More than 15m people on life-saving HIV drugs – not enough, says MSF

HIVThe Guardian, MSF Access, November 24, 2015. UNAids says additional 2 million people began antiretrovirals in the last year, but campaigners say figure must reach 3 million a year to meet 2020 targets.

More than 2 million people with HIV have been put on drugs to keep them well in the past year, according to the UN, but medical experts say there needs to be an exponential rise to comply with new guidelines.

A new report from UNAids shows that the numbers on life-saving antiretroviral (ARV) medication have doubled in five years from 7.5 million in 2010 to 15.8 million. “Every five years we have more than doubled the number of people on life-saving treatment,” said Michel Sidibé, executive director of UNAids. “We need to do it just one more time to break the Aids epidemic and keep it from rebounding.”

However, Médecins Sans Frontières, whose volunteer doctors pioneered HIV treatment in sub-Saharan Africa, say that while the 2.2 million increase over the past year is good news, a faster take-up is now necessary.

New guidelines from the World Health Organisation say that health professionals should “treat and test”, which means that those who are given a diagnosis of HIV should be put on drugs immediately, rather than waiting for the virus to impact on their immune system.

“It’s good news the pace of HIV treatment scale-up continues to increase, with 2.2 million people newly started on treatment in one year, but to achieve the global goal of reaching 30 million people with treatment by 2020, we’re going to need to see 3 million new people on treatment each year,” said Sharonann Lynch, HIV and tuberculosis policy advisor for MSF’s Access Campaign.

“Countries should waste no time and take up new WHO guidelines that call for all people living with HIV to be offered immediate treatment.”

Immediate treatment is not only good for the health of the person with HIV – it also makes them less infectious. MSF has started to test and treat in Swaziland,the country with the highest HIV prevalence in the world, and found that people have welcomed the approach. It is also offering immediate treatment in South Sudan, where less than 25% of those infected are on drugs.

The UNAids report shows that many countries are on what it terms the “fast-track” to end Aids by 2030, which is one of the sustainable development goals. It cites examples of good practice, where the response is targeted to the populations most in need of help. Kenya has successfully focused on female sex workers, reducing the incidence of sexually transmitted infections among them from 27% in 2013 to 3% in 2015.

Iran has introduced methadone for opioid-dependent prisoners. By 2009, it had reached 25,000 prisoners across the country, reducing the chances of HIV infection through illicit use of shared needles.

UNAids says 35 countries have fast-track programmes, focusing on interventions that will deliver the most impact in particular populations in specific locations. By 2030, it predicts, 21m Aids-related deaths, 28m new HIV infections and 5.9m new infections among children will have been averted.

“Everyone has the right to a long and healthy life,” said Sidibé. “We must take HIV services to the people who are most affected, and ensure that these services are delivered in a safe, respectful environment with dignity and free from discrimination.”

 

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