Anthony Fauci has hailed Australia’s success in virtually eradicating HIV in inner Sydney

Top US medical advisor Anthony Fauci says Australia has shown the virus can be effectively stamped out in areas with large gay populations, providing a powerful incentive to the world.

Dr. Anthony Fauci, now a distinguished professor at Georgetown University, says an HIV cure is on the horizon.

Top US medical advisor Anthony Fauci says Australia has demonstrated “proof of concept” that HIV can be eradicated, with the pockets of inner Sydney with large gay populations that have effectively stamped out the virus providing a powerful incentive to the world.

“It shows it can be done,” Dr Fauci told The Australian. “I think Australia as a nation and Sydney as a city should be congratulated on doing that, because once you prove a concept, it becomes an incentive.”

Dr Fauci, the chief medical advisor to seven US presidents who now holds the post of Distinguished Professor in the School of Medicine Georgetown University in Washington DC, has joined the International AIDS Society conference in Brisbane this week and spoken of his hopes for an HIV cure.

As the long-time director of the US’s National Institute of Allergy and Infectious Diseases and an immunologist, Dr Fauci has made major contributions to HIV research during his 50-plus years at the apex of public health.

He said he believes cancer immunotherapy drugs combined with a vaccine hold the best chance of providing a cure for HIV, saying “the science is looking promising”. But he’s not sure if it will be in his lifetime and is reluctant to put a timeframe on the venture.

“I think having been through this with my colleagues throughout the world including in Australia, it really is in many respects folly to make a time prediction,” Dr Fauci said. “

We’re making very important advances forward but we’re not there yet. We don’t know when or if we’re going to get there, but the science is looking promising.”

The IAS launched the Towards an HIV Cure program in 2011. At the time, Australian doctor Sharon Lewin, a pioneer and world expert in HIV research, said interventions that lead to a meaningful cure were “at least decades away”. Dr Lewin, now the president of the IAS, has said monoclonal antibody therapies were showing a lot of promise in HIV.

But in the meantime, it looks likely that many cities around the world will have effectively eradicated HIV by the time a cure comes to pass.

Research released by the Kirby Institute this week showed diagnoses of HIV in NSW had fallen 56 per cent over the past decade, similar to national trends, and inner-city Sydney from Potts Point to Marrickville, where more than 20 per cent of men are gay and bisexual, has had an 88 per cent decline in the number of HIV diagnoses from 2010 to 2022.

That means those areas have virtually met the international definition of having ended AIDS as a public health threat.

“It is very, very clear that you can suppress the virus to such a low level that the person who is being treated has actually essentially almost a normal life expectancy if treated early enough,” Dr Fauci said. “And the secondary effect is that is it’s impossible for that person to transmit the virus to somebody else. That’s not a cure but it’s a highly effective therapy.”

Scientists put the dramatic reduction in spread of HIV in parts of Sydney down to very high rates of testing, treatment and preventive measures. Ninety per cent of high-risk gay men in NSW were tested in the past 12 months and 80 per cent used PrEP.

Globally, HIV incidence has fallen by 38 per cent. Declines of about 50 per cent or more have been documented in the Netherlands, UK, Singapore and parts of the US, including New York and San Francisco. Zimbabwe, Nepal, Rwanda Eritrea, Lesotho, Eswatini and Malawi have had a greater than 70 per cent decline.