Pandemic of HIV/AIDS

Dec-27th-2011
The global pandemic HIV/AIDS still need greater attention. The vision of a world with zero new HIV infections, zero discrimination and zero AIDS related deaths has captured the imagination of diverse partners, stakeholders and people living with and affected by HIV. Research shows that antiretroviral therapy (ART) can prevent new HIV infections, and it is encouraging that 6.6 million people are now receiving treatment in low and middle income countries. Researches show that the state of AIDS epidemic is quiet controlled than in the past one decade. Annual new HIV infections fell 21% between 1997 and 2010. There were 2.7 million new HIV infections in 2010. At the end of 2010, an estimated 34 million people were living with HIV worldwide, up 17% from 2001. Though new HIV infection fell down, access to ART helped reduce AIDS-related deaths that cause the increase in the population living with AIDS. Hence, the number of people dying with AIDS related causes fell to 1.8 million in 2010 down from 2.2 million in mid 2000s.

The Sub-Saharan region is where the maximum number of people with HIV reside. In 2010, about 68% of all people living with

HIV resided in a region with only 12% of the global population.

Though there was a notable decline in regional rate of new infections, 70% of new HIV infections in 2010 were seen. In Eastern Europe and Central Asia, people living with HIV rose 250% from 2001-2010. Asia is the second largest grouping of people living with HIV that is partly attributable to the increase in people living with HIV who receive antiretroviral therapy that helps reduce the number of annual AIDS-related mortality. The epidemic’s decline is accelerating.

The world needs to maintain current efforts and make incremental progress or invest smartly and achieve rapid success in the AIDS response to “ZERO”. Antiretroviral treatment is a key to faster progress. Rapid increase in ART coverage is helping more countries achieve universal access to treatment, care and support. A major factor limiting the prevention dividend of HIV treatment, however is that more than 60% of the people living with HIV are unaware of their HIV status. So, community based awareness focusing on behavioral change program (condom use and its safe use, safe sex with only one partner) may be the key to achieve rapid decline in new HIV infection. Though the latest research shows that there is 25% decline in new HIV infection in Nepal, to continue it more attention and action are required. According to the category of ART receiving, at the end of 2010, Nepal fell in the category of 0-19% while some developed countries and more focused regions receive up to 80% ART therapy. So, the awareness program is more effective and needed in the country like ours. For the closer achievement of the goal globally, investing is to be done smartly. The future of AIDS resourcing depends on smart investing: spending now to curtail the need to ‘spend more-forever’. The rate on AIDS prevention shows the progress will move towards zero and the rate needs to be continued even faster with the clear aims: maximizing the benefits of the HIV response, using country specific epidemiology to ensure rational resource allocation, encouraging countries to implement the most effective program based on local context, increasing efficiency in HIV prevention, treatment, care and support. To achieve the aims, investment must be done in the right place

with the right strategies and the investment should be innovative.

Latest news reveal that China calls for shared responsibility in achieving zero new HIV infections, zero discrimination, zero AIDS-related deaths. UNAIDS applauds China’s decision to fill its HIV resource gap.

The current pace of AIDS pattern and the smart investment will lead soon to achieve the goal- ZERO. To achieve the goal, the smart investment needs to meet the objective of stopping new infections and keeping people alive. The basic programs to meet the alarming rate include: focused interventions for key populations at higher risk (particularly sex workers and their clients, men who have sex with men and injection users); elimination of new HIV infections among children; behaviour change program; condom promotion and distribution; treatment, care and support for people living with HIV.

Globally the betterment agenda need to be conducted which includes: new infection among children to be cut by expanding antiretroviral coverage, reducing adult incidence and meeting family planning needs; access gap for women’s family planning services must be closed which enable women to avoid unintended pregnancies and optimize other health outcomes.

Researches with strong evidence and political declaration on HIV/ AIDS heralded a moment of truth in the global AIDS response. Committed leadership, social change, innovation and rapid injection of new resources take it to this level and will transform the response into a vanguard of global health success.

The progress can be made if the relevant decisions made accordingly are implemented continuously which will determine truly the beginning of the end of AIDS.

MOHAN SHRESTHA, Himalayan...