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Health and Fitness

An Epidemic of Hope

The U.S. Military's War on HIV

Many underdeveloped countries in Africa, South America and Asia are still experiencing a crisis when it comes to preventing and treating HIV/AIDS. As of 2015, about 36.7 million people are living with HIV, and most of those infected live in sub-Saharan Africa. Of that number, an estimated 1.8 million infected are children, who contracted the virus during pregnancy, childbirth or breastfeeding.

"In some sects, actually, they still don't believe the virus exists," said Lt. Dahunsi Seun, a surgeon in the Nigerian navy, speaking about why HIV/AIDS continues to devastate his home country of Nigeria.

Nigeria, like many other countries scourged by the virus, is an ally of the United States. The U.S military regularly conducts training operations with its counterparts in the region so the HIV/AIDS outbreak remains a concern to service members working there.

In 2000, the U.S. Department of Defense stepped in, creating a program to help foreign militaries with HIV/AIDS treatment and prevention. This not only strengthens local forces, it also makes it safer for the U.S. military to partner with them overseas.

There were militaries 10 years ago who had a tough time putting together operational units that were complete and healthy enough, and that was due to the fact that many of their service members were infected with HIV and becoming ill because they weren't on treatment," said Dr. Richard Shaffer, the director of the DOD HIV/AIDS Prevention Program (DHAPP).

The program is spearheaded by the U.S. Navy, a fact that makes Shaffer, a former Navy infectious disease specialist who has been with DHAPP since its inception, especially pleased.

"I'm very proud that this was something the Navy was immediately identified to do, and done a very good job with," he said. "It gave the Navy an opportunity to shine across the entire U.S. military and show them that we can coordinate DOD-wide activities, as well as get involved in international security cooperation."

The program has grown significantly in both the size and scope of its operations, and now supports militaries in 62 different countries. With a staff of 100 at its headquarters at the Naval Health Research Center in San Diego, and 60 personnel attached at embassies around the world, the DHAPP helps some 6 million foreign military members and their dependents prevent and treat the disease. In 2013 alone, DHAPP trained 7,000 healthcare workers, tested 630,000 military members and their families, and equipped and supported 200 new laboratories around the globe.

While much of DHAPP's mission includes travel to these countries and direct, on-the-ground support, it also brings foreign doctors to California for the Military International HIV Training Program (MIHTP), an annual "mini-residency" course hosted at Naval Medical Center San Diego. MIHTP invites 10 to 12 physicians from allied nations' militaries, and focuses on sharing knowledge about how to care for, treat and prevent HIV in a military setting.

"We are learning in an environment which is totally different to ours," said Maj. Florent Rutagarama, a pediatrician with the Rwandan Defense Forces who attended the MIHTP course in February. "We're exposed to new technologies, learning new updates, and we look forward to using the skills we're learning from here. It's a very good program."

"It's not a one-way relationship" either, added Capt. Mary Bavaro, a physician on the infectious disease staff at NMCSD who helps teach the course. "We learn from them, they learn from us, and I think it better prepares everyone involved."

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During the month-long program, foreign doctors spend time working alongside their U.S. Navy counterparts, treating real Sailors with HIV. They also share knowledge about the virus in laboratory, classroom and medical settings. Because these doctors are often members of militaries with many more cases of HIV, they're usually very knowledgeable. In fact, Bavaro explained that in many cases they bring more experience to the table than their American colleagues.

While combatting HIV/AIDS remains at the forefront of DHAPP's mission, programs like MIHTP serve a dual purpose and strengthen ties between the U.S. and its allies. As Shaffer explained, oftentimes the best way to build partnerships overseas is at the military level - working together to solve common problems and sharing knowledge.

He said the program has done just that. It has built long-lasting relationships between the U.S. and other nations. It has even helped open lines of communication to countries with historically frosty views of the U.S., such as Vietnam.

Many of the doctors participating MIHTP said they agreed, and were grateful for the accord the program has helped to foster.

"I do have to thank the U.S. Navy about this partnership," said Maj. Vincent Sugira, a physician with the Rwandan Defense Forces. "Back home, we'll still be working with the doctors and the researchers here, and sharing information with them."

In fact, the program is so beneficial that Shaffer said more than 20 militaries DHAPP has partnered with no longer need American help to operate their HIV control programs.

Overall victory in the global war on HIV/AIDS is further away, Shaffer said, but he's hopeful. He's very, very hopeful.

"What victory looks like to us is the first generation that will be disease-free," said Shaffer. "The expectation is that that's not decades away - that's just years away."