“At the peak of the AIDS epidemic in Africa, HIV accounted for two-thirds of all adult deaths. Can you imagine what that would be like in our own village, our own community? There were communities in which the only business that was increasing was the funeral business,” he said.

Frieden said he remembers trying to treat hundreds of patients in the early days of the epidemic. But there was no treatment. Things began to change around 1996 when the first antiretroviral drugs came on the scene. There was initial hope that these were a cure. But it was then realized the drugs could suppress the virus, but not kill it. However, at least in developed countries, the drugs, despite many side effects, could extend lives.

Much has changed since the beginning of the HIV/AIDS epidemic. The 2011 global AIDS progress report says annual incidence of HIV has fallen since 2001 in 33 countries, 22 of them in sub-Saharan Africa. And the overall number of deaths has declined since peaking at 2.2 million in 2005. However, infections and deaths are rising in Eastern Europe and Central Asia.

Tipping point

Nevertheless, Frieden described 2012 at a tipping point. There have been advances in vaccine research, microbicides and especially in the use of antiretroviral drugs.

He said, “We know that treatment as prevention has been documented to reduce transmission by 96 percent. This is remarkable evidence of progress. We now know that if you’re on treatment not only will you live longer and healthier, but you’ll be 96 percent less likely to spread HIV to others. That’s a game changer.”