‘HIV fight needs holis­tic ap­proach’

Lesotho Times - - Big Interview -

WITH the in­ter­na­tional com­mu­nity set­ting the tar­get of en­sur­ing HIV/AIDS is no longer a pub­lic health is­sue by 2030, ef­forts to fight the pan­demic have been stepped up over the pre­ced­ing years.

Such ef­forts in­clude the Joint United Na­tions Pro­gramme on HIV and Aids (UNAIDS) Fast-track Strat­egy which was launched in 2014 with the aim of ac­cel­er­at­ing the HIV re­sponse in low and mid­dle-in­come coun­tries.

Un­der the am­bi­tious treat­ment tar­get, 90 per­cent of all peo­ple liv­ing with HIV would know their HIV sta­tus, 90 per­cent of all peo­ple di­ag­nosed with HIV would re­ceive sus­tained an­tiretro­vi­ral ther­apy and 90 per­cent of all peo­ple re­ceiv­ing an­tiretro­vi­ral ther­apy would have vi­ral sup­pres­sion by 2020.

An­other strat­egy is the Test-and-treat method which en­sures that peo­ple are put on treat­ment should they test HIV pos­i­tive.

UNAIDS has stated that the ag­gres­sive re­sponse was in­formed by the need to en­sure the strat­egy was not out­run by the pan­demic.

Last week, a UNAIDS del­e­ga­tion vis­ited Le­sotho for two days to “cap­ture high­lights of the coun­try’s HIV re­sponse” as well as con­grat­u­late gov­ern­ment for the progress made in re­spond­ing to the HIV/AIDS pan­demic.

The del­e­ga­tion was made up of the UNAIDS 90-90-90 Tar­gets Global Cham­pion, Marc An­gel, UNAIDS Re­gional Di­rec­tor for Eastern and South­ern Africa, Sheila Tlou and Badara Samb, the di­rec­tor of the Spe­cial Ini­tia­tive Unit of UNAIDS in Le­sotho.

Mr An­gel, who is also a Lux­em­bourg leg­is­la­tor, sat down with Le­sotho Times (LT) Re­porter Pas­cali­nah Kabi for an in­ter­view on the side­lines of the visit. Among the is­sues dis­cussed in the in­ter­view were his mo­ti­va­tion to be­come a 90-90-90 tar­gets global cham­pion.

LT: What mo­ti­vated you to come out of your com­fort zone and fight the HIV/ AIDS pan­demic?

An­gel: Lux­em­bourg is a monar­chy like Le­sotho and has for many years been the long-stand­ing part­ner of UNAIDS and United Na­tions Chil­dren’s Fund (UNICEF). For this rea­son and many oth­ers, the fight against HIV and Aids is some­thing which has been very close to my heart. This is why I was happy when UNAIDS Ex­ec­u­tive Di­rec­tor Michel Sidibe ap­pointed me as the 90-90-90 tar­gets global cham­pion.

I must men­tion from the get-go that I am from a civil so­ci­ety or­gan­i­sa­tion back­ground and fight­ing to end all so­cial ills like HIV and Aids is some­thing that I take se­ri­ously.

Be­sides be­ing a politi­cian, I am a HIV and Aids ac­tivist work­ing hard to en­sure that we end Aids now; that no one is left be­hind in the fight against the pan­demic. So, when I left the civil so­ci­ety, I con­tin­ued be­ing in­ter­ested in the fight against HIV. And as a 90-9090 tar­gets global cham­pion, I in­tend to work hard to help all coun­tries in­clud­ing Le­sotho achieve the set tar­gets by 2020.

Ad­vo­cat­ing for hu­man rights and en­sur­ing that ev­ery per­son has ac­cess to HIV test­ing and treat­ment for those who tested pos­i­tive is very close to my heart. We need to move to a new era where dis­crim­i­na­tion and stigma will be a thing of the past and AIDS will no longer be a pub­lic health prob­lem.

We all need to work to­gether to en­sure that no one is left be­hind. We owe it to our­selves and gen­er­a­tions to come to en­sure that by 2030 the world will be free of HIV and AIDS.

LT: What is the role of par­lia­men­tar­i­ans in end­ing the scourge of HIV and Aids?

An­gel: I think leg­is­la­tors should be role mod­els by be­ing hu­man rights ad­vo­cates. Par­lia­men­tar­i­ans’ role in end­ing the pan­demic is also to vote for bud­gets that are health-sen­si­tive and that seek to end the scourge of HIV and Aids in the world. We need to vote for bud­gets that will bring about pro­grammes seek­ing to achieve the 90-90-90 tar­gets like Test-and-treat.

While talk­ing about HIV and AIDS in their of­fi­cial speeches is one of leg­is­la­tors’ roles in end­ing the pan­demic, par­lia­men­tar­i­ans should also reg­u­larly talk about the pan­demic with vot­ers. Mak­ing of­fi­cial speeches only is not enough. We need ev­ery­one in­volved in the fight against HIV and AIDS and we must also lead by ex­am­ple.

Par­lia­men­tar­i­ans need to go to their con­stituen­cies and discuss th­ese is­sues with peo­ple be­cause, as role mod­els, they have a role to play in en­sur­ing that all coun­tries achieve the 90-90-90 tar­gets.

I also think that par­lia­men­tar­i­ans need to work closely with civil so­ci­ety or­gan­i­sa­tions in com­ing up with so­lu­tions that help each coun­try achieve th­ese tar­gets. They need to un­der­stand that health is­sues can­not be solved by politi­cians alone. We need to have a holis­tic ap­proach where ev­ery­one in­volved, like civil so­ci­ety or­gan­i­sa­tions, have a role to play. Civil so­ci­ety or­gan­i­sa­tions are not the enemy.

Par­lia­men­tar­i­ans need also vote for laws ad­vo­cat­ing for the end of HIV and AIDS and make it their mis­sion to en­sure th­ese laws are im­ple­mented.

LT: In light of ef­forts be­ing made to achieve the 2020 tar­gets, what is the cost of end­ing HIV and Aids?

An­gel: There is no fixed cost in end­ing HIV and Aids, but bil­lions of dol­lars are be­ing in­vested in this cause with the knowl­edge that in­vest­ing US$1 in treat­ment yields US$15 in pro­duc­tiv­ity. A healthy pop­u­lace is eco­nom­i­cally ac­tive and not a bur­den to gov­ern­ments; hence all gov­ern­ments should work hard to achieve the 90-90-90 tar­gets. This works as a preven­tion method as well be­cause peo­ple liv­ing with HIV can­not trans­mit the virus when it is sup­pressed.

But while fund­ing is im­por­tant, gov­ern­ments should not rely en­tirely on donor-fund­ing. They need to mo­bilise fund­ing on their own by en­sur­ing that their na­tional bud­gets are sen­si­tive to end­ing HIV and Aids come 2030.

Hu­man re­sources are very im­por­tant in end­ing AIDS, hence the need for gov­ern­ments to in­vest in hu­man re­sources from com­mu­nity health work­ers to the high­est lev­els.

Gov­ern­ments also need to cre­ate an en­vi­ron­ment where there is ac­cess to good health ser­vices. Coun­tries like Sene­gal have done it and I don’t see why Le­sotho can­not do it. From my meet­ings with sev­eral stake­hold­ers, it is ob­vi­ous that the Le­sotho gov­ern­ment takes its AIDS re­sponse se­ri­ously. It has in­vested a lot of money to en­sure that its peo­ple have ac­cess to treat­ment. “Le­sotho is one of the few coun­tries where an­tiretro­vi­ral drugs are avail­able for free).

Le­sotho is also one of the first coun­tries to launch the Test and Treat pro­gramme. With a com­mit­ment from ev­ery­one in­volved, I don’t see any rea­son why the coun­try can­not achieve the 90-90-90 tar­gets come 2020.

LT: What are some of the chal­lenges you have iden­ti­fied that might af­fect the coun­try’s abil­ity to achieve th­ese tar­gets?

An­gel: Le­sotho’s con­tin­ued po­lit­i­cal in­sta­bil­ity is neg­a­tively af­fect­ing the goal of end­ing HIV/AIDS. This is be­cause each time there is po­lit­i­cal in­sta­bil­ity, the mo­men­tum dis­si­pates. We want the fight against HIV/ AIDS to con­tinue re­gard­less of what is hap­pen­ing. An­other chal­lenge is that of fund­ing which is not to­tally absorbed.

LT: As a man, what is your mes­sage to your male coun­ter­parts who are as­sess their HIV sta­tus through their sex­ual part­ners?

An­gel: In Le­sotho, men are lucky that Test and Treat ser­vices have been brought to the peo­ple by way of mo­bile clin­ics in malls and other pub­lic spa­ces. I was so im­pressed by this ini­tia­tive be­cause it ad­dresses is­sues of dis­crim­i­na­tion and stigma.

So I urge my male coun­ter­parts to ac­cess health ser­vices, do not test your­self by your part­ner’s HIV sta­tus. Go get tested. If you test pos­i­tive, you will be ini­ti­ated into treat­ment im­me­di­ately and your vi­ral load will be even­tu­ally sup­pressed if you ad­here to treat­ment.

As a leader, you will not only be tak­ing care of your­self but you will also be lead­ing by ex­am­ple; en­cour­ag­ing other mem­bers of the so­ci­ety to go get tested. Know­ing your sta­tus is power.

If you test pos­i­tive, know that HIV is not a death sen­tence. With the right treat­ment and ad­her­ence, you will lead a nor­mal life and live for many years to come. Know­ing your sta­tus is price­less.

LT: What is the role of the me­dia in en­sur­ing that coun­tries like Le­sotho, with the sec­ond high­est HIV preva­lence rate in the world, achieve the 9090-90 tar­gets?

An­gel: I can­not stress enough the im­por­tant role the me­dia plays in help­ing coun­tries achieve the 90-90-90 tar­gets. With­out their im­por­tant role of keep­ing gov­ern­ments in check and ad­vo­cat­ing for gen­der equal­ity, em­pow­er­ing women and en­sur­ing that other key pop­u­la­tions (like les­bians, gays, bi­sex­ual, trans­gen­der and in­ter­sex) are not left be­hind. Me­dia is a key role player in en­sur­ing that no one is left be­hind, es­pe­cially young women and that health ser­vices are pro­vided and ac­cessed by all.

With­out the me­dia, we will not be able to dis­sem­i­nate cru­cial in­for­ma­tion to ev­ery cit­i­zen of ev­ery coun­try. Jour­nal­ists help us en­sure that the gov­ern­ment in­vests money in health­care and that money is ac­counted for.

UNAIDS 90-90-90 Tar­gets Global Cham­pion Marc An­gel.

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