PROFESSOR NANA POKU
With new options for treating AIDS and preventing HIV now available, the world could bend the curve of HIV, but only if investment in the delivery of services fully involves community-led organisations.
Two decades ago, the HIV pandemic seemed unstoppable. More than 2.5 million people were acquiring HIV every year, and two million lives a year were lost to AIDS.
Today, there is hope for those living with HIV and AIDS. Three-quarters of those living with HIV – roughly 30 million people – are receiving treatment. Medical advances mean that what was once a death sentence is now a manageable chronic condition.
But this success has bred complacency and a diminished sense of urgency. AIDS has ceased to be at the forefront of the public’s attention. Yet it is still destroying lives, particularly in marginalised communities where lives are often shamefully undervalued.
At present, the world is not on track to end the HIV pandemic soon. New infections are not decreasing fast enough for the HIV pandemic to be brought under control by 2030. Beyond sub-Saharan Africa, declines in new infections have been small – and numbers are rising alarmingly in some countries.
New infections have increased by 49% in Eastern Europe and Central Asia since 2010, and by 61% in the Middle East and North Africa. These trends are driven primarily by a lack of prevention services for marginalised groups and key populations, as well as the barriers posed by punitive laws, violence, social stigma and discrimination.
And nearly everywhere, gender discrimination continues to make young women and girls particularly vulnerable to infection. They now account for 63% of all new infections.
We must revitalise our efforts to bring an end to the HIV epidemic. Far from being at the mercy of HIV and AIDS, it is within our power to accomplish this – but we need to act quickly and through the communities who best understand the local complexities underlying HIV transmission.
For this reason, the World Health Organisation (WHO), together with communities and partners, commemorated World AIDS Day 2023, under the theme “Let communities lead”.
With new options for treating AIDS and preventing HIV now available, the world could bend the curve of HIV, but only if investment in the delivery of services fully involves community-led organisations.
Too often, decision-makers treat community organisations as disparate actors to be managed rather than as organisations fundamental to effective provision of leadership and change agents needed for ending the HIV pandemic.
But it is vitally important that community-led efforts reach out to marginalised groups, whose fear of seeking counselling, testing and treatment is a key driver for the continuance of the epidemic. HIV does not discriminate — and if we are to defeat AIDS once and for all, nor can we.
There is no one technique or one programmatic response that will work in the variety of human communities worst affected by HIV and AIDS; and because marginalised populations are most at risk, it matters greatly that we continue to work collaboratively with community-based organisations to concentrate on them – and on utterly fundamental matters such as accessible sexual and reproductive health clinics, prevention programmes and HIV testing.
Turning the infection curve is possible, but only if we change our approach and ensure that our community spirit is wholly inclusive, on the principle that no one is safe until everyone is safe.
Professor Nana Poku is the Chair of the Board of Trustees of Frontline AIDS. He is also the Vice-Chancellor and Principal of the University of KwaZulu-Natal.
Daily News