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Monday, November 26, 2012

AIDS Free Africa is Possible

An estimated 34.2 million people around the world are infected with the virus that causes AIDS, H.I.V. The scary part, what is disconcerting is that 23.5 million or 70% of those suffering from AIDS live in my part of the world, sub-Saharan Africa.

There is no prospect that scientists will find, any time soon, a vaccine that will prevent infection with the AIDS virus or a cure for our brothers and sisters, mothers and fathers, uncles and aunts, husbands and wives, friends and neighbors already infected with the virus.

But today our spirits must continue to soar. Our collective will must be indomitable. Our embrace of the gift of life has never been stronger. The vision of attaining zero new HIV infections and zero AID-related deaths remains the collective resolve of all of us.

It is possible that in the not too distant future, no African child would be born with the AIDS virus. I have a dream that one day millions of African teenagers and young adults, heterosexual and homosexual, would have a very low risk of becoming infected and those who do would have access to affordable treatment.  Achieving an AIDS-free Africa is truly imminent. We can and we must get there.

Here is why we will get there. Historic success in scaling up HIV programmes, combined with the emergence of powerful new tools to prevent new infections and AIDS-related morbidity and mortality has enabled the foundation to be laid for zero new HIV infections.  We are beginning to reap the benefits many years of concerted work and multiple strategies: behavior change campaigns; promotion and use of condoms; medical male circumcision; access to antiretroviral therapy; and, focused programs targeting sex works, gay or straight. 

According to the just released UNAIDS report on the global AIDS epidemic, new infection rates have fallen by 50% or more in 25 countries – 13 of them in in sub-Saharan Africa. Moreover, the number of people dying from AIDS-related causes in sub-Saharan Africa declined by 32% from 2005 to 2011. What is most heartening is that half of all the reductions in HIV infections in the past two years have been among children. The scaling up of antiretroviral therapy has saved 14 million life-years in low-middle-income countries, including 9 million in sub-Saharan Africa since 1995. The pace of progress has accelerated. In just two years, 60% more people have accessed lifesaving HIV therapy, with a corresponding drop in mortality.

In what has been billed as a scientific breakthrough, scientists have shown that antiretroviral therapy reduced the risk of heterosexual transmission by 96%. Today treatment as prevention (TASP) is a term used to describe prevention methods using antiretroviral treatment. An HIV-positive person’s viral load is the single biggest risk factor in HIV transmission. Antiretroviral therapy decreases the amount of virus in a person’s bodily fluids, significantly reducing the risk of transmission.
Circumcision substantially decreases a man’s risk of becoming infected with the AIDS virus by a female partner, cutting infection rates by 40 to 60 percent. In Kenya medical male circumcision in Kenya is focused on Nyanza Province. 54% of the targeted 230 000 male circumcisions have been performed as of December 2011. As a medical procedure circumcision is simple. A nurse can perform it safely and it can be done in assembly-line fashion using devices that do not require scalpels and stitches.
Although progress is heartening, the war against AIDS is yet to won. The sharp reduction of AIDS in Uganda was hailed as a stellar success reduction, providing a new impetus and inspiring novel public health strategies to fight disease in the developing world. Today, Uganda is one of only two African countries, along with Chad, where AIDS rates are on the rise. Infection rates in Uganda have increased to 7.3 percent today from 6.4 percent in 2005. Furthermore, Uganda is one of in six sub-Saharan African countries where less than 5% of the target number of men had been circumcised by 2011.

According to the UNAIDS report on the global AIDS epidemic, HIV affect more women and girls across sub-Saharan Africa. It is estimated that women represent about 58% of people living with HIV.  More significantly, because of social and economic power imbalances between men and women, a majority of girls and women and girls have little capacity to negotiate sex, insist on condom use or otherwise take steps to protect themselves from HIV.

The UNAIDS report on the global AIDS epidemic provides specific recommendations critical to the goal of zero new infections: provide HIV testing, counseling; ensure timely HIV care, treatment and support for women an children living with HIV; strengthen safe sex behavior to ensure that reproductive-age women and their partners avoid HIV infection. 

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