In commemoration of Dec. 1, World AIDS Day, here are five things the United States can do to help usher in the administration’s goal of creating an AIDS-free generation:

1. Issue a global challenge to join the United States in creating an AIDS-free generation. At the beginning of 2011, 34 million people around the world were living with HIV. In 2010, 1.8 million people died of AIDS-related causes, and 2.7 million were newly infected with HIV. Currently, more than 6.5 million people have access to effective antiretroviral therapy (ART), but this represents less than 50 percent of the more than 14 million people who need it. The majority of people affected by the AIDS epidemic worldwide are women, poor people, and people of color, and the disease continues to follow other faultlines of social inequality. Both in the U.S. and internationally, marginalized communities such as gay and bisexual men and other men who have sex with men (MSM), as well as transgender women, bear a vastly disproportionate burden of the epidemic.

2. Invest in high-impact AIDS prevention strategies, including treatment as prevention. HIV is a preventable disease. Over the last decade increased access to appropriate HIV prevention mechanisms, including condoms, treatment for pregnant women that prevents mother-to-child transmission of HIV, and voluntary male circumcision, have resulted in a 15 percent reduction in new infections worldwide. New scientific breakthroughs in antiretroviral therapy have also demonstrated that ART not only improves the health and well-being of people with HIV – it also stops further HIV transmission. Simply put, treatment is prevention: we now know that treating a person living with HIV reduces the risk of transmission to a heterosexual partner by 96 percent.

3. Commit to defending, optimizing, and increasing PEPFAR funding to reach a U.S. treatment target of 6 million by 2013. In 2008, the U.S. recommitted to its leadership in ending the global AIDS epidemic by setting aside up to $48 billion over five years to fund the President’s Emergency Fund for HIV/AIDS Relief (PEPFAR). These funds directly support ART for more than 3.2 million people and care and support for 11 million, including 3.8 million vulnerable children, in more than 30 countries. In the current deficit-focused U.S. fiscal climate, we cannot fail in our commitment to finding the resources needed to continue existing treatment, care, and prevention efforts and to expand these services to everyone who needs them. Read more

President Obama challenged the world to usher in an AIDS-free generation during a panel discussion in George Washington University this morning to commemorate World AIDS Day, and announced that the administration is committing an addition $50 million in increased funding for domestic HIV/AIDS treatment and care: $15 million for the Ryan White program that supports care provided by HIV medical clinics across the country and $35 million for state AIDS Drug Assistance Programs. Obama also set a new target of helping six million Americans obtain access to HIV treatment by the end of 2013.

Citing the success of the President’s Emergency Plan for AIDS Relief program in providing anti-retroviral (ARV) treatment to people living with HIV/AIDS around the world, Obama admitted that new infections are still increasing in the United States and specifically identified the LGBT community:

The infection rate here has been holding steady for over a decade. There are communities in this country being devastated by this disease. When new infections among young, black, gay men increase by nearly fifty percent in three years, we need to do more to show them that their lives matter. When Latinos are dying sooner than other groups; when black women feel forgotten even though they account for most of the new cases among women, we need to do more. This fight isn’t over. Not for the 1.2 million Americans who are living with HIV right now. [...]

Now, I want to be clear about something else – since taking office, we’ve increased overall funding to combat HIV/AIDS to record levels. With bipartisan support, we reauthorized the Ryan White CARE Act. And, as I signed that bill, I was so proud to also announce that my Administration was ending the ban that prohibited people with HIV from entering America. Because of that step, next year, for the first time in two decades, we will host the International AIDS conference. So we’ve done a lot over the past three years. But we can do more.

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Indeed, in the United States, medical progress now ensures that HIV/AIDS is no longer a death sentence, but only for those who can access good medical care. The Centers for Disease Control and Prevention reports that almost three out of four Americans with HIV are not receiving enough medicine or regular health care “to stay healthy or prevent themselves from transmitting the virus to others.” Out of the 1.2 million Americans with HIV, 850,000 aren’t receiving regular treatment to keep the virus at a low enough level to prevent transmission or hurt their own health and 240,000 Americans don’t even know they’re infected with HIV.

Next year, “the CDC will require 75% of about $359 million in annual HIV prevention grants to state and local health departments to go toward programs that get more people tested and into regular care.” It is also spearheading a $2.4 million campaign “to promote testing among black gay and bisexual men, who account for 22 percent of new infections.”

Earlier this month, Secretary of State Hillary Clinton called on the United States and its allies to scale up their funding for HIV/AIDS prevention and treatment to “change the course of this pandemic and usher in an AIDS-free generation.” “No institution in the world has done more than the United States government,” Clinton said, praising President Bush’s Emergency Plan for AIDS Relief (PEPFAR) for providing anti-retroviral (ARV) treatment to people living with HIV/AIDS around the world. She called PEPFAR “one of the strong platforms upon which the Obama administration is building our global health initiative.”

But new analysis published Tuesday on the Health Affairs blog from Matthew Kavanagh and Marguerite Thorp suggests that “funding to AIDS treatment has actually fallen significantly since 2008 in both absolute dollars and as a portion of total budgets—just at a pivotal moment when investment could change the course of the epidemic”:

Taking advantage of decreasing treatment costs (as discussed more fully below), PEPFAR is continuing to enroll new people on ARVs—expanding support to reach 3.2 million people as of last year. Yet, enacting Clinton’s policy directive will require ARV access to expand much faster. In this context, reversing the decline in investments in treatment is critical—last year alone the funding could have paid for ARV access for nearly half a million more people.

Look:

According to AVERT — an international HIV and AIDS charity — funding for PEPFAR from 2009-2010, “was effectively flat-lined in contrast to the much higher previous year-on-year increases in funding, especially from 2006-2009.” “President Obama’s proposed 2011 budget included almost $7 billion for PEPFAR, representing a 1.8 percent increase on the previous year. However, according to some activists this slight increase actually represents a ‘step backwards’ due to inflation and increasing demand for treatment.” The FY2011 budget “included a 5 percent ($50 million) decrease in funding to the Global Fund compared to the previous year.”

Kavanaugh and Thorp note that new studies are showing that providing anti-retroviral (ARV) treatment could “dramatically” lower viral load and transmission rates, allowing populations to “begin to control and ultimately end the AIDS pandemic.”

Medical progress now ensures that HIV/AIDS is no longer a death sentence, but only for those who can access good medical care. The Centers for Disease Control and Prevention reports that almost three out of four Americans with HIV are not receiving enough medicine or regular health care “to stay healthy or prevent themselves from transmitting the virus to others.” Out of the 1.2 million people in the U.S. have HIV, 850,000 aren’t receiving regular treatment to keep the virus at a low enough level to prevent transmission or hurt their own health and 240,000 Americans don’t even know they’re infected with HIV.

For some, medical treatment is hard to come by. A Williams Institute study found that 5 percent of dentists in Los Angeles refused services to those with HIV/AIDs, a rate that is “lower than that of other health care providers. Over the past decade, “55% of obstetricians, 46% of skilled nursing facilities, and 25% of plastic surgeons” in L.A. “had policies that specifically discriminated against people living with HIV or AIDS.” Successful treatment rates “were lowest in blacks and women,” according to CDC director Dr. Thomas Frieden.

Data provided by The Williams Institute.