Any End To HIV/AIDS Scourge By 2020?

Thirty years after the first diagnosis of Human Immune Virus (HIV) and Acquired Immune Defficiency Syndrome (AIDS), the solution to the global pandemic still remains far-fetched, despite concerted efforts by scientists, health experts and other stakeholders in health sector. Official statistics indicate that an estimated 34 million people worldwide are still living with the virus, even as treatment remains the only hope for such persons.

Towards effectively checking the pandemic, experts say prevention remains the watchword for people at risk, especially when access to treatment is very limited in resource-poor nations of the world.

Health analysts point out that, while patients in advanced countries have easier access to genuine drugs for treatment at affordable rates, the same can not be said of poor nations that rely on generic versions of the drugs, and the high risk of adulterations.

As part of measures to sustain the pandemic as an agenda for public discuss, the United Nations, last June in New York, hosted a high-level meeting of world leaders and stakeholders, to tackle emerging challenges related to the global problem. At the summit, political commitments were made by the world leaders to continue to tackle the global scourge even in the face of daunting challenges.

Nigeria’s President Goodluck Jonathan was one of the world leaders who graced the summit. He restated Nigeria’s “unequivocal support” for the global action against the prevalence of HIV and AIDS.

According to him, “time is ripe for a final solution to the 30-year-old pandemic”.

He said that the human, social and economic costs of inaction were too great to contemplate, underscoring the imperative for the UN Security Council to set clear and decisive goals in the campaigns against the global pandemic.

Jonathan called on the donor countries and agencies to fulfill their pledges to resource-poor countries, especially in crisis-stricken regions of the world, where gender-based violence was related to the spread of HIV and AIDS.

On his part, the U N Secretary-General, Ban Ki-moon reiterated that the global body was passionate about combating HIV and AIDS.

He called for coordinated action by world leaders to end the scourge by 2020, stressing that the goal of the UN by that target date was to achieve “zero new infection, zero stigma and zero all-AIDS related deaths”.

The HIV-AIDS epidemic officially started on June 5, 1981, when the United States Centre for Disease Control and Prevention, in its Morbidity and Mortality Weekly Report newsletter reported its manifestation in five homosexuals in Los Angeles, US.

After that report, politics engulfed the issue of the origin and beclouded efforts to find effective solution. Over time, however, the scourge dramatically spread to its current level across the world.

Against this backdrop, the political declarations that emerged from the last UN summit became most apt as they included a commitment by the summit’s participants to reach an estimated 15 million people with anti-retroviral therapy (ART) by 2015.

By implication, they pointed to the provision of life-saving treatment for 80 per cent of persons in need of treatment in low and middle income countries by that date.

The results, announced by the United States National Institute of Health shows that if an HIV-positive person adheres to an effective anti-retroviral therapy regime, the risk of transmitting the virus to his or her uninfected sexual partners would be reduced by 96 per cent.

The trial, conducted by the HIV Prevention Trials Network, has enrolled more than 1,700 sero-discordant couples from Africa, Asia,  US and Latin America.

The World Health Organisation (WHO) and United Nations Programme on HIV-AIDS (UNAIDS), have both hailed the result from the clinical trial, with the Executive Director of UNAIDS, Mr Michael Sidibe, describing it as “a serious game changer that will drive the prevention revolution forward”.

“This is a crucial development because we know that sexual transmission accounts for about 80 per cent of all new infections,” said WHO’s Director-General. Dr Margaret Chan.

Two other studies have also shown that pre-exposure prophylaxis reduced the risk of infection with HIV by up to 78 per cent.

Other declarations of the UN summit on HIV-AIDS included the consolidation of all existing programmes, aimed at preventing the spread of the disease, such as the mother-to-child transmission mode.

In Nigeria for instance, one of such programmes — Prevention of Mother-to-Child Transmission (PMTCT) is effectively on course, courtesy of the National Agency for Control of AIDS, which is in partnership with the National Primary Healthcare Development Agency (NPHCDA) in the execution.

NPHCDA officials say that the programme has effectively covered 23 per cent of pregnant women in Nigeria, with the prospect of a wider coverage in the nearest future, while risks have been drastically reduced for the children.

Notwithstanding these measures, sceptics still wonder if the declarations are far-reaching enough or are capable of giving boost to the fight against the global pandemic.

One of such concerns was expressed by the International HIV/AIDS Alliance — a non-governmental organisation that supports community action on AIDS in developing countries.

The organisation, which works in partnership with UNAIDS, described as welcome, the ambitious targets of the stakeholders, as well as previous commitments made in 2001 and 2006. The organisation, nonetheless, acknowledged that important progress had been made, especially as an estimated one-third of persons, who needed anti-retroviral treatment, were having access to drugs. It ascribed the feat largely to the magnanimity of countries like US, UK, Netherlands, France, Kenya, South Africa and Brazil, among others.

According to the organisation, access to such treatment had extended the life-span of over five million persons infected with HIV, while enabling them to care for their families and continue to contribute their quotas to their local economies.

“To treble this achievement in the next four years, the international community must not falter to uphold the new commitments made,’’ it advised.

It expressed that for the first time, key population groups — sex workers, homosexuals and drug addicts — who were at great risk of HIV infections were mentioned explicitly in the political declarations at the UN summit of HIV-AIDS, but, however cited the glaring omission of transgender people, who did not receive any mention.

A virologist and founder of Innovative Biotech Limited, Dr Simon Agwale, says the idea of universal access to treatment of HIV-AIDS is welcome, especially if it extends to Africa and other developing countries.

Agwale, who claimed to have designed a candidate vaccine for HIV, urged global leaders to make good their pronouncements to check the global pandemic by not abandoning the fight midway.

A Keffi-based medical practitioner, Dr Pechulano Simon, however, warned that UN’s pronouncements must not be politicised. He advised that in the course of implementation of the summit’s decisions, target groups must be reached, rather than “political actors”, who were always handy as middlemen.

No doubt, the New York declarations mark a turning point in the global efforts to combat the HIV and AIDS pandemic. But how realistic is the 2020 terminal date for exterminating the HIV/AIDS scourge that has defied any known solution for the past 30 years is a question that is better left for the next nine years to answer.

Okwor writes for the News Agency of Nigeria

Mbadiwe Okwor