How South Africa’s fight against HIV stacks up

Published in Featured Articles
Monday, 23 September 2013 13:33

About six million people in South Africa are living with HIV, according to UNAIDS new report. Here’s how South Africa’s HIV response stacks up against other countries.

 

Treatment

About 2.5 million people in South Africa are on HIV treatment, making the country’s public HIV treatment programme the world’s largest. The UNAIDS report lauds government’s recent tender that introduced the country’s first three-in-one – or fixed-dose -ARV into the public sector. UNAIDS estimates that this tender, which negotiated an almost 40 percent price reduction for the fixed dose ARV, will save South Africa more than R2.6 billion.

 

Footing most of its own HIV treatment costs, South Africa relies on donors to fund less than 25 percent of its HIV response.

 

Malawi, Zambia, Zimbabwe and Mozambique rely on donors to fund at least three-quarters of their responses, according to the UNAIDS report.

 

HIV and Tuberculosis (TB)

More than 75 percent of all people co-infected with HIV and TB live in just ten countries, including South Africa, Zimbabwe and Mozambique.

 

Zimbabwe, Malawi and Namibia have at least halved the number of TB deaths among people living with HIV. While South Africa has yet to reduce these kinds of deaths by even 25 percent, the report notes that the country has made huge strides in scaling up ARV access for co-infected patients – far outpacing other countries with similarly large epidemics like India and Nigeria.

 

South Africa has also become the world’s largest provider of preventative isoniazid TB therapy to HIV patients. An estimated 370,000 people living with HIV now receive the anti-TB drug to prevent the development of active TB. In South African studies, the provision of preventative TB therapy to people on ARVs halved their risk of death.

 

Globally, TB remains one of the leading killers of people living with HIV and a leading cause of death in South Africa.

 

Prevention

Zimbabwe leads the region in scaling up medical male circumcision, which has been shown to reduce a man’s risk of contracting HIV by as much as 60 percent. Zambia, Uganda and Swaziland are all out pacing South Africa on increasing uptake of the procedure.

 

With falling rate of mother-to-child transmission, South Africa joins most other countries from southern Africa in reaching at least 80 percent of all HIV-positive expecting mothers with ARVs to prevent mother-to-child HIV transmission. Malawi and Lesotho are close behind, extending this kind of prevention services to at least half of all such mothers while less than 20 percent of HIV-positive pregnant women will access these services in Angola.

 

New infections and deaths

An estimated 370,000 South Africans contracted the virus last year. While South Africa’s new infection rate has fallen by about half in the last decade, it remains the world’s highest. Second only to South Africa, Nigeria saw an estimated 260,000 new cases in 2012.

 

Both countries recorded 240,000 AIDS-related deaths last year.

 

Article courtesy of Health-e News Service.

South Africa is an “outstanding model” of what can be achieved in the fight against HIV/AIDS, according to Michel Sidibe, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

 

Sidibe was in Pretoria yesterday (Tues 30 July) for the release of the UNAIDS report, “Getting to zero: HIV in eastern and southern Africa”.

 

In the past five years, there has been “extraordinary progress” in reducing HIV in eastern and southern Africa, including a 38% reduction in AIDS-related deaths, according to UNAIDS.

 

Half–a-million fewer Africans died in 2011, including 100 000 fewer South Africans, than in 2005 when AIDS claimed an estimated 1.3-million people. This is largely thanks to a tenfold increase in access to antiretroviral medicine.

 

In a single year – between 2011 and 2012 – an extra one million people in the region got access to ARVs, bringing the number of people on treatment to 6.3-million.

 

One-third of those on ARVs are South Africans, according to UNAIDS.

 

“In 2010, South Africa embarked on an unprecedented national campaign to provide free treatment to all eligible people living with HIV, coupled with a massive programme of testing and counseling for HIV and screening for TB,” according to UNAIDS.

 

“During the last financial year (2012/13), more than nine million people were tested for HIV. The country currently has the largest ART programme in the world, with more than 2.1 million people receiving ART.”

 

A large study in KwaZulu-Natal, the province worst affected by HIV, recorded an 11-year increase in life expectancy in a mere seven years (2007 to 2011).

 

South Africa also managed to slash mother-to-child infection by 50% in two years (between 2009 and 2011), while the region managed to cut HIV infection from mothers to their newborn babies by one-third.

 

“Most countries in the region are within reach of the goal of eliminating new HIV infections among children by 2015 and keeping their mothers alive,” according to UNAIDS.

 

Almost three-quarters of pregnant HIV positive women in the region had access to treatment to prevent transmission to their babies.

 

In the past decade, there has also been a 30% decline in new HIV infections, rolling the infection rate back to the level it was in 1998. In South Africa, new infections amongst adults have dropped by 41%.

 

“In South Africa we have made significant progress in reducing new infections among children. We should keep the momentum going,” said Health Minister Dr Aaron Motsoaledi.

 

“We need to ensure that women continue to benefit from universal access to antiretroviral treatment so that we can reduce maternal mortality. No women or baby should be left behind.”

 

Motsoaledi said while South Africa has made progress in putting 2million people on treatment, aim was to reach 3,5 million people by 2015.

 

Amidst progress, there are still serious weaknesses. Uganda has had a 21% increase in new HIV infections over the past decade, while there have been minimal decreases in Lesotho and Tanzania.

 

In addition, less than a third of HIV positive children were on ARVs, which was “unacceptably low”.

 

“The low ART coverage in children was due to countries not having proper diagnostics and proper following up strategies for mothers with children born with HIV. But a mjor challenge was that there wasn’t a proper treatment regimen catering for children,” says Sidibe

 

Finally, there was an estimated shortfall of $7-billion if all countries were to scale up to meet the HIV challenge.

 

“Ways have to be found to deliver treatment more efficiently and at lower cost. Part of the solution may involve collective investment in the local production of drugs and commodities to drive costs down,” concluded UNAIDS.

 

Article courtesy of Health-e News Service.

GENEVA - The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) has recently launched a new funding model for AIDS, tuberculosis and malaria. The launch follows a three-year period where funding for the three diseases was halted due to insufficient funds and calls for reforms of the institution and its business model. In this new wave of funding the Global Fund has announced that up to US$1.9 billion could be available in 2013 and 2014.

 

This is welcome news to the countries which have been most affected by HIV, tuberculosis and malaria and which have been struggling to produce truly effective responses due to a lack of funding. The new model announced by the Global Fund will focus on countries with high disease burden and low resources, allowing the Global Fund to support the countries with the most serious epidemics and least ability to pay.

 

“This new funding model will bring critical additional resources to the AIDS response,” said Luiz Loures, UNAIDS Deputy Executive Director of Programme. “UNAIDS is looking forward to continue working with the Global Fund to ensure that these resources are available to countries rapidly for scaling up HIV treatment and prevention services.”

 

The model focuses on strategic investments whereby applications will need to be based on solid scientific evidence using the best epidemiological data to determine where the investments will make most impact. The Global Fund has also announced that the new funding model will be firmly focused on results and that the countries which are producing high impact, well-performing programmes will be able to apply for additional funding on top of their initial allocation.

 

As well as investing more strategically to maximize on results, the new funding model will provide more predictable funding. All eligible applicants will receive an indication of the funds that will be made available for a three-year allocation period. This will allow for better planning as countries will have a good idea of what funds will be coming to them over the next years. They will then be able to seek funding from this allocation when it suits them best, according to their own national planning cycles.

 

The new funding model is expected not only to provide countries with more flexibility with the timing of their funding requests but also to encourage a solid country dialogue around coherent, strategic and high impact investments and strengthened national strategic plans. Each recipient country will be expected to engage a diversity of partners, including civil society, to ensure the most effective and inclusive response to each of the three diseases.

UNAIDS: Less children HIV infected

Published in Featured Articles
Wednesday, 21 November 2012 09:36

South Africa has received global recognition for achieving a significant reduction in the number of children newly infected with HIV.

 

The United Nations Joint Programme on HIV/AIDS (UNAIDS) launched the 2012 Global Epidemic Report yesterday (SUBS: TUES) and praised South Africa for major gains with the number of children newly infected with HIV declining by between 40 and 59 percent from 2009 to 2011.

 

International efforts have focused on ending new infections among children and reducing the number of women living with HIV who die from pregnancy-related causes.

 

According to the report 330 000 children were infected with HIV in 2011, almost halving the rate since 2003 when almost 600 000 children were infected.

 

More than 90% of the children who acquired HIV infection in 2011 live in sub- Saharan Africa, where the number of children newly infected fell by 24% from 2009 to 2011.

 

Sub-Saharan Africa remains most severely affected, with nearly one in every 20 adults living with HIV and accounting for 69% of the people living with HIV worldwide.

 

Worldwide, the number of people newly infected continues to fall. The number of people (adults and children) acquiring HIV infection in 2011 (2.5 million) was 20% lower than in 2001.

 

The sharpest declines in the numbers of people acquiring HIV infection since 2001, have occurred in the Caribbean (42%) and sub-Saharan Africa (25%).

 

During the past decade, many national epidemics have changed dramatically. In 39 countries, the incidence of HIV infection among adults fell by more than 25% from 2001 to 2011.

 

Twenty-three of the countries with steep declines in HIV incidence are in sub-Saharan Africa, where the number of people acquiring HIV infection in 2011 (1.8 million) was 25% lower than in 2001 (2.4 million).

 

However, despite these gains, sub-Saharan Africa accounted for 71% of the adults and children newly infected in 2011.

 

Access to antiretroviral treatment also increased significantly, reaching eight million people by end of 2011 – a 20-fold increase since 2003.

 

More people initiated antiretroviral therapy in 2011 than in any previous year, with the number of people living with HIV receiving treatment rising by 21% compared with data from 2010.

 

This article is courtesy of Health-e News Service.

UNAIDS: Stigma remains a concern

Published in Featured Articles
Thursday, 22 November 2012 09:38

The world is making significant progress in coming to grips with the HIV epidemic, however in many countries stigma and lack of human rights remain.

 

The United Nations Joint Programme on HIV/AIDS (UNAIDS) launched the 2012 Global Epidemic Report yesterday and reported significant declines in new infections among adults and children with high numbers of people placed on antiretrovirals.

 

Still the region most severely affected, sub-Saharan Africa has shown progress with an estimated 1.8-million new HIV infections in 2011 compared with 2.4-million in 2001.

 

Between 2005 and 2011, the number of people dying from AIDS-related causes in sub-Saharan Africa declined by a third from 1.8-million to 1.2-million.

 

Since 2004, the number of tuberculosis-related deaths among people living with HIV has fallen by 28% in sub-Saharan Africa.

 

However, while there have been a number of victories in the treatment and prevention arena – fear, ignorance and discrimination – in its worst forms, including abusive treatment and violence, remain in a number of countries.

 

According to data collected, more than half of people living with HIV in Zambia reported having been verbally abused as a result of their HIV status. One in five people living with HIV in Nigeria and Ethiopia reported feeling suicidal.

 

In Nigeria, more than one in five people living with HIV said they had been denied health services as a result of their HIV infection.

 

According to a nine-country study by the International Labour Organisation and the Global Network of People Living with HIV, the percentage of people living with HIV who reported discriminatory attitudes among employers ranged from 8% in Estonia to 54% in Malaysia.

 

As of 2012, about 60 countries have adopted laws that specifically criminalise HIV transmission, with some 600 convictions reported in 24 countries.

 

According to a 2012 global review, more than 40% of United Nations Member States (78 of 193 countries) criminalise same-sex relations, with some jurisdictions permitting imposition of the death penalty for convictions under such laws.

 

Laws deeming some aspect for sex work to be illegal are in place in the majority of countries and are often used to justify harassment, extortion and violence against sex workers by police and clients, placing them at increased risk of HIV infection.

 

Some countries have reformed laws to decriminalise key populations at higher risk – Portugal decriminalized drug possession and use in 2000 while New Zealand adopted the Prostitution Reform Act 2003 that decriminalized sex work.

 

The report praised South Africa for declines in the number of children newly infected with HIV which went down by between 40 and 59 percent from 2009 to 2011.

 

According to the report 330 000 children were infected with HIV in 2011, almost halving the rate since 2003 when almost 600 000 children were infected.

 

More than 90% of the children who acquired HIV infection in 2011 live in sub- Saharan Africa, where the number of children newly infected fell by 24% from 2009 to 2011.

 

Worldwide, the number of people newly infected continues to fall. The number of people (adults and children) acquiring HIV infection in 2011 (2.5 million) were 20% lower than in 2001.

 

During the past decade, many national epidemics have changed dramatically. In 39 countries, the incidence of HIV infection among adults fell by more than 25% from 2001 to 2011.

 

Twenty-three of the countries with steep declines in HIV incidence are in sub-Saharan Africa, where the number of people acquiring HIV infection in 2011 (1.8 million) was 25% lower than in 2001 (2.4 million).

 

More people initiated antiretroviral therapy in 2011 than in any previous year, with the number of people living with HIV receiving treatment rising by 21 percent compared with data from 2010.

 

This article is courtesy of Health-e News Service.

World has five years to secure victory in HIV fight

Published in Featured Articles
Wednesday, 19 November 2014 12:56

UNAIDSThe world has five years to increase access to HIV treatment and prevention to end HIV as a global health threat – and prevent the pandemic from resurging, according to the latest global HIV report released last night.

 

“We have bent the trajectory of the AIDS epidemic,” said the United Nations Joint United Nations Programme on HIV/AIDS (UNAIDS) in its latest global report released last night. “Now we have five years to break the epidemic or we risk the epidemic springing back even stronger.”

 

The report cautions that eliminating HIV as a global health threat does not necessarily mean no new infections.

 

Instead, ramping up the HIV response through improved access to HIV treatment and prevention for high risk groups like sex workers and men who have sex with men (MSM) will safeguard the world’s gains in reducing new infections and AIDS-related deaths, argues the report.

 

South Africa, alongside many of its neighbours, remains one of the 30 countries responsible for about 90 percent of all new HIV infection globally.

 

The new report scores South Africa high on preventing mother-to-child HIV transmission and on condom use among sex workers. More than 80 percent of HIV-positive expecting mums access antiretrovirals (ARVs) to prevent their unborn children from contracting the virus and a similar percentage of sex workers report using condoms with clients.

 

At the recent Southern African HIV Clinicians Society conference, South African National AIDS Council (SANAC) CEO Dr Fareed Abdullah revealed that recent studies found that more than 70 percent of some sex workers were living with HIV.

 

“For sex workers to have condoms and ARVs confiscated from them when they are arrested is just a blatant violation of rights, which has a direct impact on our programming,” said Abdullah, who launched a national HIV prevention and care plan for sex workers last year.

 

International report echoes local calls for focus on those most at risk

However, South Africa falls short on targets to ensure that 80 percent of adults and children living with HIV are on treatment. This is despite the fact that South Africa’s ARV programme is responsible for about 18 percent of the 13.6 million HIV-positive people that UNAIDS estimates are on treatment in low and middle-income countries.

 

Globally, HIV-positive children remain neglected and are about 40 percent less likely to be on ARVs than adults living with the virus. According to UNAIDS, AIDS-related illnesses remain the largest killer of Africa’s teenagers.

The country also gets low marks for condom use among MSM, less than 50 percent of whom report regular condom use in South Africa.

 

In July, World Health Organisation (WHO) recommended the use of ARVs in HIV-negative men who have sex with men in order to prevent HIV infection.

 

While the Southern African HIV Clinicians Society has released guidelines on the use of the brand name ARV Truvada to prevent HIV infection, the drug is not yet registered for use to prevent HIV. Reacting to the WHO’s announcement in July, Anova Health Institute’s Dr Kevin Rebe said this would prohibit the Department of Health from rolling Truvada out for HIV prevention and called for the registration of the drug to prevent HIV infection a “matter of urgency”.

 

The UNAIDS report recommends that Truvada be offered to HIV-negative sex workers, men who have sex with men and those in long-term relationships in which one partner is living with HIV in order to prevent infection.

 

The UN agency adds that ramping up the HIV response now could also mean a 17-fold return on countries’ investments in the fight.

 

An edited version of this story first appeared in the 19 November edition of  The Star newspaper.

 

This article is courtesy of Health-e News Service.

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