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Is a complete end of the epidemic possible? The experts of these days are discussing it in Paris. The goal is ambitious, but achievable in principle.
Nowadays, experts at the World AIDS Conference discuss a goal that seemed unimaginable in the twentieth century: the end of the ancient AIDS horror disease. How this can be achieved is explained by four answers
What are the plans to end the disease?
The turning point of the millennium marked a turning point: for the first time, the global curve of HIV infections flattened out and then gradually declined. Driven by this success, UN member countries have agreed to defeat the immunodeficiency disease by 2030. In fact, it is not about the complete eradication of the virus. The project of the authoritative authority Unaids is rather in the practical formula 95-95-95. This means that by 2030, about 95 percent of all infected people should know about their infection. Of these, 95 per cent should receive drugs, which, in turn, 95 per cent, hopefully will work so that those who suffer from them are not sick and do not transmit pathogens. Extrapolated, this means that 86% of all people infected with HIV are treated optimally. New infections are not excluded in this future scenario. However, they should not exceed 200,000 per year.
How can these objectives be achieved?
Currently, the global community is still struggling to reach the first milestone set for 2020, based on the 90-90-90 formula has been brought. The biggest role comes from antiretroviral drugs. By these means, infected people not only have an almost average life expectancy, but also drastically reduce their risk of infecting others. In the plans developed by Unaids, 60% of the infections avoided come back to these drugs. Nevertheless, other measures retain their validity. Because AIDS shows different facets in many parts of the world. In many states of southern Africa, the disease affects the general population; It is not uncommon for mothers to infect their babies. In Eastern Europe, especially addicts who share needles are infected. Prostitutes are a high-risk group in almost every region of the world: in Western Europe and the United States, homobadual men in particular are at risk of changing partners. The procedure must be adapted accordingly – better pregnancy care to needle exchange programs.
Where is the world now?
Experts suggest that targets will be missed by 2020. Instead of 90-90-90, the values are currently 75-79-81. Germany has not yet reached the desired mark. For the year 2016 the balance was: 86-86-93
What role does the preparation play?
Pre-exposure prophylaxis (prep), which according to the wishes of Health Minister Jens Spahn must also be paid in Germany, is effective safety. Prep is something like the pill to take in people who are not yet infected. If they do it regularly, they are 90% protected against HIV infection. However, it has been shown in previous studies that the tablet has been forgotten again and again. The protective effect has therefore been partially reduced to less than 50%. The preparation is also expensive compared to other retirement options. It is not, like the usual vaccinations, recommended nationwide, but is intended only for people at high risk of infection. The success of the strategy therefore depends on the timely identification and persuasion of vulnerable people. Since drug prevention is a relatively new instrument of AIDS control, it does not play a major role in previous strategies.
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