“‘Getting to Zero’ has been the slogan for World AIDS Day (Dec. 1) since 2011 and will remain so through until 2015, coinciding with the Millennium Development Goal target of halting and beginning to reverse the spread of HIV/AIDS,” Francoise Barre-Sinoussi, director of the Regulation of Retroviral Infections Unit at the Institut Pasteur in Paris, and Adeeba Kamarulzaman, director of the Center of Excellence for Research in AIDS and dean of the Faculty of Medicine at University of Malaya in Kuala Lumpur, write in a New York Times opinion piece. “This offers a starting point for some more sanguine reflection on how, amid generalized talk of zeros, targets and goals, we can so easily lose sight of the extraordinary barriers that prevent them being reached in the first place,” they continue.

“Stigma and discrimination have always been the main drivers of HIV/AIDS,” the authors write, adding, “It has been a combination of community activism, evidence-based policy programming, political courage and scientific developments based on the three pillars of prevention, treatment and care that has successfully tackled those barriers.” They highlight the need to provide improved access to care and treatment for injection drug users, sex workers, gay men, and pregnant women. They add, “Yes, we do have the science to eventually get to zero and end AIDS but the road is full of barriers, bolstered by the stigma of marginalized groups.” In addition, “[m]ore than ever, we need a fourth pillar: an HIV cure,” Barre-Sinoussi and Kamarulzaman write. “We still have some way to go to completing the cure puzzle, but some of the pieces are ever so slowly beginning to fall into place,” they write, concluding, “Some 15 trials on HIV cure-related research are currently taking place, the results of which over the coming years will help to inform us if we are on the right track towards getting to zero and ending AIDS” (11/19).