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A UN report released on Wednesday, July 18 denounces a number of new infections still too high to curb the pandemic.
Prevention deficit, lack of funding, slow progress … The number of HIV infections is still far too high. In 2017, 36.9 million people were living with HIV worldwide. And UNAIDS released an alarming report on Wednesday (July 18th). Entitled "A long way to go" the study states that "the global AIDS response is in a particularly worrying situation: the successes, certainly remarkable – but still limited – that we have saved lives and stopping new HIV infections are dangerously opening the way for some form of complacency. "Midway towards the goals to be achieved by 2020, the pace of progress is still far from being in keeping with the ambition displayed. " A statement shared by Aurélien Beaucamp, president of the badociation Aides
How do you explain this crisis of prevention?
Aurélien Beaucamp – The term may be a little strong everything depends on where you talk. When we talk about Western countries, especially France, we have never had so many opportunities to talk about prevention. There are a lot of tools: the condom, the screening, a person on treatment no longer transmits HIV because there is a drug that is effective today, the Prep. More generally we are in places where access to care is easy enough, access to prevention quite simple … The difficulty in our countries is the marginalization, the precariousness, and then all that will concern the problems related to contamination on the most vulnerable populations. I'm talking about men who have bad with other men, drug users, bad workers …
Where we're going to talk about the crisis of prevention, it's going to be for countries where we has an epidemic that has clearly exploded, this is the case of Central Africa, Eastern Europe and Central Asia where prevention does not go fast enough. Because the goal for 2020 was to put about 30 million people on treatment out of the 37 million in total, and today we arrive painfully at just over 22 million. So we took a lot of time behind the targets. And this is where the executive director of UNAIDS, speaks of "crisis of prevention" . We did not have a scale increase as large as we should have had in the objectives we set ourselves 5 years ago.
In this context, the objectives of 2020 can they be achieved?
They can not be achieved unless we have a form of acceleration this year, that is, more money. The HIV badociations around the world are coming together, and estimate that there is a need for 26 billion euros in terms of financial need to meet these goals by 2020 in the fight against HIV. But when dealing with the issue of HIV, we must also deal with the issue of tuberculosis and malaria. And there, it will take 46 billion euros. Today, we are running out of $ 7 billion, and that is the goal of the next replenishment conference of the Global Fund to Fight AIDS, Tuberculosis and Malaria to be held in Paris in 2019. This fund is one of the tools to dramatically improve the funding and effectiveness of prevention treatments around the world and in the countries that need them most. And so we hope that there will be a real acceleration, because we have to recover an additional 7 billion in total. It should therefore be between 14 and 18 billion for this period.
In the report of UNAIDS, it is stated that "the successes […] are opening dangerously the way to some form of complacency ". Do you also think that there is a form of trivialization of HIV today?
For years, when there was no treatment for HIV, there was talk of a situation of silence. And in the early 2000s, one of the slogans of the HIV badociations was to say: "Break the silence" because countries did not want to talk about HIV, were deaf hear. South Africa, which is the country where there is the most contaminations, the most people who die of AIDS. By the mid-1990s, they had 90 people on treatment for millions of infected people. Today, it is almost 10 million people infected, for 5.5 million people who live under treatment.
We are in a form of complacency today because, finally, the rich states manage to say : " So much has been given for HIV that we must stop today" and we give much more than countries with low or intermediate incomes. Except that this is not true since in recent years when we see the increase in global efforts in health, especially on the issues of HIV, malaria and tuberculosis, we realize that in low- and middle-income countries have increased much faster than in rich countries. Rich countries have remained at the same level. The idea is to say to oneself: today, it is necessary that the rich States stop with these received ideas and increase their financial contribution to mutualize them in the world fund.
There is a species of current political cynicism . Donald Trump recently said he wanted to cut HIV funding, or take that money and put it on the management of migrants crossing the border between the United States and Mexico. We arrive at completely paradoxical situations where struggles are opposed to subjects that have nothing to do with. The problem is not that we gave too much to HIV, we did the right thing, but we did not do it fast enough, and today, if we do not continue to do so the epidemic is likely to resume. Because if we do not put people under treatment, the epidemic will start again with new inflections. We went from 7 million people on treatment to more than 22 million. So it's not enough, but we still have objectives that are there.
What is the urgency today?
We have all the technical and scientific tools to put an end to HIV epidemic: screening, prevention combined with Prep. What we are lacking today is political will, leadership from national and international political leaders. And this necessarily involves funding, and the fight against discrimination of a section of the population. It can be men who have relations with other men, people who are in danger, people who use drugs … Because these people, when they are discriminated against, or even criminalized, in their country, they go to hide, they do not go not go to the screening centers or health because anyway they will be poorly received. In the figures of the UNAIDS report we can see that all the areas where we can not have an impact on the epidemic, where on the contrary the figures are exploding, are the countries where human rights are not not respected. Russia this year, for example, has become the third country where the number of untreated infected people is the largest, so that means that there is an explosion of new infections. On top of that, these people are not treated because they are hiding and often they are part of a minority. And it's the same for Central Asia.
Interview by Fanny Marlier
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