HIV/Aids gaining ground as govts drop their guard
- Author:
- The Nation
What are the key findings?
The report finds that the world must drastically accelerate Aids efforts or face more HIV infections and deaths than five years ago, and there are four reasons behind this:
1. People and governments are becoming complacent
We are extremely concerned about global complacency and the rhetoric that the end of Aids is in sight. The truth is that there's a resurgence of new infections. If the current rate of new HIV infections continues, merely sustaining the major efforts we already have in place will not be enough to stop Aids increasing within five years in many countries.
There are more than two million new HIV infections per year and around 1.5 million people die from Aids every year. Just sustaining already significant Aids efforts will not suffice, as new infections and deaths will increase simply because the global population is growing. Countries which previously had great success in reducing HIV infections have gone backwards. In Uganda, for example, after a decade of new HIV infections falling, HIV infections have risen, in part because its population has increased enormously and there's been less focus on HIV prevention.
2. Get serious about HIV prevention
Far more needs to be done to prevent HIV infections. On this front, many countries have dropped the ball. There's been huge focus on treatment and not enough on prevention. Expanding sustainable access to treatment is essential, but we will not treat ourselves out of the Aids epidemic.
3. More funding is essential
Middle income countries have the capacity to pay for treatment and prevention programmes, but low-income countries with a high HIV burden do not have the funds. Just sustaining current HIV treatment and prevention efforts requires up to 2 per cent of GDP, and at least a third of total government health expenditure. As many low-income countries can't afford this, there's an urgent need for substantial global solidarity. The more people we get on board, the better.
4. Stigma is preventing progress
We still live in an age where stigma devastates open communication about HIV/Aids - it's one of the biggest challenges to tackling infection rates in some countries.
What's key to reducing HIV infections?
Over the next five years we need an increase in resources, and a more strategic and efficient use of those resources. We need to ensure that affordable treatment remains accessible in low-income countries. HIV programmes have a maximum effect when tailored to the needs and contexts of populations at higher risk and in regions with high levels of HIV infections. Such policies have been very successful in countries such as Kenya, but key to doing this successfully is having resources and the right strategy.
Currently, around US$16 billion to $18 billion goes into treatment and prevention programmes globally. Far more investment is needed. The Global Fund to fight Aids must be replenished next year; otherwise, doing more will be impossible.
Will we see a surge in global funds in a year's time?
At the moment, it's hard to tell. But it will be an indication of whether tackling HIV/Aids is still on the global agenda.
What has the response to the report been like?
This report, we hope, will be the turning point in the global Aids response. Change won't happen overnight, but positive discussions are happening. For example, since the report was published last month, officials and commissioners held a discussion about the report's findings in the Caribbean, the second most affected HIV region in the world.
Now, what we urgently need is for governments, policymakers, activists, civil society representatives and the private sector to come together, raise awareness and increase funding. More must be done, or we will pay with lives.
Professor Peter Piot is director of the London School of Hygiene and Tropical Medicine and also chairs the MRC Global Health Group and was the founding executive director of UNAIDS.
