2012 was a year when political leaders and top health officials freely spoke of attaining an AIDS-free generation. In November, Secretary of State Hillary Clinton unveiled a blueprint for achieving that goal.

Secretary Clinton said not long ago it would have been impossible to speak of an AIDS-free generation.

“Now by an AIDS-free generation, I mean one where, first, virtually no children are born with the virus. Second, as these children become teenagers and adults they are at far lower risk of becoming infected than they would be today, thanks to a wide range of prevention tools. And third, if they do acquire HIV, they have access to treatment that helps prevent them from developing AIDS and passing the virus on to others,” she said.

Mrs. Clinton made the comment in a speech at the National Institutes of Health. She said that HIV may be with us well into the future, but the disease that it causes need not be.”

“Now, while the finish line is not yet in sight we know we can get there because now we know the route we need to take. It requires all of us to put a variety of scientifically proven prevention tools to work in concert with each other,” she said.

Those tools include effective treatment, male circumcision, eliminating stigma and discrimination and preventing mother-to-child transmission of HIV. It’s a combination approach to stopping the spread of HIV.

Mitchell Warren, head of the AIDS advocacy group AVAC, applauds the U.S. blueprint for an AIDS-free generation.

“That was by far the culmination of a great year. That blueprint, which she put out, really recommits the U.S. government to a bold agenda to both provide both direct support for treatment and for prevention around the world. It also throws down the challenge to countries all over the world to really step it up and join the U.S. government in this commitment,” he said.

But Warren said bold speeches must be followed by bold actions.

“2012 will certainly be remembered as the year when the conversation changed. The big question is will we see movement beyond just the conversation,” he said.

Warren said besides outlining the immediate needs in fighting the epidemic, Mrs. Clinton’s address also highlighted the importance of scientific research.

“The same research that got us to this point is just as important going forward, particularly around the search for a microbicide and the search for a vaccine and eventually a cure,” he said.

In the last few years there’s been promising research in both vaccines and microbicides. However, follow-up studies are not expected to provide any findings until 2014 or later.

“So it’s a longer term trajectory, a longer horizon, but the science is as exciting as it’s ever been in AIDS vaccines. And certainly we need to keep pushing for that longer term solution even as we deliver on the tools that we have today,” said warren.

Dr. Anthony Fauci is one of the top U.S. scientists working on HIV/AIDS. He’s head of the National Institute of Allergy and Infectious Diseases.  At July’s International AIDS Conference in Washington, he said learning how HIV replicates revealed some of its weaknesses.

“It’s that kind of basic science which brings us to the next step. And that is the step of interventions, predominantly in the arena of treatment and prevention,” he said.

Dr. Fauci called for a “care continuum…That is seeking out, testing, linking to care, treating when eligible and making sure they adhere.”

AVAC’s Mitchell Warren said the international AIDS conference held much promise. But 2013 will determine whether it’s a promise fulfilled.

“If in mid-2013 or World AIDS Day 2013, we look back and say, wow, that conference told us it was possible and we blew it—we blew the opportunity of changing the way we did our work—then it will have been an enormous failure. 2013 needs to be the year that we really transition from rhetoric to reality. . 2013 needs to be the year that we really transition from rhetoric to reality,” he said.

As the New Year begins, an unwelcome realty will be continued tight international spending, as many advocates hope to gear up research, treatment and prevention.

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Joe DeCapua