Writing the Final Chapter on AIDS

Inter Press Service (IPS) | October 17, 2014

By Miriam Gathigah

NAIROBI, Oct 17 2014 (IPS) - Although AIDS has defied science by killing millions of people throughout Africa in the last three decades, HIV experts now believe that they have found the magic numbers to end AIDS as a public health threat in 15 years.

The magic numbers are 90-90-90 and are informed by growing clinical evidence showing that HIV treatment equals prevention because putting people on antiretroviral therapy (ART) reduces new infections.

The new treatment targets seek that, by 2020:

The 90-90-90 plan, unveiled by the Joint United Nations Programme on HIV/AIDS (UNAIDS) earlier this year, seeks to halt the spread of HIV by 2020 and to end the epidemic by 2030.

While this is the most ambitious strategy to eliminate HIV yet, experts such as Dr Lucy Matu, director of technical services at the Elizabeth Glaser Paediatric AIDS Foundation in Kenya, says that it can be done.

She told IPS that in Kenya 72 percent of the estimated total number of people living with HIV have been tested, and 76 percent of the 880,000 adults and children diagnosed with HIV were on ART by April 2014.

Kenya will get closer to the 90-90-90 target as it implements the 2013 World Health Organisation (WHO) guidelines, which increased the CD4 count threshold to start ART from 350 to 500, says Matu.

As eligibility for ART becomes broader, she explains, “it will push the number of people on ART up by at least 250,000 to 300,000 to at least 90 percent of those in care, and of course more people will continue to enroll in care.”

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In Zimbabwe, Dr Agnes Mahomva, country director for the Elizabeth Glaser Paediatric AIDS Foundation, told IPS that 90-90-90 is not too ambitious for the Southern African country.

Already, she told IPS, “HIV positive pregnant and breast feeding mothers are universally eligible for ART for life as well as HIV positive children below five years, regardless of their CD4 count.”

While many experts are optimistic that 90-90-90 targets will be met, Ugandan HIV activist Annabel Nkunda says the targets do not necessarily speak to each other.

Nkunda told IPS that many HIV positive people, “when put on treatment, do not adhere to the treatment because of stigma.”

Without a specific target to reduce stigma, she says, “no amount of intervention will get us to zero HIV/AIDS.”

But some experts like Dr Matu disagree: “If you know your status, you are more likely to be put on HIV care. If you are on ART, you are more likely to stay within the health system for follow up.”

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Read the full article, at IPS.