Africa can learn a lot from Zim’s HIV response
THIS week, Zimbabwe hosts the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), a biennial event designed to address the HIV/ AIDS pandemic and sexually transmitted infections on the continent. The Joint United Nations Programme on HIV/AIDS (UNAIDS) will play a central role during this year’s event. The Sunday Mail’s
EMMANUEL KAFE (EK) interviewed UNAIDS executive director WINNIE BYANYIMA (WB) on the agency’s participation at ICASA and other issues.
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EK: Why is UNAIDS participating at ICASA?
WB: ICASA is a vital gathering of people from science, civil society, governments and international partners that can help spur action to end AIDS as a public health threat by 2030.
UNAIDS is working together with many others at ICASA to address inequalities and to accelerate inclusion and innovation to drive progress in the HIV response.
UNAIDS is highlighting that the end of AIDS as a public health threat is possible if communities are supported in their leadership. EK: What is the current state of the HIV response in the Sub-Saharan Africa region? What needs to be addressed? WB: We should, first of all, note the progress that has been made.
In a world where so much is bleak, the AIDS response is an unfinished, but inspiring success story of international cooperation.
New HIV infections have been reduced by almost 60 percent since the peak in 1995.
AIDS-related deaths have been reduced by almost 70 percent since the peak in 2004.
But AIDS is not yet over, and of the 39 million people living with HIV, over nine million still do not have access to treatment.
That’s an emergency and it requires that we mobilise resources to accelerate the HIV response.
To overcome the AIDS pandemic, we need to overcome the inequalities that drive it.
For example, in Sub-Saharan Africa, women and girls accounted for 63 percent of all new HIV infections in 2022.
Adolescent girls and young women (between 15 years and 24 years) in Sub-Saharan Africa were over three times more likely to acquire HIV than their male peers in 2022.
Unless we confront these inequalities, we will not end AIDS. EK: What lessons can other countries in the Sub-Saharan Africa region learn from Zimbabwe’s
success in meeting important UNAIDS targets?
WB: Zimbabwe has met the “9595-95” targets, meaning 95 percent of the people who are living with HIV know their HIV status, 95 percent of the people who know they are living with HIV are on life-saving antiretroviral treatment, and 95 percent of people who are on treatment are virally suppressed.
Firstly, this is a vital reminder that progress is possible.
Secondly, elements that have driven success in Zimbabwe can be applied, in tailored ways, by other countries. Thirdly, we must all — together — finish the job.
There is no room for “almost” succeeding or succeeding only for some. AIDS will not be over until it is over for all communities, everywhere. EK: How important is international support in ending AIDS? WB: Ending AIDS requires collaboration — south and north, governments and communities, the UN system and member states together.
The end of AIDS is within our grasp. Now is not a moment for
donors to step back; it is a moment for donors to step up.
That is why UNAIDS is highlighting to donor partners that ending AIDS is less expensive than not ending AIDS, and that ending AIDS on the time scale promised is less expensive than ending AIDS more slowly. EK: How does the 2023 UNAIDS Global AIDS Update report inform what is needed in HIV responses? WB: HIV responses succeed when they are anchored in strong political leadership, which follows the data, science and evidence; tackles the inequalities holding back progress; enables communities and civil society organisations in their vital role in the response; and ensures sufficient and sustainable funding. EK: What is the main message of UNAIDS’ World AIDS Day campaign? Also, what are the main recommendations of UNAIDS’ World AIDS Day report?
WB: Our message is simple: Let communities lead.
This is not doing communities a favour; this is how the world will end AIDS.
Communities understand what is most needed, what works and what needs to change.
We have seen it in Windhoek, Namibia, where young people are using e-bikes to deliver antiretroviral medicines, food and adherence support to young people who cannot attend clinics because their hours conflict with school.
We see it here in Zimbabwe, where the Sisters Project is improving HIV prevention and treatment outcomes of female sex workers and has expanded its services to reach male sex workers.
It is campaigning by communities across the world that brought the price of anti-retroviral medicines down from US$25 000 per person per year in 1995 to as low as US$70 per person per year today.
It is communities who most effectively monitor how services are delivered to enable improvements.
The World AIDS Day report’s recommendations focus on how to support communities in their leadership.
There is a need for governments, international organisations and partners to:
◆ Make communities’ leadership roles central to the formulation, budgeting, implementation, monitoring and evaluation of all plans, policies and programmes that will affect them and that impact the HIV response.
◆ Provide urgent additional multiyear core resources for community-led HIV programmes so they can be scaled up, and the people implementing them can be properly supported and remunerated.
◆ Remove barriers to community leadership.
◆ The human rights of women, adolescent girls and people from key populations need to be upheld.
◆ To protect everyone’s health, protect everyone’s human rights. EK: How should decision makers shift their perspective on communities? WB: Community leaders have expressed it to us this way: “We should not be seen as a target of interventions, but as the principal intervention.
“We should not be seen as the problem, but as the key to the solution.”
Communities are not in the way; they light the way.