By Mpho Shelile
MASERU – The world is a home to young people aged 15-24 now more than any other time in history. Simultaneously, the world is committed for the first time in 2023 to a universal agenda for sustainable development of extraordinary ambition – including a target to end the HIV/AIDS epidemic by year 2030. The global community will never deliver on ending AIDS if young people are not fully engaged and in the lead. Young people are the most effective engine for social change.
Henceforth UNAIDS held a youth engagement dialog with the agenda of presenting a clear path that ends AIDS. This path will also help prepare for and tackle future pandemics and advance progress towards achieving the Sustainable Development Goals. The path to ending AIDS is clear.
“We have a solution if we follow the leadership of countries that have forged strong political commitment to put people first and invest in evidence-based HIV prevention and treatment programmes. The building blocks of a successful AIDS response comes together through partnerships between countries, communities, donors including the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) and the private sector”, Stated Mr. Lethola Mafisa.
He further indicated that Botswana, Eswatini, Rwanda, the United Republic of Tanzania, and Zimbabwe have already achieved the “95-95-95” targets. Which means 95% of the people who are living with HIV knowing their HIV status, 95% of the people who know that they are living with HIV being on lifesaving antiretroviral treatment, and 95% of people who are on treatment being virally suppressed. A further 16 other countries, eight of them in sub-Saharan Africa, the region which accounts for 65% of all people living with HIV, are also close to doing so.
Mr Poloko Mokhele in his presentation on the global aids report reckoned that the biggest breakthroughs are occurring in countries that have forged and maintained strong political commitment to put people first and invest sufficiently in proven strategies. He stated that they have prioritized inclusive approaches that respect people’s human rights, and they have engaged affected communities across the HIV response. They have acted to remove or defuse the societal and structural factors that put people in harm’s way and prevent them from protecting their health and well-being—including criminalizing laws and policies, gender and other inequalities, stigma and discrimination, and human rights violations.
“HIV programmes succeed when public health priorities prevail, as experiences in multiple countries test” he stated. In Botswana and Cambodia, evidence-based polices and scaled up responses have paid off in reducing new HIV infections and AIDS-related deaths. Cameroon, Nepal and Zimbabwe have achieved major reductions in new HIV infections due to focused prevention programmes. The number of people on pre-exposure prophylaxis (PrEP) in Latin America has increased by over 55% since 2021, with 10 countries providing PrEP to people from key populations in 2022.
The achievements of the global HIV response have more relevance and impact to the improvements, the strengthened health and community systems underpinning them, bringing benefits that spill over beyond the public health realm and add to progress towards several other Sustainable Development Goals (SDGs) by protecting the lives and livelihoods of millions of people. HIV programmes are shielding them against poverty and food insecurity, enabling them to financially support the schooling of their children, and contributing to the ongoing reduction in deaths in children and maternal mortality
Botswana, Eswatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already achieved the 95–95–95 targets overall,1 and at least 16 other countries (eight in sub-Saharan Africa) are within reach of those targets (Table 1.1). Among the latter are low-income countries such as Malawi, which has targeted improvements and introduced tailored interventions in districts where testing and treatment coverage were lacking. As a result, in 2022 an estimated 94% of people living with HIV in Malawi knew their HIV status, 98% of people who knew their HIV-positive status were receiving antiretroviral therapy, and 94% of people on treatment were virally suppressed. Comparable progress has been made in other regions, with countries such as Cambodia, Denmark and Togo within reach of the 95–95–95 targets.
In order to achieve all the targets, annual funding for PEPFAR has remained largely unchanged over the last decade, PEPFAR continues to have a positive impact on mobilizing growing domestic financing for HIV. In the majority of PEPFAR-supported countries that provided data to UNAIDS, the increase in funding from PEPFAR and the Global Fund triggered an increase in their domestic HIV funding. This is particularly important at a time when overall domestic funding for health and development in low- and middle-income countries is declining.
This and other data demonstrate the positive impact of PEPFAR’s political, programmatic and financial support. PEPFAR-supported countries are furthest ahead in ending AIDS—on par with countries in Europe and North America, which have a significantly lower HIV burden. PEPFAR works in 55 countries, and 78% of people living with HIV reside in these countries. The continued progress and success of PEPFAR is having a systemic impact, supporting global efforts to end AIDS as a public health threat.
A student from NUL Mats’eliso Molapo stated that the core principles and demands which have propelled the HIV response for decades are echoed in a central theme of the SDGs: the insistence that no one shall be left behind. Since the early days of the AIDS epidemic, activists have linked the spread of HIV to social inequalities, discrimination, and failure to uphold human rights. “If only human rights were upheld there could have been better HIV and AIDS results”, said Molapo.
“We need to invest more into activism and education of HIV and AIDS” stated another youth representative Miss Tokelo Phamotse. Another one pointed out that culture is stagnant and is the only thing that is going to kill us, because most people follow and respect culture.
In her closing remarks Mrs Tiisetso Piet who is a program manager of NAC stated that they are advocated by the Global Alliance to End AIDS in Children, focused efforts and that stronger commitment are needed to address the unequal HIV service access and outcomes experienced by children. It will take significant shifts in service delivery and the creation of a more supportive environment to recover the earlier momentum.
That includes making integrated antenatal and postnatal care and HIV services more affordable and convenient, especially for adolescent girls and women who are stigmatized and marginalized, or who require parental consent to access services. “We plan on working together and focusing our efforts towards the youth”, declared Piet. She concluded her remarks by adding that they plan on creating a youth forum which will promote youth leadership.