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Africa has made great strides in reducing HIV infection rates and their impacts, but trends are uneven across the continent and around the world. This is worrying, progress in the fight against HIV / AIDS has slowed, according to an annual report from UNAIDS.
"We urgently need more political leadership to end AIDS," said Gunilla Carlsson, executive director of UNAIDS. "It starts with a wise and judicious investment, then an badysis of the success factors of certain countries. Ending AIDS is possible if we focus on people, not on diseases, create roadmaps for people and places left behind, and take a human rights-based approach to reaching those most affected by HIV / AIDS. HIV. "
South Africa, where new HIV infections have been reduced by more than 40%, and AIDS-related deaths, have declined significantly since 2010.
"We used to bury people every Saturday," said Babongile Luhlongwane, a community health worker in Eshowe, quoted in the new report "Communities in the Center." The report was launched at a community event in Eshowe by Carlsson and David Mabuza, vice president of South Africa.
"South Africa has a rich history of communities at the center of the AIDS response. It is therefore timely that we publish the UNAIDS 2019 World AIDS Awareness Report in Eshowe, KwaZulu-Natal, where a model service delivery, with HIV at the center, is showing results, "he said. Mabuza.
Years later, in one of the places hardest hit by the HIV epidemic and where a diagnosis once involved some death, hope is back. It's not true everywhere.
The number of deaths in the world, estimated at 1.7 million in 2004, has fallen to 770,000 in 2018, and eastern and southern Africa – where more than half of people living with HIV live – 39, is significantly improved. However, success has been uneven, with death rates in North Africa increasing by 9% since 2010. The number of new HIV infections has also increased by 10% in the Northern Region, where more than a quarter of new cases are attributed to the intravenous drug. use.
The community-based approach targets people, and especially groups of drug users or prisoners and their partners, who now account for more than half of new HIV infections worldwide – and 95% of all infections in North Africa and the Middle East. , Eastern Europe and Central Asia.
"For me, the AIDS response is about people," said Carlsson. "Young women who do not know how to protect themselves from HIV, men who do not want or can not get treatment, transgender people who are discriminated against, and hundreds of thousands of people who die every year, even if HIV can be prevented and treated. "
Among those at risk are pregnant women, and improved care has reduced the number of new HIV infections among children by 41%. Botswana has experienced an 85% reduction in HIV among children, Rwanda has decreased by 83%, and Malawi, Namibia, Zimbabwe and Uganda have experienced a 65% or more reduction since 2010.
In KwaZulu-Natal, where one in four adults aged 15 to 59 years old were living with HIV in 2016, the community-based approach to HIV testing linking people to treatment and helping them to stay has worked well in Eshowe and in the United States. nearby.
"Community-based advisory committees – made up of traditional leaders, traditional health practitioners, civil society representatives, women, youth, people with disabilities and people living with HIV – discuss project activities and provide input. contribution, "says the report from UNAIDS. "Similarly, annual youth camps are organized with student representatives from each school. School Learning Support Officers and Ministry of Education representatives also solicit opinion and advice from young people. "
This has allowed Eshowe to reach its 90-90-90 targets by the 2020 deadline. The goals mean that 90% of people living with HIV know they are HIV-positive, 90% will receive ongoing treatment and 90% will get viral suppression through treatment. the overall rates are 79-78-86.
One of them is Sthandwa Buthelezi, founder of Shine, an organization based in Eshowe that tackles stigma and discrimination in the community and prevents confirmation of HIV status and effective care.
"I have been on treatment for 16 years, my virus is being suppressed and I'm fine," Buthelezi said. "But stigma and discrimination are still widespread, especially in health care settings. As an activist, I encourage everyone, including community leaders, to talk openly about HIV so that people can live positively and shine. "
Criminal laws, harbadment and violence continue to marginalize people living with HIV, and discriminatory attitudes towards people living with HIV remain a concern. More than half of the respondents in 26 countries expressed discriminatory attitudes toward people living with HIV, the report said.
South Africa has the largest antiretroviral treatment program in the world and strives to provide treatment for approximately one in five people living with HIV on the planet. Despite this, nearly half of people living with HIV in South Africa did not receive anti-viral suppression care last year, and community-based programs seek to fill gaps in HIV awareness. specific risk populations.
Image: Médecins Sans Frontières
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