child survival rates for all women and children and overcoming the barriers to care caused by poverty, underdeveloped health systems and lack of education.

Kenya’s Homa Bay district is just one place where a comprehensive approach is making a dramatic difference. This region has the highest rate of HIV in Kenya, a country that ranks fourth in the world in HIV prevalence. Yet great progress is being made at a modest dispensary in Ngegu, a community on the south shore of Lake Victoria. When I visited the dispensary recently, the nurses on staff were working to ensure that every baby in their care would be born and remain HIV-free.

The nurses administer prevention of mother-to-child transmission of HIV treatment with incredible competence and devotion. They are determined that no woman within their community who tests positive for HIV misses out on treatment. And those nurses do so much more. They are bringing HIV and other health services, such as malaria treatment and prevention, closer to the people that need them and diligently following up with families — resulting in higher retention and greater efficiency. The work being done at Ngegu shows what trained and dedicated health workers can accomplish if they have the support and resources they need.

Today, we are on the cusp of eliminating mother-to-child transmission of HIV globally. We have the knowledge. We have the tools, the medicines and the treatment. All we need to finally end this epidemic is the continued resources and collective will of the global community.

Like the health workers in Ngegu, we know that maintaining the status quo won’t be enough. We need to scale up our efforts to aggressively close gaps in access, treatment and care and to combat the stigma and fear that are so destructive to the lives of people living with HIV. We need full integration of PMTCT and maternal and child care and treatment at community sites where all of the immediate health needs of the clients should be addressed.

This is the model for success as we look toward defining our next, hopefully final, set of goals: the Sustainable Development Goals. The final SDGs will not be agreed upon until the end of 2015, so the global conversation around the post-2015 framework and how HIV will be represented is still very much underway. However, we do know that this will be a model that focuses on sustainability, integration and partnership — concepts that have proven tremendously effective throughout EGPAF’s history.

As we look to 2030, we cannot be satisfied with the progress we’ve made, no matter how improbable it seemed 15 years ago. In the twilight of the Millennium Development Goals, we have generated momentum and we must not waste it. Over the next 500 days, we must work harder than ever to raise awareness and strengthen the resolve of the global community so that we accomplish even more over the next 15 years.

What we are able to achieve and express as a global community in these next 500 days may very well define thousands of days to come. Let’s make them count.

Aug. 18, 2014, marks the 500-day milestone until the target date to achieve the Millennium Development Goals. Join Devex, in partnership with the United Nations Foundation, to raise awareness of the progress made through the MDGs and to rally to continue the momentum. Check out our Storify page and tweet us using #MDGmomentum.

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