By Caleb Mwamisi

Going by findings of a survey conducted by the WHO, over 73 countries are running out of stock of HIV medicine and 24 of these have confirmed either having acute stock or experiencing interruptions in the supply of antiretrovirals (ARVs). A similar research done by the UNAIDS, shows that intensified use of ARVs has deterred an approximated 12.1 million deaths since 2010, further cementing the great role played by the drugs in the war against HIV and AIDS. The findings featured in presentations made during the opening session of the International AIDS Conference held virtually from July 6-10, 2020.

This news is grim because, besides enabling HIV positive people to fight opportunistic infections and to live longer, ART serves to prevent onward sexual transmissions to other people from PLHIV, and to rein in Mother to Child Transmissions (MTCT).  In 2014, the joint UNAIDS and partners launched the 90-90-90 targets geared towards diagnosing 90% of all HIV persons, providing antiretroviral therapy (ART) for 90% of the diagnosed, and achieving viral suppression for 90% of those treated by 2020. This shows how critical ARTs are to the coordinated war on HIV and AIDS. In 2019, there were about 1.7 million new infections globally, exceeding the UNAIDS target of 500,000 by that year.

In May, and based on analysis of the COVID19 global impact, the WHO and UNAIDS jointly projected a six-month disturbance in the access of ARVs which, they said, could lead to a double expansion in number of deaths in sub-Saharan Africa over 2020 alone. “These disruptions highlight the need for robust and flexible health systems that are able to cope with outbreaks while ensuring the delivery of essential health services such as HIV [care],” said, WHO Director-General Tedros Adhanom Ghebreyesus in his presentation in the Virtual conference opening.

Of greater concern is that COVID19 has meant that agencies who deal with HIV and AIDS may not see the achievement of certain targets hitherto set in the fight against the virus across the world. “We were already off track to achieving our HIV goals, but the coronavirus is really blowing us completely off track,” said Winnie Byanyima, UNAIDS director when addressing the AIDS 2020 opening press conference. “One disease cannot be sacrificed for another. That is a poor solution.”, she asserted.

“We cannot have poor countries at the back of the queue. It should not depend on the money in your pocket or the color of your skin to be protected against these deadly viruses. We cannot take money from one disease to treat another. Both HIV and COVID-19 must be fully funded if we are to avoid massive loss of life.”, added Winnie.  Funding for HIV and AIDS is 30% less than the US$ 26.2 billion required for 2020 and her statement also means that it is possible that significant focus has shifted from fighting HIV to contending with COVID19.

Findings from the UNAIDS 2020 global AIDS update, show that women and girls are the most affected in Africa accounting for 59% of new infections. Based on it, Byanyima noted that social and economic inequalities are still rife across the globe, as she observed that barriers to the fight against HIV and AIDS such as the denial of rights, must be tackled. In many countries, rights of the most marginalized in society remain neglected.

Of further worry is that the funding gap for HIV responses is broadening and impetus developed in the Millennium Development Goals is being dropped in the Sustainable Development Goals time. In low and middle-income countries, resources for HIV interventions reduced by 7% in the period of 2017-2019. The total HIV funding available in these countries in 2019 was about 70% of the 2020 target set by the UN General Assembly.

Out of an estimated 38 million people in the world living with the virus, 25.4 million have been on ART with 12.6 million unable to access it, but this progress is now being repressed, according to the UNAIDS and WHO. 2020 is the year at end of which interim targets had been agreed to be achieved with all eyes strategically on 2030 when HIV and AIDS are supposed to be finished.

References:

Byanyima W. Seizing the moment: Tackling entrenched inequalities to end epidemics. Presented at: International AIDS Conference; July 6-10, 2020 (virtual meeting).

Tedros AG. WHO: access to HIV medicines severely impacted by COVID-19 as AIDS response stalls Presented at: International AIDS Conference; July 6-10, 2020 (virtual meeting).