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By Michael Sainsbury | International
That the world is falling short of meeting its own disease control hurdles — even ahead of the COVID-19 pandemic — means that global leaders were already falling short of their completely meetable healthcare obligations to their people. So, it's hardly surprising that if targets for a virus (HIV) that has now been with us for well over four decades have not been met, precautions for a pandemic were not in place.
"Missed targets have resulted in 3.5 million more HIV infections and 820 000 more AIDS-related deaths since 2015 than if the world was on track to meet the 2020 targets. In addition, the response could be set back further, by 10 years or more, if the COVID-19 pandemic results in severe disruptions to HIV services," UNAIDS said on the release of its July 2 annual report. The funding gap between 2019 funding and that needed for 2020 in Asia Pacific is 26 percent.
A six-month complete disruption in HIV treatment could cause more than 500 000 additional deaths in sub-Saharan Africa over the next year, bringing the region back to 2008 AIDS mortality levels. Even a 20 percent disruption could cause an additional 110 000 deaths, the UN noted.
Many countries were seeing HIV resources, medicines, medical staff and equipment being moved to the fight against COVID-19. Observers noted that good lessons and practices of the HIV response, such as meaningful participation and accountability, are being ignored.
Even before the pandemic, HIV funding was falling short. In 2019, it fell by 7 percent from 2017 to US$18.6 billion, leaving global funding 30 percent short of the $26.2 billion needed to effectively respond to HIV in 2020.
At least 82 countries criminalize some form of HIV transmission, exposure or non-disclosure. Sex work is criminalized in at least 103 countries and at least 108 countries criminalize the consumption or possession of drugs for personal use.
Even more shamefully for a region where the disease can be rife, Asia is helping drag down the rest of the world. Only Thailand, Cambodia, Myanmar, Vietnam and Singapore have met at least one of the 90-90-90 marks for 2020 set by UNAIDS.
This refers to 90 percent of people living with HIV knowing their HIV status, of whom 90 percent are on antiretroviral treatment and of whom 90 percent are virally suppressed.
Performing worst on most measures, especially in terms of access for gay men and drug addicts to HIV services, were Pakistan, Bangladesh and Malaysia. There was better news in the region about the purchase of condoms, which is rising across Asia as it falls in most of the rest pf the world.
HIV/AIDS is a manageable disease.
The antiretroviral drugs used to treat it are relatively inexpensive and provision of them for free or at a nominal cost for poor people is vital for public health as they crunch the disease to such an extent inside the body that it is undetectable and untransmittable. They help halt the spread of the disease as well as keeping infected people healthy, saving much needed hospital beds and doctor hours.
"Every day in the next decade decisive action is needed to get the world back on track to end the AIDS epidemic by 2030," said Winnie Byanyima, executive director of UNAIDS.
"Millions of lives have been saved, particularly the lives of women in Africa. The progress made by many needs to be shared by all communities in all countries. Stigma and discrimination and widespread inequalities are major barriers to ending AIDS. Countries need to listen to the evidence and step up to their human rights responsibilities."
If they are provided with the right medication, those afflicted can lead long and healthy lives. Most countries in the West have HIV/AIDS under relative control, as do increasing numbers of developing nations. Thailand and Cambodia are best in class in Asia.
Yes, it's a problem that requires money and education, but some governments need to wake up, smell the coffee and pick up their game on this important global health issue. It is vital that COVID-19 does not become an excuse to allow HIV infections to fester and begin growing faster once more.
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