Lara Adejoro
Eradicating the HIV/AIDs epidemic requires a multi-pronged approach, the Deputy Executive Director, Programmes and Assistant United Nations Secretary-General at the Joint United Nations Programme on HIV/AIDS, Dr Angeli Achrekar has said.
She stated this at the 2024 Nigeria HIV prevention conference organised by the National Agency for the Control of AIDS in Abuja.
According to her, the goal of HIV prevention is to put an end to new HIV infections and make smart investments that ultimately lead to a reduction in the number of people needing treatment and the associated cost.
Achrekar noted that the global HIV response has achieved tremendous results with 86 per cent of the 39 million people living with HIV knowing their HIV status, 76 per cent receiving life-saving antiretroviral treatment, and 71 per cent virally suppressed.
“AIDS-related deaths have been averted, with a huge investment in the health systems, and the recognition of the key role of communities in efforts to end AIDS. We have also seen progress in addressing societal barriers and enablers of HIV putting several countries a step closer to ending AIDS as a public health threat by 2030.
“Why then should we talk about HIV prevention? We are quite not on track.
“Despite the availability of a wide array of effective HIV prevention tools and methods and a massive scale-up of HIV treatment in several countries within recent years, new infections among adults globally have not decreased sufficiently as expected,” she said.
Reeling out global figures, she said in 2022, about 4,000 adults and children acquired HIV each day — a total of 1.3 million new HIV infections.
She noted that intensive effort is needed to reach the global target of fewer than 370,000 new HIV infections annually by 2025.
“Despite its efficacy, there remains a stark underinvestment in HIV prevention. In sub-Saharan Africa, only 42 per cent of districts with high HIV incidence have dedicated HIV prevention programs.
“We, therefore, require an acceleration of progress in HIV prevention. HIV prevention is not only a moral imperative but also a pragmatic and cost-effective public health strategy.
“Let’s remind each other that no single prevention method or approach can stop the HIV epidemic on its own.
“Several methods and interventions have proved highly effective in reducing the risk of, and protecting against HIV infection, including male and female condoms, the use of antiretroviral medicines as pre-exposure prophylaxis, voluntary male medical circumcision,
behaviour change interventions to reduce the number of sexual partners, the use of clean needles and syringes, opiate substitution therapy and the treatment of people living with HIV to reduce viral load and prevent onward transmission,” she stated.
Achrekar said proven strategies that address the needs of specific populations to protect themselves and others from HIV including key populations, adolescents and young people, women, and other priority populations should be identified and prioritised.
“Over the years, we have observed three interconnected reasons that underpin the failure to implement effective Prevention Programmes to scale – lack of political commitment and, as a result, inadequate investment; reluctance to address sensitive issues related to young people’s sexual and reproductive needs and rights, key populations, and harm reduction and the absence of systematic and sustainable implementation of prevention programmes.
“We know that placing communities at the centre of HIV prevention programs significantly enhances their effectiveness. Programmes led by community-based organisations yielded a fourfold increase in consistent condom use among at-risk populations. We need to continue to support communities with the resources they need to excel,” she said.
She stated that the coverage of prevention of mother-to-child transmission of HIV services has remained low in Nigeria with a reach of only 30 per cent of eligible women in the country
“Nigeria is among the countries with the slowest decline in new HIV infections among children. In 2020, there were an estimated 21,000 new child HIV infections in Nigeria, the highest in the world, which accounted for 14 per cent of the global estimate.
“I understand that funding is currently not one of the major challenges of the PMTCT program in Nigeria. We would want to see renewed and intensive efforts to achieve the level ofPMTCT program scale-up needed to meet the eMTCT goals.
“The future of Nigeria’s children cannot be left unchecked, concerted and urgent action must be taken to avert children being consigned to live a lifetime with a virus that is now preventable. We need to end the vertical transmission of the epidemic to have an AIDS-free generation in Nigeria,” she added.
Achrekar called for urgent action to end the inequalities that fuel the AIDS epidemic.
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