AUSTIN (KXAN) — The year is 2030. HIV and AIDS have surged back, undercutting meaningful progress fighting the disease in the first three decades of the epidemic. People are dying without access to the resources they need, all because the world at large thought the virus was under control.
That’s one possible scenario Dave Barstow lays out in his new book, “HIV and AIDS in 2030: A Choice Between Two Futures.”
The Austin activist, now living in Oregon, has been helping communities in eastern and southern Africa fight the disease for the last decade and a half through his organization, EMPACT Africa. An elder in the Presbyterian Church, Barstow relies on his faith to inform his work.
What started as a mission to partner with local faith leaders to reduce the stigma around testing and treatment in the regions most affected by HIV and AIDS has morphed into one of global advocacy. The risk, he warns, is that the world becomes complacent and the global investment in fighting the virus wanes.
“The AIDS epidemic isn’t over,” Barstow said. “We really have made great progress, but somehow we have this misperception that that progress will just inevitably continue.”
Barstow spoke to KXAN via Skype from an Oregon airport Wednesday. He was flying back to Austin for a Thursday event at his former church, Westlake Hills Presbyterian Church, in which he planned to present his diverging visions for what the next decade could look like.
The progress over the last decade is tangible. The World Health Organization reports the rate of new infections in the eastern and southern parts of Africa dropped 30% between 2010 and 2017. Nearly 20 million people in those regions are living with HIV, and two-thirds of those were getting treatment in 2017. More than half of those on treatment were “virally suppressed,” meaning medications made the virus undetectable.
The number of deaths associated with the disease is down 42% in the region over the same period, but there were still 380,000 people who died from AIDS-related illnesses in 2017 alone.
“The reality is both internationally and even in the U.S., that the epidemic isn’t over,” Barstow said.
His experience has led him to three prescriptions to keep up the fight against the spread of the virus. First, he recommends continuing to partner with religious organizations and faith leaders in Africa; churches that serve as gathering places in communities can provide testing and access to treatment, he said, and are a vital piece in the ongoing battle against HIV.
Second, he’d like to see the continued reduction in the stigma associated with the disease. Barstow told KXAN in 2011 that a primary way HIV is transmitted (through sometimes-taboo sexual practices) automatically puts infected Africans at odds with their communities. Moving past the judgment means moving toward stopping the spread.
Finally, Barstow said the need for funding to fight the disease is as great as ever. The Global Fund, a collection of concerned nations sending money to fight HIV, has led to massive successes, helping save some 27 million lives through $40 billion in investments in 120 countries.
The U.S. has led the way in donating to the fund since its inception in 2002, pumping in nearly $17 billion through 2018. But the next replenishment cycle, in which the international fund asks countries to make multi-year commitments, starts this October, and it’s not clear what the U.S. will contribute.
American leadership in this arena will be key, Barstow said, in combating HIV and AIDS over the coming years.
Despite the continued challenges the world faces in dealing with the epidemic, he remains optimistic. The scenario he lays out in his new book doesn’t have to become reality, he argues, as long as governments and aid groups recognize the fight is not over.
“We know what to do,” Barstow said, “and we actually could do it. We, being the world collectively, really could pull it off. We could win the war.”