[cheers and applause] more people will feel better understood had cared for. . .

ofwe are showing you some the recent 19th international aids conference held in washington. talking with david brown at the "washington post" to cover the conference. what was the significance about the event being held in washington? >> guest: well, it was the first time it had been held in the united states in 22 years, which is a very long time, particularly in the narrative in history of the hiv epidemic. almost everything has changed from our understanding of the disease to its therapeutics and

the prognosis of people with the infection. it had an essentially banned from the united states because of the restriction on hiv-infected people from entering the country, which was part of -- was an integration regulation and the international aids society, which runs the conference had decided that this was a form of stigmatizing exclusion that they did not agree with and that until the united states changed it, there would not be in a conference is held in the united states of these international aids conferences. and he was lifted by president obama very early in his term. >> host: he wrote the subject of money is always a big topic at the state's conferences, particularly this one. can you tell us how much the

u.s. contributes each year to the fight against aids worldwide? >> guest: the u.s. contributes about $6 billion to the overseas aid efforts. in the year 2000 that believe the government's total global health spending was about 1 billion. that gives you some idea of the enormous growth over time, much of it coming through pepfar, the president's emergency plan for aids relief, which president bush, george w. bush started announced to everyone's surprise in the state of the union address in 2003. and that has gone up under obama and flattened out in the last couple years and an enormous amount paying for drugs, paying for clinics, paying for labor,

paying for the whole, you know, sort of transportation and infrastructure it takes to put millions of people on the life-saving -- life extending therapies. >> host: was very consensus this year on the latest and best approaches to prevention and treatment? >> guest: well, i wouldn't say there was a consensus, but there was more stuff to do. there's more options now than there have been ever before. big ones are the so-called is prevention and this means that if you -- if someone is in fact did and you treat him even very early or perhaps especially very early in their infection, the amount of virus they have in the

blood stream goes almost to zero and they become essentially noninfectious. in other words, they cannot transmit the virus on to anyone else. it occasionally happens, but it's rare. so the idea is everyone, as soon as they are diagnosed and he put them on the drugs, then the chance of them passing it on to someone else is hugely reduced. so that is one strategy. there's other strategies like circumcision and then there is even taking prophylactic drugs, people who don't have the virus, but are at risk -- high risk of acquiring it. they can take drugs to lower their risks usually. >> host: former president, bill clinton, one of the major speakers, how has his foundation been so successful in driving down the price at eight drives

worldwide? >> guest: well, his foundation , which has really had a huge effect on the international response basically has helped rationalize the market for generic antiretrovirals and it is basically gotten the makers of the consumers of these drugs together and say okay, if we can assure you that there will be those -- this demand, you know, demand for x million doses of this particular drug, how cheaply can you make it? and is there some way that we can guarantee that it will be delivered in time, that it's not going to run out on shelves, it isn't going to be held up in customs, on and on, just make a system seamless and efficient.

and once the makers, the producers can a generic producers know what the markets going to be, they could ramp up and produce huge quantities at a much lower price. it is basically getting the price -- to praise ray. >> host: what is your sense after this conference? what is left to be done in the fight against aids clinics >> guest: well, quite a bit. there's still room for the prices of drugs to come down. in the united states, there's very important drugs about to go off patent, which will save some money here, up to a billion dollars potentially a year, particularly if doctors and patients are willing to make a small adjustment to their drug regimen. the whole issue of getting people on drugs early. you can't of course force

anyone, but perhaps you can make it easier for people to start the therapy early if they're interested. there's a huge amount of room to make that happen more efficiently. and then there's things like option b., which is kind of a brand-name for putting all pregnant women who are in fact dead, putting them on antiretrovirals drugs for life, just keeping them on the drugs. in the past and was put them on during their pregnancy and breast-feeding and if they don't have a clinical indication, then stop the drugs. until their own disease progresses. now the idea is forget all the stopping and starting, just get them on the drugs can preserve their life for as long as possible. >> host: david brown with the

"washington post," along with alina sun reported on the 19th international aids conference. read the reporting of "washington post".com. thanks for joining us. >> guest: my pleasure. >> at this year's aids conference, secretary of state hillary clinton announced tens of millions of dollars in new funding for combating hiv and others around the world. it includes all of eliminating other two chat rooms mission by 2015. this portion is 40 minutes.xecui >> please welcome, executive [ap

director of human names. [applause] >> fran's, when they got from the opening ceremony, to the of extreme, to think of opportunit. , we are to have thiso epidemic. to be able to say 20 years fromr now, not their generation shoul, cross over the finish line. our generation made the decision be finally end a for all of us. and to be given the honor to introduce a great leader who is

turning -- she's an advocate for hiv. [cheers and applause] president obama, secretary clinton, secretary sebelius and my friends. vi [applause] secretary clinton is a person of vision, courage and intellect. o a leadership impasse, so manyple people to educate. a and to promote global healthr e, good for example in appointingos global women's issues.

she was the first global leader to speak out about the economic impact of violence against women. [applause] and lastly, she was the first global leader to call for an aids free generation. [applause] she challenged us all to imaginl a world where all babies are a born free from hiv. for everyone needs access toomed treatment, for the right of women and girls are protected and promoted. >> [applause]

where it is met with global solidarity and where all people, especially those most effect to drive the epidemic by the stigm. discrimination. .. and governments around the world. it will -- introducing one of the most inspiring leaders but also, as one of its most effective and committed visionaries for change. >> [applause] >> at a moment when she has so many other obligations from syria to afghanistan,

this is a powerful testimony of heart and sincerity. and despite her global comilments she has always found time to be a caring mother of her impressive daughter. it is my tremendous pleasure and honor to introduce, the secretary of state of the united states of america, hellery rodham clinton. >> -- hillary rodham clinton.

>> good morning! good morning, and -- >> [chanting] >> hillary! hillary! >> now, what would an aids conference be without a little protesting! we understand that. >> [cheering] >> part of the reason we've come as far as we have is because so many people all over the world have not been satisfied that we have done enough.

and i am here to set a goal for a generation that is free of aids. >> [applause] >> [cheering] >> but first, let me say five words we have not been able to say for too long. welcome to the united states! >> [applause] >> we are so pleased to have you all finally back here, and i want to thank the leaders of the many countries who have joined us, i want to acknowledge my colleagues from the administration, of the congress, who have contributed so much to the

fight against aids. but mostly, i want to salute all of the people who are here today who do the hard work that has given us the chance to stand here in 2012 and actually imagine a time when we will no longer be afflicted by this terrible epidemic and the great cost and suffering it has imposed for far too long. >> [applause] >> on behalf all of americans, we thank you. but i want to take a step back and think how far we have come since the last time this conference was held in the united states. it was in 1990, in san francisco, dr. eric guzbee,

who's now our global aids ambassador, ran a triage center from for all the hiv positive people who became sick during the conference. they set up i.v. drug drips to rehydrate patients, they gave antibiotics to people who aids-related pneumonia, many had to be hospitalized and a few died. even at a time when the world's response to the epidemic was sorely lacking, there were places and people of caring, where people with aids found support. but tragically, there was so little that could be done medically. and thankfully, that has

changed. caring brought action, and action has made an impact. the ability to prevent and treat the disease has advance dollars beyond what many might have reasonablably hoped 22 years ago. yes, aids is still incurable. but it no longer has to be a death sentence. that is a tribute to the work of countless people around the world, many of whom are here at this conference, others who are no longer with us but whose contributions live on. and for decades, the united states has played a key role. starting in the 1990s under the clinton administration, we began slowly to make hiv treatment drugs more

affordable, we began to face the epidemic in our own country. then in 2003 president bunch launched pepfar with strong bipartisan support from congress and this country began treating millions of people. today under president obama we are building on this legacy. pepfar is shifting out of emergency mode and starting to build sustainable health systems that will help us finally win this fight. and deliver an aids-free generation. it's hard to overstate how sweeping or craicial this -- crucial this change is. when president obama took office we knew that when we were going to win the fight against aids we could not keep treating it as an emergency.

ehad to fundamentally change the way we and our global partners did business. so we've engaged diplomatically with ministers of finance and health, but also, with presidents and prime ministers, to listen and learn about their priorities and needs in order to chart the best way forward together. now, i will admit, that has required difficult conversations about issues that some leaders don't want to face. like government corruption, and the procurement and delivery of drugs. or dealing with injecting drug users. but it has been an essential part of helping more countries manage more of their own response to the epidemic. we've also focused on supporting high impact

interventions, making tough decisions driven by science about what we will and will not fund, and we are delivering more results for the american taxpayers' dollar by taking simple steps, switching to generic drugs which saved more than three # on million dollars in 2010 alone. -- and crucially, we have vastly improved our coordination with the global fund, where we used to work independently of each other, we now sit down together, to decide, for example, which of us will funds aids treatments somewhere and which will fund the delivery of that treatment. that is a new way of working together for both of us. but i think it holds great results for all of us.

all of these strategic shifts have required a lot of heavy lifting but it only matters in the end if it means if we are saving more lives, and we are. since 2009, we have more than doubled the number of people who get treatment that keeps them alive. we are also reaching far more people with prevention, testing, and counseling. and i want publicly to thank, first and foremost, dr. eric guzbee who has been on the front lines of all this work since the 1980s, in san francisco. >> [applause] >> he is somewhere in this vast hall, cringing with embarrassment, but more than anyone else, he had a vision

for what pepfar needed to become and the tenacity to keep working to make it happen. and i want to thank his extraordinary partners here in this administration, dr. tom frieden at the centers for disease control and dr. raj shah at usaig. >> [applause] >> now with the progress we are making together, we can look ahead to an historic goal. creating an aids-free generation. this is part of president obama's call to make fighting global hiv-aids at home and abroad a priority for this administration. in july 2010, he launched the first comprehensive national hiv-aids strategy which has reinvigorated the domestic response to the epidemic, especially important lower in

washington, d.c., which needs more attention, more resources, and smarter strategies to deal with the epidemic in our nation's capitol, and last november, at the national institutes of health, with my friend dr. tony fauche there, i spoke in depth about the goal of an aids-free generation and laid out some of the ways we are advancing it through pepfar, usaig and the cdc, and on world aids day, president obama announced an ambitious commitment to the united states to reach 6 million people globally with life saving treatment. >> [applause] now, since is that time -- since that time, i've heard a few voices from people raising questions about america's commitment to an aids-free generation.

wondering whether we are really serious about achieving it. well, i am here today to make it absolutely clear. the united states is committed and will remain committed to achieving an aids-free generation. we will not back off. we will not back down. we will fight for the resourceses in to achieve this historic milestone. >> [applause] >> i know that many of you share my passion about achieving this goal. in fact, one could say i am preaching to the choir. but right now, i think we need a little preaching to the choir. and we need the choir and the congregation to keep singing,

lifting up their voices and spreading the message to everyone who is still standing outside. so while i want to reaffirm my government's commitment, i'm also here to boost yours. this is a fight we can win. we have already come so far. too far to stop now. i want to describe some of the progress we've made toward that goal and some of the work that lies ahead. let me begin by defining what we mean by an aids-free generation. it is a time when, first of all, virtually no child anywhere will be born with the virus. >> [applause] >> secondly, as children and teenagers become adults, they will be at significantly

lower risk of ever becoming infected than they would be today, no matter where they are living. >> [applause] >> and third, if someone does acquire hiv, they will have access to treatment that helps prevent them from developing aids and passing the virus on to others. so yes, hiv may be with us into the future until we finally achieve a cure, a vaccine, but the disease that hiv causes need not be with us. >> [applause] >> as of last fall, every agency in the united states government involved in this effort is working together to get us on that path to an

aids-free generation. we're focusing on what we call combination prevention. our strategy includes condoms, counseling, and testing, and places special emphasis on three other interventions: treatment as prevention, voluntary medical male circumcision, and stop be the transmission of hiv from mothers to children. since november,by have -- since november, we have elevated combination prevention in all our hiv-aids work, including right here in washington which still has the highest hiv rate of any large city in our country, and globally, we have supported our partner countries shifting their investments towards the specific mix of prevention tools that will have the greatest impact for their people.

for example, haiti is scaling up its efforts to prevent mother to child transmission, including full treatment for mothers with hiv, which will in turn, of course, prevent new infections. and for the first time, the haitian ministry of health is committing its own funding to provide antiretro viral treatment. >> [applause] >> we're also making notable progress on the three pillars of our combination prevention strategy, on treatment as prevention, the united states has added funding for nearly 600,000 more people since september. which means we are reaching nearly 4 1/2 million people now, and closing in on our national goal of 6 million by the end of next year.

that is our contribution to the global effort to reach universal coverage. on male circumcision, we have supported more than 400,000 procedures since last december alone. and i'm pleased to announce that pepfar will provide an additional $40 million to support south africa's plans to provide voluntary medical circumcision for almost a half a million of boys and men this coming year. .

could participate. in zimbabwe some male lawmakers of the wanted to show share constituents how safe and virtually painless the procedure is. so they went to a mobile clinic and got circumstance sited. that's the kind of leadership we welcome. and we're also seeing the tralopment of new tools that would allow people to performt safprocedure with less training dd equipment than they need today without comprising safety and when such a device issuppt approved by the world getting the number to zero. over the years, we have invested more than $1 billion

for this effort. in the first half of this fiscal year, we've reached more than 370,000 women globally, and we are on track to hit pepfar's target of reaching an additional 1.5 million women by next year. there also setting out to overcome one of the biggest hurdles in getting to zero. when women are identified as hiv-positive and eligible for treatment, they are often referred to another clinic, one that may be too far away for them to reach. as a result, too many women never start treatment. today, i am announcing that the united states will invest an

additional $80 million to fill this gap. these funds -- [applause] these funds will support innovative approaches to ensure that hiv-positive pregnant women get the treatment they need to protect themselves, their babies, and their partner. the united states is accelerating its work on all three of these fronts in the effort to create an aids-free generation. and look at how all these elements have come together to make a historic impact. in zambia, we are supporting the government as they step up their efforts to prevent mother- to-child transmission. between 2009 and 2011, the number of new infections went down by more than half, and we're just getting started.

together we are going to keep up our momentum on mother-to-child transmission. we will help many more zambians get on treatment and support a massive scale-up of male circumcision as well, steps which will drive down the number of new sexually- transmitted infections by more than 25% over the next five years. as the number of new infections in zambia goes down, it will be possible to treat more people than are becoming infected each year. so for the first time we will get ahead of the pandemic there, and an aids-free generation of zambians will be in sight. think of all the people who will never be impacted by this disease, and then multiplying it across the many other

countries we're working with. in fact, if you are not getting excited about this, please raise your hand and i will send somebody to check your pulse. [applause] [laughter] but i know treating an aids- free generation takes more than the right tools, as important than they are. ultimately, it is about people, the people who have the most to contribute to this goal and the most to gain from it. that means embracing the central role that communities play, especially people living with hiv and the critical work of the

faith-based organizations. we need to make sure we are looking out for orphans and vulnerable children who are too often overlooked in this epidemic. [applause] and it will be no surprise to you to hear me say i want to highlight the particular role that the women play. [cheers] and sub-saharan africa today, women account for 60% of those living with hiv. women want to protect themselves from hiv, and they want access to adequate health care, and we need to answer their call. pepfar is part of our comprehensive effort to meet the health needs of women and girls, working across the united states government, and with our partners on hiv, maternal and

child health, and reproductive health, including voluntary family planning and our newly launched child survival call to action. every woman should be able to decide when and whether to have children. this is true whether she is hiv- positive or not. [applause] and i agree with the strong message that came out of the london summit earlier this month -- there should be no controversy about this, none at all. and across all of our health and development work, the united states is emphasizing gender equality, because women need and deserve a voice in the decisions that affect their lives. [applause]

and we are working to prevent and respond to gender-based violence, which puts women at higher risk for contracting the virus, and because women need more ways to protect themselves from hiv infection. last year we invested more than $90 million in research on microbicides. these efforts will close the health gap between women and men. if we're going to create an aids-free generation, we also must address the needs of the people who are at the highest risk of contracting hiv. one recent study of female sex

workers and those who traffic in prostitution in low- and middle-income countries found on average 12% of them were hiv-positive, far above the rates for women at large. and people who use injecting drugs account for about 1/3 of all the people who acquire hiv outside of sub-saharan africa. and in low- and middle-income countries, studies suggest that hiv prevalence among men who have sex with male partners could be up to 19 times higher than among the general population. now, over the years, i have seen and experienced how difficult it can be to talk about a disease that is transmitted the way that aids is. but if we are going to beat aids, we cannot afford to avoid

sensitive conversations, and we cannot fail to reach the people who are at the highest risk. [applause] unfortunately, today, very few countries monitor the quality of services delivered to these high-risk key populations. fewer still rigorously assess whether the services provided actually prevent transmission or do anything to ensure that hiv-positive people in these groups get the care and treatment they need. even worse, some take actions that rather than discouraging risky behaviors actually drives more people into the shadows where the epidemic is that much harder to fight.

and the consequences are devastating, for the people themselves and for the fight against hiv. because when key groups are marginalize, the virus spreads rapidly within those groups, and then also into the lower- risk general population. we are seeing this happen right now in eastern europe and southeast asia. humans might discriminate, but viruses do not. and there is an old saying that goes, why rob the bank? because that is where the money is. if we want to save more lives, we need to go where the virus is and get there as quickly as possible. [applause] and that means science should guide our efforts. today i am announcing three new

efforts by the united states government to reach key populations. we will invest $15 million in implementation research to identify specific interventions that are most effective for each key population. we're also launching a $20 million challenge fund that will support country-led plans to expand services for key populations. and finally through a civil society that works, we will invest $2 million to bolster the efforts of civil society groups to reach key populations. [applause] americans are rightly proud of the leading role that our country plays in the fight against hiv-aids. and the world has learned a great deal through pepfar about what works and why, and we have learned about the needs that

are not being met and how everyone can and must work together to meet those needs. for our part, pepfar will remain at the center of americans' commitment to an aids-free generation. i have asked the ambassador to take the lead in sharing our blueprint for the goals and objectives for the next phase of our effort and to release this blueprint by world aids day. what all of our partners here at home and around the home want to have a clearer picture of everything we have learned and a road map that shows what we will contribute to achieving an aids-free generation. reaching this goal is a shared responsibility. it begins with what we can all

do to help break the chain of mother-to-child transmission, and this take leadership at every level, from investing to health-care workers to removing the registration fees that discourage women from seeking care. we need community and family leaders, from religious leaders to encourage women to get tested and demand treatment if they need it. we have a share this possibility to support multilateral institutions like the global fund. in recent months, as the united states has stepped up our commitment, so have saudia arabia, japan, germany, the gates foundation, and others. and i encourage other donors, especially in emerging economies, to increase their contributions to this essential organization.

and then finally, we all have a share in responsibility to get serious about promoting country ownership, the end state where a nation's efforts are led, implemented, and eventually paid for by its government, its communities, its civil society, its private sector. i spoke about how the united states is supporting country ownership, but we also look to our partner countries and donors to do their part. they can follow the example of the last few years, in south africa, namibia, botswana, india, and other countries who are able to provide more and better care for their own people because they are committing more of their own resources to hiv-aids. and partnered countries also

need to take steps like fighting corruption and making sure their system for approving drugs a as efficient as possible. i began today by recalling the last time this conference was held here in the united states, and i want to close by recalling another symbol of our cause, the aids memorial quilt. for a quarter century, this quilt has been a source of solace and comfort for people around the world, a visible way to honor and remember, to mourn husbands and wives, brothers and sisters, sons and daughters, partners and friends. some of you have seen the parts of the quilt that are on view in washington this week. i well remember the moment in

1996 when bill and i went to the national mall to see the quilt for ourselves. i had sent word had that i wanted to know where the names of friends i had lost were placed so i could be sure to find them. when we saw how enormous the quilt was, covering acres of ground, stretching from the capitol building to the washington monument, it was devastating. in the months and years that followed, the quilt kept growing. back in 1996 was the last time it could be displayed all at once. it just got too big. too many people kept dying. we're all here today because we

want to bring about that moment when we stop adding names, when we can come to a gathering like this one and not talk about the fight against aids, but instead, commemorate the birth of a generation that is free of aids. now, that moment is still in the distance, but we know what road we need to take. we're closer to that destination than we have ever been. and as we continue on this journey together, we should be encouraged and inspired by the knowledge of how far we have already come. today and throughout this, we must restore our own faith and renew our own purpose, so we may together reach that goal of an aids-free generation and truly honor all of those who have been lost. thank you all very much. [applause]

allergy and infencer diseases an sp anthony s. fauci outlines the steps necessary to end the spread of hiv and aids. he's followed by the substitute in paris and nobel prize winner. [applause] >> thank you. [inaudible]

it's ab honor to introduce [inaudible] of the 2012 conference in what she tends of science and what science can do for public health. the reason i'm really dloighted to introduce these persons. ton anthony s. fauci on infencer

disease. since 1984, he has overseen an extensive research using forces to preventing -- [inaudible] and treating infections and immunizations. he was is the chief of [inaudible] where he has made numous important discoveries related to hiv-aids and one of the most best scientists in the field. [inaudible] 1,200 [inaudible] including several others. [inaudible] he has received [inaudible] including the national medal of

science, merit -- [inaudible] and the presidential medal of freedom. i'm pleased to call anthony s. fauci. [applause] thank you very much for the kind introduction. i want to thank the organizations for giving me the opportunity kick off the scientific component of this international meeting and take the theme that was developed last night with great enthusiasm and discuss with you all of my time a lotment why we now have the scientific basis to be able to even consider the feasibility

and the reality of an hiv-aids screen generation. i want to start first with a little background. i love matt. i love the deep blue of the oceans, the refreshing green of the plains, and the mountains. but we look at maps in the room over the past couple of decades they have taken on a different complexion within the dreaded differential shading indicating prevalence in different regions in the world with 34 million people lifing with hiv/aids. if you look at the upper left-hand corner of the slide you see the united states we have 1.1 billion people living with hiv and focus in a little bit and see washington, d.c., now there a couple of issues about washington, we welcome you here, but it was twenty five

years ago that the international aids conference was in washington. i've had the privilege and the opportunity to participate in every one of the nineteen conferences of the international aids society. but i want to play a little bit moment with you with washington when you talk about what we share globally like i said i like maps inspect is a google map of washington, d.c. this is where you are sitting. again, the dreaded shadings because in washington, d.c., we have a prevalence that in many respects equals some of the nations. as she said last night, it is the best of times and the worst of times. the worst times is the prevalence. want hope for the best of times is as you heard from the mayor last night, washington, d.c.,

has implemented an aggressive and innovative program to have a major impact which can serve as an camp, i'll get back to that in a moment. let's get to the gist of what i want to develop with you over the next several minutes. we want to get to the end of aids that. will only occur with some fundamental foundation and the town dailingses are the clinical research give us the tools which will ultimately lead to interventions and ultimate these will need to be implemented together with studies about how best to implement them. so let me briefly go through each of these with you. the basic and the clinical research. we have had a stunning amount of advances in the arena of basic and clinical science which are the delineated on the slide. i don't have time to go through

each and every one of them with you. there are some that stand out. some as great things as the initial identification of the virus. you can -- the demonstration that is the agent by galway and the colleagues. the increment of breakthrough, the incremental science each year learning more and more about the hiv virus themselves as well as the path againic mechanism. this is a confusing slide. i put on one slide about 30 years of incremental research. and with a we know now a lot about the virus the prier mare infection, the establishment of infection in the tissue massive -- [inaudible] of organs and partial but never complete imneurological controls. and the ab sense of therapy.

very important in the process of incremental scientific knowledges is understanding the early events in hiv, particularly as it surfaces with the vulnerable a host and vulnerability of the virus and understanding it is extraordinarily important in insight transmissions and vaccines development. probably the most important of the cumulation of scientific advances is understanding the hiv rep indication cycle on the binding fusion insertion of r and a reverse transcription into integration and viral budding. each of that year after year has given us targets of vulnerability or of on the part of of the -- it brings us the next step. that is a step of intervention,

precome innocently in the arena of intervention. let's start with treatment. i dub this slide out of the archives a picture of me and fellow students in the early 1980s when we were frustrated clinically but beginning to make headways scientifically. i refer to these as the dark years of my medical career. but what kept us, myself, and my colleagues not only here but throughout the country and the world going forward, even though we were much in the dark, was reading what people were going through in the community and e consequently stated by jones in some of the film what was going on in the san francisco. larry crammer in the normal heart describing what was going on in the village. but things began to happen, the sign lead to intervention, and

if you look at the evolution of treatment strategy, the first drug in 1987 give a glimmer of hope. virus goes down very little. doesn't stay down. resistance occurs. years go by, new drugs, virus go down further for a little bit longer but not enough. then the transforming meeting and crewinger in 1996 with a three-drug therapy brings down the virus to below the detectable level. stays there potentially indefinite nately. we have a new dawn of therapy pediatric with hiv/aids that transformed the life of individuals. we now have up to 30 hiv antihiv approved drug by the fda. multiple classes used in combinations that have completely transformed things. but we can't stop there. because there is still those who are not responding to these strugs and we need long-acting

drugs particularly with regard to hearings. the result have been speck lar. i'm going pick out a couple of examples. if you look, this is a study from holland, i told you back in the dark year of my experience, the survival of my patients was -- if a person walk into a clinic at the nih or any other place that has availability of the treatment is young 25 and recently infected you put them on combination therapy and look in the eye and tell them it is likely they adhere to that regimen, they will live an additional fifty years. there is not only confined -- [applause] just in the developed world it's known now in countries, for example, analysis at the same similar results with normal life

expectancy. that's the good news. there's challenging. this is a very scary slide. because if you look at the united states the 1.1 million people infected, 20% don't know they're infectded. 162% are linked to -- 41 areed contained. only 36% on antiviral and 28% are sur pressing. we have to do better that than. we have the tools. we need to implement that. it can -- question take example from the developing world. whey need to do is we need and are doing it having continuum that is seeking out testing, linking to care, treating when eligible and making sure they adhere and in fact getting back to the d.c., there is a study ongoing now with six cities two. of which are implement cities

the south bronx in washington, d.c., where we're starting to see can actually a cur if you put the effort in it . i'm sure you'll be hearing more about it later. it doesn't only happen in the developed world. that's when people keep saying. is it going to be able to be done? take a look what's going on in rwanda. you have a community-based program, two-year retention 92% with 98 percent tested at two years had suppressed viral loads. similar results in bots wan a that. extending the intervention what about prevention? combination hiv prevention the message to this is prevention is not dimension fall. we all know that. terrorist a combination of comprehensive on the lower level of the wilding blocks are interventions that are not necessarily biological driven.

we were implementing them before we knew there was a virus. as the years went by, science lead us. some examples prevention of mother to child transmission. the breakthrough study of o76 indicating by treating the mother you can actually decrees dramatically now. now we treat mothers for the disease and together with the mother's help the baby is born uninfected. in the united states this is transformed what you see now on the red bars the estimated number of hiv infected ininfants. remember what mayor said last night, in this city with hard prevalence there has not been a child born with hiv infected since 2009 in a city with -- [applause]

that's the good news. 600,000 we have a challenge. there are 330,000 new infections in 2011 alone. what about male sir come suggestion? this is a stunningly successful. the initial trials in the south africa, kenya show that in the confines of a trial it works. the real question is, was it work in the field and as a matter of fact you anemically, this is one of the few prevention interventions that actually gets better with time because the initial result was 55 or 60%. it you go to the district in you began d.a. five years out in the effectivenesses in the community is 73%. good news and challenging news because of mixed results the

capricious study proved the concept you can have a woman dated intervention on -- [inaudible] when you adhere to it. this study and the press study has been issuerly told something. biological interventions work but don't work if you don't adhere. which tells us why we have marry biological with behavioral. there's no doubt about that. [applause] we know that from the voice study which shows the study continue -- [inaudible] fertility hopefully get the answer from the fact study. getting back to the long-acted moral the same thing has to do with -- [inaudible] we're pleased at the approach of use if two studies starting to see the aspire study and the studied which will hopefully bring a greater debris of hearings to show that can equal

effectivenesses. again, mixed results. the breakthrough study was the [inaudible] in the recent apriewl by the fda both for men who have sex with sex and heterosexuals. but there are some studies that show it doesn't work. it doesn't work with some biological effect with the continues concentration of drug. hammering home to us the concept that biological will not be effective without adhering. probably the most game changing advance over the last couple of years of the treatment and prevention with the famous trials which we reduce by *eu69% the likelihood that someone will transmit to their uninfected partner if you treat argue a

great argument for getting people on treatment. before i go on to the implementation. i want to mention that i'm telling you a lot of good news about science. we have challenges. we have challenges in the arena of vaccination, we have challenges in the reason of cure. what about development of the vaccine? fee f we were able to plug in a vaccine block, we would surely have a very robust combination, prevention package even if it wasn't a perfect vaccine even if it wasn't out% we could do that. you're familiar with the rv144 trial. it's a humbling trial because it showed an honest degree of -- when you behind down and try to figure out the potential, we find out that it's nonnews losing related

what about a cure a couple of days ago, sponsored an extraordinary about approaches to hiv cure.

two general types either eradication purging it which would be difficult or perhapses what i called years ago a functional cure. mainly either enhancing hiv specific immunity or moving the whole cells to be resistant. i want to i'm sure people in the room understand. others don't. it's not an implementable intervention. it's way upkeen on the basic discovery level. so that you can put an end to the hiv pandemic as mark said is an epidemiological without curing anybody. you cure a few people without putting an end to the hiv pandemic. it's a scientific challenge. let's go on to implementation. we have been able to implement what we've discussed over the last day or so. the extraordinary effect of the program the global funds,

philanthropy, the clinton foundation but importantly recently the assumption by host countries of their own responsibility, and this has been very important. so i want to -- let's take a look at this. a couple of minutes of this. what happens when you take an clinical trial based scientific observation and you try to scale it up regionally or locally to see if it becomes effective. there are many examples, i'm going to give you a few, what about the positive impact of scaling bots wanna. take a look at the red dot which is is a percent able of mothers who are being treated. taking the diminishing blue bars, the number and percentage of children who are born with hiv. it works. what about the fact that if you treat people do you really save their lives? we now have 8 million people

receiving antiretrovirals in low and middle income countries. a ton of deaths have been alerted in 2011 alone. as to the question, what about the positive impact of therapy on the hiv disins in you go to a place where you have 30% coverage [inaudible] and another section there's 10% coverage. there's a 38% lower risk of acquiring hiv in the high coverage areas. treatment as prevention works in the field if you implement. we know that scientifically. [applause] what about impact of voluntary men. if you look at the study, if you take nonmuslim population who generally don't get circumcised and increase the circumi guess up to 35% by 2011 you have a 42%

decrees in accusation of infection. what about -- [inaudible] art and tv. a very marriage between the two diseases. but look what art is doing for it it reduces it in the best way to prevent it is by treating the hiv. it's decreases it by 67%. it has the recurrent rate and reduces mortality up to 90 plus%. you're going hear a lot of models over the few days important models, models in the complex and confusing depending upon what the assumptions are. you model scale of the -- [inaudible] rather than go to complexity of the model, i want to talk now to scare you just for a minute about a very uncomplicated aspirational model.

we know now the incident is going down from 2.7 to 2.5. the slope going down. notice in the lower right, i don't have the date there. we can't talk about a at a time. -- date..

the critical question is, what is going to have been because this will not happen spontaneously. but it will require are things that secretary clinton spoke about when she introduced the possibility of november 2011 at the nih other generation. a lot of people, a lot of countries come a lot of regions have a lot to do from country ownership, capacity building, strengthening, increased commitment to current partners involving new partners, get rid of what does work and removed the legal political and stigma barriers. always done, only then will this occur. [applause] selected back to this dreaded map. i mentioned in the beginning of my talk but i have the opportunity to present at every

one of them 18 meetings. this is a ap to what i hope for her over the coming meetings of the international aids society is to be able to start to show a map that goes like this and this and this until finally we can say that we are the generation that opens the door to our scientific endeavors in our implementation to an aids free generation. thank you. [applause]

>> introduced in our present speaker, please welcome, as ben johnson, ceo of presumption and member of the helena network. [applause] >> good morning. first is a woman from the united states, and so pleased to welcome you back and graduate the list of the travel ban. [applause] but as of black women residing in washing nbc, where we face the highest rate of hiv and were black women are the epicenter of vulnerability, it is a pleasure to welcome back the call of

action. [applause] it is my pleasure to introduce for the u.s., bill wilson. bill wilson is president and ceo of the black aids institute. the black aids institute is the only national hiv/aids in the united states, focused exclusively on ending the aids pandemic in the black community by engaging in mobilizing black institution in individuals and effort to confront hiv by interpreting public and private sector policy, conducting training, providing technical assistance and disseminating hiv/aids advocacy. from a uniquely and unapologetic black perspectives. wilson previously served as the coordinator for the city of los

angeles and director of policy and planning for project los angeles and cochair of the los angeles health commission and as an appointee for the advisory committee. he has been involved in a myriad of agencies from their inception across the united states. they include the national black and leadership forum, the national task work on a, the chris riley hospice, the aids health care foundation, the national minority aids council, taubensee county color consortium, and mr. wilson has also worked very extensively across eastern western europe in sub-saharan africa, india and mexico. in 2001, phil wilson was named as changing the world recipient.

he received the discovery health channel medical honors. he has also been named as the 2005 black history makers in the making i black television. he is in newspaper writing. please welcome to the stage. thank you. [applause] [cheers and applause] >> i am both honored and humbled to share my talk with you this morning. but i'm also intimidated by one of the greatest heroes in this movement. and i'm always been a little nervous to stand between neo and one of the highlights of this conference, secretary of state, hillary clinton.

i'm thinking something between a rock and a hard place. but on behalf of the estimated 1.1 early in americans, with hiv and tens of thousands of doctors, nurses, researchers, activists and volunteers of service i work every day to end the aids epidemic in this country, welcome back to our house. [applause] 22 years is a long time and we miss you. i'm welcome to the first international aids conference, where we know that we can and in spirit or gears up to 50 users discovered right here in this country, we finally have the right combination of tools and knowledge to stop the epidemic. no, we don't have a cure for a vaccine yet, but david only had a slingshot and he killed

goliath. our tools are not perfect, but they are good enough to get the job done if, and this is a big if, if we use them efficiently, effectively, expeditiously and compassionately. and that is what i want to talk to you about is learning. i'm an openly gay and who has been living with hiv for 32 years. [cheers and applause] treatment may be prevention, but i approve their treatment as treatment. [applause] when half of the people living with hiv in this country are black and over 60% are men who have sex with man come i understand why the organizers of this meeting would invite someone like me to give this talk. you see, i am black, i'm gay,

i'm hiv positive and according to aarp, a live off the senior fund as well. [applause] it is not lost on me all the things that i am not. i am not a one-man, a straight man. i am not in asian pacific islander, latino, native american, wiser emigrant. i don't speak spanish, creole or vietnamese. , homeless or the victim of domestic violence. i don't live in the rural south and i've never even been to anchorage or bismarck. but i know this, i know that we will not in the aids epidemic in this country unless some of those phrases are included.

[cheers and applause] all of what i am and am not have to be a part of the conversation. the united states stands nine time zones and a population of over 300 billion people come and speak in three languages and 14 million american households english is not the primary language. even i think the united states has a d.c. and in some ways we do. we have great universities that generate an ashburn doral and experience and were wealthy. but even so, many of our residents live in debilitating spots with unacceptable levels of homelessness, addiction and mental health illness. we have large numbers of people with hiv's who suffer from other diseases such as hepatitis c and

ian are marginalized and stigmatized. we not only have the largest epidemic in this world, we have one of the most concentrated epidemics in the entire world. we faced gigantic challenges, es that demand we rely on lessons learned in many other countries, lessons learned to you in this room and challenges that offer the possibility for learning last-in that can be applied all over the globe. approximately 50,000 people get infected each year in the united states. that's a dramatic decrease for where we were in the mid-80s. but efforts have been stalled for at least the last 50 years. demographically or epidemic of 75% male and 25% female. estimated hiv prevalence among person range from 14% to 59%. and epidemic is 43% black, 34%

white, 19% latino, 1% asian pacific islander and 1% native american and hawaiian. 44% of the epidemic was in 12 cities, the new hiv infections are rapidly rising number of communities, especially the south. the u.s. epidemic is primarily a concentrated epidemic, but in certain populations, where generalized epidemics. for example, the backer in hiv of almost 3% and 835 new hiv infections in 20 time, the aids epidemic in washington d.c. right here is a generalized and is one that is worse than the aids epidemic. black man who has sex with men are engulfed in a page of generalized epidemic. according to a new report released by the national black

gay man, the research group and institute, black men or an elevated risk for hiv and action regardless of age. the odds that a black man will be infected increases from one in four, one and four at age 25259.3% chance by the time he reaches 40 years old. let's think about that for a minute. by the time a black gay man reaches 40 years old, nearly 60% of them, six out of 10 will be hiv positive. the aids epidemic in america is a tale of two cities. that seems to be a theme this week. it is definitely the best of times and the worst of times. we have a system that can work very well for some of last, but for many of us, the system is terribly, terribly broken. the other day, i saw to my

friend david would not in the aids foundation of chicago about his friend louise, a mexican immigrant who lived the last nine years of his life in the united states. he worked six and sometimes seven days a week of the busboy and dishwasher dishwasher at two restaurants. he pays taxes and otherwise obeys the law. he is silly and loves to dress in drag, don't we all. [laughter] his health declined rapidly and tragically in 1995 at the age of 25, luis died of complications. his friends pulled together the resources to bury him, but what follows next shot to everyone who knew him. his name was not louise. that was an alias he assumed for workpapers, social security and

medicaid. he lived the most secretive life of all. in fact, his sister who traveled from mexico to collect learned only after his death that her brother was to nine and had aids. the weise's deception helped him in other ways he could not afford, but denied him a chance to live and die in dignity. laurent stopwords is in the evidence today. he was 70 years old he was positive. there's only one mistake to become a personal reality for him. lawrence's father once he found out his son had hiv react to it by going to the bathroom and closing the door. courts eventually got link to care, found a job working in hiv. unfortunately his job didn't

offer health insurance and did not pay enough for his own treatment. said he was forced to choose between working or a stain on medication. what kind of choices that? luis and lawrence are not isolated examples. this next model first described by the university of colorado asked amazed how many people with hiv in the u.s. are engaged in the various tasks in the continuum of care from diagnosis to viral suppression. there are three things in this life does strike me most. first, 80% of hiv-positive people in the united states know their status. now we can do better, but that's not too bad. second, once we get people on antiretrovirals, allow 71% get suppression. i can't, we can do better. but the real problem is in this

middle section here. we do a terrible job of moving people to the non-antiretrovirals. train testing positive in berlin in antiretrovirals, we have is 54% of people with hiv. remember, these are people for whom we have some kind of contact. bottom line, and the richest nation on the planet, and at, and at a quarter of the people with hiv aren't fully effective treatment. more than 70% are either not on treatment at all. that is bad for them and it's bad for everyone else because when they are not, they are much, much more likely to spread the virus. we, you and i and the people in the global villages, people doing work back at home every day who couldn't afford have to change that. luckily there are people and

programs showing us how. right here in this city, the community education group, a small not-for-profit organization serves predominantly black neighborhoods offers hiv tests and a whole lot more. of the people in the sense that turn out to be positive, 95% -- 95% are confirmed to be received hiv care and treatment services. [applause] rather than giving individuals the paper referral, the immediate personal ax court if needed by financial incentives to go is provided. this new technology will conduct written assessment and the road community members to insurance programs and/or medicaid. they also provide patient

follow-up such as text messaging and indications of when they have medical appointments. something else happens here in washington d.c. it's called affordable care act, better known as obamacare. [applause] because of this law, no insurance company can deny coverage because you have a preexisting condition. jack up your raise her job because you get sick or because your care costs to match. for people with hiv and names, these provisions are absolutely life-saving. leadership matters. two years ago, president obama released the first-ever comprehensive hiv/aids strategy in the united states. according to the vision, the

united states would become a place where new hiv infections are rare and when they do occur, every person, regardless of age, gender, race or ethnicity, orientation, gender identity or social economic circumstance will have better access to high-quality, life extending care, free from stigma and discrimination. [applause] to gather, we can manifest that vision if we do the following names. first, we must fully implement the affordability care act. [applause] this will deliver health coverage to more than 30 million people who are currently uninsured. single childless adults who are typically not eligible for medicaid, a critical failure in

epidemic concentrate among low income, gay men. other than the affordable care act, ever want to have a means to pay for life-saving treatment. [applause] this most important piece of legislation over the last 40 years has generated a lot of opposition and misinformation. aids advocates must be at the forefront of opposing any effort, and the effort to roll back reforms on affordability care act. [applause] we need to be sure that the mac will benefit pass under the legislation include an annual physical for everyone, in hiv test at every physical, including a least two annual hiv test for high-risk individuals, twice a year for people living with hiv and comprehensive

coverage of arv for treatment and prevention. [applause] second, abreu one living with hiv must come out. we all have come out, living openly and proudly with hiv nathalie conference hiv stigma, but it also helps build demand for essential services. openly hiv-positive people serve as a living, reminders of the importance of knowing one's hiv status. and that is also communicating that is possible to live a full, healthy life with hiv and that's important. [applause] when you come out about your hiv status you not only save your life, but she's a mother lives

as well. my family is here in this room this morning. my brother, my dad and my mom. when i was 24, i gave my mother a book called loving someone gay. and she said today, why did she give me this book? i don't love anyone gay. yes you do i set. he loved me. and i was right. i'm alive today because i have the love and support of family and friends. [applause] that they could not support me if i denied them a chance to truly know me, not just some one-dimensional "avatar" of me, but all of me, despite the story

of our lives that are largely untold and i notice, we want our families to love us and to support as. but they cannot love us at a don't know us and they can't know us if we hide it from them. [applause] now, i am not naïve. i know it's too dangerous for a semester come out right now. but some of us can. and if we do, others will join us later. third, we need to put as much emphasis on building the treatment as we do access. our health care system has long been a source of shame. the united states is the only industrialized country that does not guarantee health coverage for citizens, but through a combination of programs such as medicaid and the care act, we actually build a robust system

of care for people living with hiv. it only about one in four people with hiv in our country are now receiving the care they need and deserve. if we demand it, they will come. health services aren't beautiful unless their use. too many people are terminated by those system. to many believe a positive hiv test is a dead ringer and too many people believe that hiv treatment requires a fistful of pills every day with horrible side effects. we need a massive investment into community education in hiv science to keep literacy. we need a army of patience, navigators that link individuals to the care they need. fourth, we need to integrate the biomedical and behavioral prevention intrude gaffers. some people continue to recess the so-called medical aids, while others promote biomedical

tools and the panacea. neither perspective is correct. these new biomedical strategies, the treatment has prevention and others still to be developed are more powerful than anything we've ever had and are too busy for. [applause] back to work, these powerful biomedical tools will need to connect with actual people. those who deliver them and those who use them. our biomedical interventions won't be good as people are frustrated by the complexity of our medical delivery service systems. and they give out. if they don't understand that adherence to the supply of measurement or if they are providers or judgment alert displays that they don't unders and what our lives are like, over the course of this epidemic, we've learned a lot about how to influence human

behavior and we need to apply these lessons as we put our new biomedical tools and to crack this. the crucial point here is that it is not an either or, they both and. the biomedical model only works with education, counseling, and behavioral change and support are all they are. the whole epidemic has shown us that while education and social and behavior intervention are necessary, they are absolutely not sufficient. if they were, the epidemic would be over already. if the addition of biomedical intervention that can lead us to the promise of ending name, we must turn this tide together. finally, the fifth thing we need to do instead is organizations need to refuel themselves to rapidly revolving aids

landscape. communities will always remain fiscal to her ability to end aids, but most of our community based organizations have focused their expertise and behavioral interventions only. if you have meaningful scientific expertise and fewer still actively delivered health care services. with biomedical tools you become a critical part of our aid response. i was affordable care act, off of the terrain for health and social services, aids organizations, risk becoming wholly irrelevant. fortunately, some visionary organizations for birdie begun to retool. as it actively works to adapt to dynamic environment, readying itself for a state advocate reforms and shifts in the nation's health care system. it began as a small organization

but today's is a federally qualified health system with 3000 patients. harlem united connects the dots between medical care and social services. eric de la torre is also here this morning. he is a health advocate or,a. social service advocate serving by building an infrastructure that connects prevention and treatment and science. eeg and vms star are three examples of what effective aids service organizations must look like if her point and the aids epidemic. i have a reoccurring dream with the little boy is a wise old woman. what did you do in millions of people were dying from aids? i always wake up before the wise old woman has a chance to

answer. i am afraid i wake up because i'm afraid of the answer. i'm afraid the answer will be not enough. idler for a tiny organization and for all i know they may close our doors next week heard that this week, this week with our 30 black advocates in our black scientists, did speak with our journalists we are going to squeeze every drop of information. [cheers and applause] my worst nightmare is that we will squander the historic opportunity. and this is what i know. the day will come in this epidemic will be over. and when it does, it is important for them to know that we were not all monsters, that we were not all powers, but some of us dare to care in the face of it. some of us dare to fight because

of it and some of us -- some of us dare to love in spite of it because it is in the care renowned fighting and the love and that we forever. this is our time. this is our deciding moment. together we are greater than a. [cheers and applause] >> now come u.s. assistant secretary for health, howard koh talks about the a's strategy would set a goal of reducing the rate of new and actions 25% by 2015. his remarks are 20 minutes. >> the next speaker is my pleasure to introduce dr. howard koh. he is the assistant secretary of health of the united states department of human and health services. a former commissioner of public health, the commonwealth of the

state of massachusetts, he has also served as a professor of medicine and associate dean at the harvard school of public health. a graduate of yellow college and medical school, he is the author of over 200 papers and the recipient of numerous awards. it was not until 2010 that the united states had its first national aids strategy introduced by president obama. this strategic plan has shaped the public held response for our country over the last two years. so now i will come dr. howard koh to address building on success, a national strategy to save lives. [applause]

>> dear friends and colleagues, i am so honored to join you this morning on behalf of the united states government to present the status of our commitment for an aids free generation. in particular, i am so pleased to review the development and implementation of the first-ever comprehensive u.s. national hiv/aids strategy, which addresses many of the domestic challenges already reviewed this conference. this strategy also incorporates lessons learned among many domestics and global partners. it was more than 30 years ago when the first hiv cases were identified in the united states. during this critical time, i was beginning my tenure as the chief

medical resident at boston city hospital. i will never forget the patience we lost and the way they suffer. since then, more than 640,000 americans have lost their lives to aids. and today, an estimated 1.1 million people are living with hiv in the united states. one in five is unaware of his or her infection. while the u.s. incidence remained relatively stable in recent years with approximately 50,000 new infections annually, this figure is unacceptably high. we also know that in the united states the burden of hiv is not shared equally by population or by region. populations most affected

include men who have back with men of all races, in particular african-americans and latino men, women of color and women, people who use drugs and young people, especially young, black men who have back with men. the regions most affected include urban areas, the north east and the south. none of this is acceptable. so many in our country have contributed to building a system of early detection that by providing linkages to watch or care leads to viral suppression. but in the united states, only one in four people living with hiv currently achieves a level of viral suppression needed to preserve health and reduce the risk of hiv transmissions to and infect partners.

national strategies are critical to affect his country leadership on hiv. national strategies outline framework for responding to hava in ways that reflect each country epidemiology, burden and trend and they demonstrate the importance of country ownership and the need to maximize efficiency and effectiveness of hiv aids programs. in 2009, president obama made it a top priority of his administration to develop a live national hava strategy. when drafting a plan, the white house office of national aids policy consulted with people living with hiv, community-based

programs, health care providers, researchers, public health asked earth than others. the white house office of national aids policy is also consulted with pepfar interviewing hiv strategies from various countries to the global north and south. pepfar has long prioritized supporting countries as they develop and implement national strategies. maximizing efficiency and effectiveness of our programs is a shared area of emphasis between pepfar and domestic hiv efforts. the following year, 2010 when president obama unveiled the national hava's strategy, he noted and i quote, the actions we take now will build upon a legacy of global leadership, national commitment and

sustained efforts on the part of americans from all parts of the country and all walks of life debt and the hiv epidemic in the united states and allow the world. [applause] this process for community dialogue continues today. the white house recently across the nation were ideas for implementation at the local level would discuss with key stakeholders. the national strategy has reinvigorated our efforts and reenergized our community under a unifying set of goals. in a short period of time, we have demonstrated progress on the national strategy of three

key goals. in particular, each of the goals is guided by strong science, solid evidence of what works best. we have the benefits of the world's leading scientists and researchers at the national institute of health. they and other researchers at the u.s. and across the world have contributed in many scientific breakthroughs that provide but the knowledge and tools that and aids. national strategies first goal is to reduce new hiv infections because after all, this is a preventable disease. by the year 2015, we seek to lower new infections by 25%. we plan to do this by reducing hiv transmission rates and increasing the percentage of people living with hiv who note the zero sadness.

to reach these targets as well as support similar global efforts to produce hiv, nih continues to confess and cutting-edge prevention research related to vaccine. and we are so pleased to see greater emphasis on the use of treatment as prevention. also, last week's approval after about a by the u.s. food and drug administration marks a milestone for preexposure prophylaxis and adds another tool to her at first you reduce incidents. as part of the national strategy, all the department of health and human services these are charged with real adding federal dollars that concentrate on both geographic areas and populations with the greatest ease.

the control and prevention apartments have high strategies in the most heavily affected populations and is promoting its recommendation that every adolescent adult get tested for hiv at least once in his or her lifetime and the increased risk get tested every once per year. for example, the center, the centers for disease control and prevention has released a new social marketing campaign called testing makes us stronger. that was designed for and in consultation with african-american gay and men, the fastest growing for hiv infection. meanwhile the department of health resources administration of 8100 publicly funded community health centers are

skilled at hiv testing of low income people leading to a 13% increase last year alone. in communities implementing more strategies. here in the nation's capital, the district of columbia, department of health takes hiv testing available at the department of motor vehicles so customers waiting in line for driver's license or other services for a free hiv tests. after 35 people are taking advantage of this resource every day. we need to continue to build on this effort and others to reach people in nontraditional settings. the second goal of the national strategy is to increase access for care and improve health outcomes for people living with

hiv in fewer than 50% retained and consistent care. currently, health resources and service administration's ryan white come hiv programs, federal government program that provides services to low-income people and publicly funded are working together to expand nationwide access care for people living with hiv. in addition, a new health care lot signed by president obama two years ago is crucial for hava and implementing the national hava strategy. [applause] thanks to the affordable care act, we are putting into place commonsense rules that prevent insurance companies from

blocking people with hiv/aids out of the market, by tapping their care or refusing to sell review these in their conditions. [applause] specifically, the preexisting condition ban will apply to all americans by january 1, 2014 and rd in effect for children. the affordable care act will soon expand access to services including making hiv aids screening available for women at no cost. [applause] and in 2014, it will extend coverage to millions more americans that will result in a dramatic expansion of coverage to people living with hiv. recently, the united states secretary of human services, kathleen sebelius announced two

important actions relevant to the national strategies second goal. first, the secretary announced nearly $80 billion in new grant awards that will expand care to an additional 14,000 low income people living with hiv and based on estimates provided by state administrators, will eliminate any waiting list for aids drug treatments. [applause] also, secretary sebelius announced that the department is working in partnership with the pilot or the grand that will use mobile phone tag needs to provide important steps and reminders about management to people living with hiv. ..

gender based violence often goes hand in hand with the disease. women and girls are all too frequently victimized by intimate partner violence and sexual assaults. this not only increases risk for acquiring hiv, it also blocks women and girls from seeking prevention options and treatments. this is unacceptable. [applause] >> so in an effort to address gender disparate, the white house recently established an interagency working group on with section of hiv aids, violence against women and girls

and gender relate health disparities. this will foster opportunities for partnership. finally, we know that stigma drives discrimination and disparity. as a result too many americans avoid finding their hiv status or disclosing their status or seeking care. our center is a campaign called "let's stop hiv together." which features people living with hiv, standing with family and friends and calling on all americans to join the fight against the disease. this national communications effort will not only address stigma associated with the infection but also complacency

about the epidemic. we must prevent the next generations from suffering the burdens we witnessed in the past in conclusion we're making important progress in the first two years of the national hiv/aids ahead strategy but much more lies ahead. we can succeed by making our international public health community even stronger. over the years the united states has been part of efforts to build that community, along with so many domestic and global partners. and in particular, -- coordinated it, planning, coordinating and collaborating to save lives. so as we go forward, let us reflect on the past but accelerate our effortsed in the

fight against hiv/aids ahead for the future. here in the united states, we believe the national hiv/aids strategy can bring us closer to a vision of a society where new infections are rare and everyone receives the care they need and deserve. you can follow our effort0s implement the strategy on aids.gov. my hope is that together, we can seize this moment of opportunity and channel its momentum towards achieving our goal of an aids-free generation. thank you very much.