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"Victory has a thousand parents, but defeat is orphaned"
JF Kennedy
The report "HIV / AIDS Infection – Challenges and Strategies 2018" presented last Thursday led to various public interventions.
First, the epidemiological data presented for 2017 are, as in previous years, provisional and likely to be corrected throughout the current year. This is not new, that 's what has happened for many years, because of the delay in communicating information to INSA.
More important are the recitals (especially the official health authorities) on the evolution of the epidemiological situation in Portugal compared to the 90-90-90 targets, defined for HIV prevention
For those who know This theme, the significance and importance of this strategy, as defined by WHO and UNAIDS, should be strengthened in 2014 in order to end the epidemic of HIV / AIDS. HIV by 2030. This goal is crucial to achieve, in 2020, the 90-90-90 goals: 90% of people diagnosed; 90% under treatment and, of these, 90% with an undetectable viral load. Now, the reflections:
1. The data presented are for the year 2016. Of course, they do not reflect (and could not) any intervention or influence of the current ministerial team that took office on November 26, 2015.
2. These data, now made public, are positive and encouraging, they appear in the continuity of existing data for 2014, when Portugal had already reached the top 90, concerning 90% of people diagnosed (data presented publicly in 2016).
3. Compared with 2014, the improved data presented for the first and second "90" is conditioned by the reanalysis of deaths among people living with HIV, whose evolution was unknown. Correct measure (assumed already in 2017) even if, personally, she does not agree with the methodology used. Thus, the improvement observed compared to 2014 may not reflect a real improvement in the epidemiological situation, but only a better analysis of the information currently available
. However, compared to the second '90', 90% of people diagnosed in treatment, there is an additional factor justifying the improvement of this goal. In September 2015 (yes, 2015), Portugal became the fourth European country to adopt the strategy of "treating all infected persons" regardless of their clinical / immunological situation. The implementation of this decision decisively contributed, no doubt, to the improvement of the second "90" and had, as one might expect, that it was not possible to do so. a real impact the following year (2016), the year of publication of this report
. When we hear that the day of the presentation is a "historic day" in the fight against HIV infection, although the statement may be of interest as an article title or article, an error of Assessment is made and another of the dangerous overvaluation:
a) The historical days were, for example, the days when Portugal decriminalized the drug use, where the program of exchange of syringes was implemented, in which it was recommended that pregnant women with HIV infection. Was the hypothesis of the participation and funding of community organizations for the implementation of projects for prevention and diagnosis of HIV infection. The historic days were the days when the implementation of the HIV test was started at least once in life and it was decided that all infected people should immediately begin the treatment of the infection.
(b) History, it was not July 5, 2018, when the results reported to the situation verified in Portugal two years ago were presented. Even because, after all, we have not yet achieved the goals "90-90-90" …
6. Last, but not least, a thank you to the current Minister of Health for recognizing, albeit belated, the quality of work done until 2016 (in fact, in much more difficult circumstances than in the past). 39; today) when he says that Portugal has a health care system and whose results are in sight and recognized. "
PS: Personally, I would like to see all the" 90 "targets already achieved by the end of 2016, thanks to the health policies that have been adopted so far. I said in 2016, I still believe that by 2020, we will get there.Not to mention that they are worth, first and foremost, a mandatory midpoint for 2030
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