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Scientists and HIV activists believe that the AIDS-specific approach must be challenged and "make common cause with the field of global health."
HIV prevention is in crisis, particularly vulnerable populations continue to remain out of reach of the health system, and the global momentum, which has mobilized unprecedented resources and saved millions of lives, is declining. The model of the exceptionality of HIV / AIDS, which has prevailed since the beginning of the pandemic and has led to the creation of specific programs and structures, no longer responds as it should. It should give way to an approach in which the fight against the human immunodeficiency virus would be integrated into broader health programs also targeting the diseases badociated with it.
This is the conclusion reached by 47 experts involved in the response to the pandemic that has already killed more than 35 million people. After two years of work as part of a commission convened by the International AIDS Society (IAS), organizer of the International Conferences on HIV / AIDS, and the medical weekly The Lancet, [19459008theyinvitethisparadigmshift
The fruit of their work appears in a special issue of the journal published Friday, July 20. Among the signatories of the document are current IAS President Linda-Gail Bekker and her predecessor Chris Beyer, but also former UNAIDS Executive Director Peter Piot and two former Executive Directors of the Global Fund against AIDS, tuberculosis and malaria, Michel Kazatchkine and Mark Dybul, or the former president of Aides Bruno Spire
"Dangerous complacency"
The tone is clearly distinct from that of international institutions such as UNAIDS or the Global Fund, which emphasize the unquestionable progress made. The commission questions the dominant discourse in recent years centered on the prospect of ending AIDS.
According to the commission, the hype about this objective set in 2030 by the United Nations "fueled a dangerous complacency and may have precipitated the weakening of global resolve to fight HIV. " Believing that "existing HIV tools and strategies are insufficient and that dramatic progress can be made in maximizing current prevention and treatment strategies, the HIV pandemic is likely to remain a major global challenge in the near future " affirms the document of Lancet .
See also:
AIDS: the self-test, a means of "practical" screening but still poorly known
Peter Piot sees a reflection of this complacency in flattening the curve of financial resources, international and national, dedicated to fight against HIV. "We are very concerned about the world proclaiming a victory long before our fight against AIDS is over. It would be catastrophic, because we have seen epidemics rebound, for example malaria, which we had planned the elimination " he warns.
Integrated Services
Going further than the report published Wednesday July 18 by UNAIDS, which advocates combining HIV and TB prevention and care, the commission advocates for integrated services that respond to HIV and other diseases that share the transmission pathways, affect the same groups at risk and often coexist in patients. Such an offer would include badual and reproductive health, tuberculosis, viral hepatitis, drug addiction and mental disorders, "says Chris Beyer
See also Professor Patrick Yeni's presentation:
"We need to rethink the fight against HIV overseas"
It could also be extended to chronic diseases such as diabetes and high blood pressure (hypertension). The commission's modeling illustrates the positive cost-effectiveness of such an approach to HIV: for example, the integrated offer combining HIV, diabetes and hypertension testing over ten years would prevent 69,000 infections. in South Africa and 216,000 in Kenya. "There has never been a blood pressure campaign in my country" Nduku Kilonzo of the Kenya National AIDS Control Council, who is one of the signatories of the document of the commission. The debate is launched.
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