Ending HIV as an epidemic by 2030 isn’t just an EU target, it’s about unleashing potential. The potential of people impacted by the disease to live full, vibrant and free lives. And the potential of bold and transformative science to deliver medicines that finally end HIV. That’s where Dr. Jared Baeten comes in.
As vice president of clinical research at Gilead Sciences, he leads the company’s strategy for HIV treatment and prevention. He spoke to POLITICO Studio about the search for solutions and the state of the fight against HIV in Europe during COVID-19 as part of our Telescope series, The New AIDS Epidemic.
Q. HIV in Europe has come a long way since the 1980s when being HIV positive was considered a death sentence. Now, it’s a manageable condition. What lessons should we take from success stories, particularly in Europe?
A. Success emanates from places where testing, treatment and prevention are all accessible. Where communities are engaged. And where political leaders become vocal advocates.
One great example is the European cities taking part in the Fast-Track Cities initiative, a global partnership aimed at achieving 90 percent of people with HIV diagnosed, 90 percent of diagnosed people on antiretroviral treatment (ARTs), and 90 percent of ART-treated people virally suppressed around the world.
Cities like Amsterdam have exceeded their targets, now catapulting to 95-95-95 goals. In France, cities like Montpellier have seen a substantial reduction in new HIV infections. For European leaders, the success of this initiative is a tremendous opportunity to learn best approaches from each other so that no city or country gets left behind.
Q. Due to the great progress in HIV treatment, complacency around the urgency of elimination has become an issue. HIV activism has suffered as a result. How can we bring the fight back to public consciousness?
A. The goal has always been to keep working hard enough so that we don’t have to fight anymore. The challenge is that we’ve done so well the end is actually in sight. But we aren’t there yet and can’t let up on the gas before we reach that horizon. We’ve got to double-down on community and political engagement. Entertainment can be hugely influential here.
Since the BBC aired the drama, “It’s a Sin” about the bad old days of AIDs in the 1980s, testing is up three times in the UK as of February compared to previous years. That’s entertainment that sparks real consciousness. It should also pique the attention of European policymakers and politicos.
Q. You’ve advocated for a person-centric approach to HIV treatment. What does this mean exactly?
A. It’s about empowering people to make choices about the treatment or prevention, options that are best for them — that reflect their needs, realities and capacities. Giving people options lets them make choices, which leads to greater commitment to therapies and better outcomes.
It’s a lot like contraception. The more options that are available, the better women are able to make the choices that are right for them. We should want the same freedom for people living with or at risk for HIV.
Q. Will an HIV vaccine ever emerge?
A. Developing an HIV vaccine is a tremendous scientific challenge that has confronted us for over four decades now. While we’re clearly not there yet, the world is realizing the benefits of this investment. It’s directly because of HIV vaccine research that we now have a COVID-19 vaccine — the COVID work built directly on the investment in the technologies and innovations developed for HIV work. This clearly shows how research and development investments now, in one area, can pay off in multiple ways later, and why continuous innovation is absolutely necessary.
Q. Forty years into the HIV epidemic, AIDS remains the leading cause of death for women of reproductive age worldwide. As a leading researcher on women and HIV prevention, why have women been left behind?
A. Stigma and discrimination keep women from effective prevention. The condom is the man’s choice. Taking treatment is the man’s choice. Thus, bringing prevention choices into women’s hands that are person-centric has been the driver of my whole research career.
Six thousand women acquire HIV every week around the world. In the European region specifically, 50,000 women acquire HIV each year. It’s time to end the silence about sexual health and empower women with choices to protect themselves.
Q. COVID-19 threatens to roll back decades of progress in the fight against HIV. What should policymakers do to unite the fight against HIV and COVID-19?
A. In one year, COVID has highlighted everything we’ve learned in four decades fighting HIV. It’s shown that we’re all connected. That no one is safe until everyone is safe. And the ones that are most at-risk are often the most vulnerable. Both diseases track the fault lines in our society. But they also both reveal the power of science and public engagement to solve global health crises.
We can learn from COVID how to end HIV faster. COVID has certainly proven that we can provide health care more flexibly. With digital tools and other person-centric adjustments, people have received services outside of clinics with more convenience and less fear of stigma or discrimination. We need to carry forward and expand that flexibility and focus on people in care for HIV treatment and prevention — it’s really an opportunity for breakthroughs to accelerate our progress.
Q. You’ve worked with Dr. Fauci, known as America’s doctor for COVID-19, but whose real claim to medical fame is with HIV. What have you learned from Dr. Fauci as an advocate and as a researcher?
A. I learned from Dr. Fauci to lead with science. To be clear and compassionate in my communication. To listen to communities. And especially to partner. Because ending AIDs by 2030 can’t be done by any one organization or government alone. We all need to play our part. At Gilead, we’re committed to doing ours.
Q. What motivates you to keep up the fight?
A. Working to end the epidemic has always been very personal to me. The work I do is driven by a strong sense of justice, equity and wanting the best health care for everyone, everywhere. Like Dr. Fauci, I’m an advocate as much as I am a scientist. I hope one day that I’ll be out of a job because it’s a disease we battled with, and finally triumphed over.
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