Every year, on December 1, the world commemorates World AIDS (Acquired Immune Deficiency Syndrome) Day. People around the world unite to show support for people living with and affected by HIV (Human Immunodeficiency Virus) and to remember those who lost their lives to AIDS.
Over the years, a detailed understanding of the HIV epidemic has emerged through the collection, analysis and dissemination of data, helping programs to reach the right people in the right place and at the right time. Having high-quality data on the AIDS response has enabled ambitious, measurable and time-bound targets to be set for tracking progress and ensuring accountability.
Inequalities
As the United Nations points out, the inequalities which perpetuate the AIDS pandemic are not inevitable; we can tackle them. This World AIDS Day, UNAIDS has urged societies to address the inequalities which are holding back progress in ending AIDS.
The “Equalise” slogan is a call to action. It is a prompt for all to work for the proven practical actions needed to address inequalities and help end AIDS. Accordingly all countries will have to increase availability, quality and suitability of services, for HIV treatment, testing and prevention, so that everyone is well-served; Reform laws, policies and practices to tackle the stigma and exclusion faced by people living with HIV and by key and marginalised populations, so that everyone is shown respect and is welcomed; Ensure the sharing of technology to enable equal access to the best HIV science, between communities and between the Global South and North.
Communities will be able to make use of and adapt the “Equalise” message to highlight the particular inequalities they face and to press for the actions needed to address them.
Lives at risk
Data from UNAIDS on the global HIV response reveals that during the past two years of Covid-19 and other global crises such as wars and conflicts, progress against the HIV pandemic has faltered, resources have shrunk, and millions of lives are at risk as a result.
The world has only eight years left before the UN’s 2030 goal of ending AIDS as a global health threat. Economic, social, cultural and legal inequalities must be addressed as a matter of urgency. In a pandemic, inequalities exacerbate the dangers for everyone. Indeed, the end of AIDS can only be achieved if we tackle the inequalities which drive it. World leaders need to act with bold and accountable leadership. And UNAIDS suggests that all of us, everywhere, must do all we can to help tackle inequalities too.
UNAIDS issued a stark warning that if leaders fail to tackle inequalities the world could face 7.7 million AIDS-related deaths over the next 10 years (until 2032). UNAIDS further warns that if the transformative measures needed to end AIDS are not taken, the world will also stay trapped in the Covid-19 crisis and remain dangerously unprepared for the other pandemics to come. The warning comes in a new report by UNAIDS titled “Unequal, unprepared, under threat: why bold action against inequalities is needed to end AIDS, stop Covid-19 and prepare for future pandemics”.
Here in Sri Lanka, little attention has been paid to HIV/AIDS. But the latest statistics on the prevalence of HIV here are rather alarming. The National STD (Sexually Transmitted Diseases) and AIDS Control Programme has diagnosed 50 university students with HIV.
Startling revelation
This startling revelation was made recently by Director of the National STD and AIDS Control Programme Dr. Rasanjali Hettiarachchi. She said that there are four schoolchildren and two monks also diagnosed with HIV. As far as we know, this is the first time that school students have been diagnosed with HIV in Sri Lanka.
The HIV infected among young people between the ages of 18 and 30 has doubled this year compared to last year, Dr. Hettiarachchi said. During the nine months since the beginning of this year, 342 infected people have been reported. The first HIV patient was found in Sri Lanka in 1987, several years after the first case was reported globally.
She said that since 1987, 4,404 HIV infected people have been reported from Sri Lanka, out of which about 1,000 people have died and about 2,300 people are still in need of treatment.
Fortunately, HIV is no longer a death sentence for those infected here or abroad, thanks to the widespread availability of generic Anti-Retroviral Therapies (ART). A combination of drugs such as Ziagen, Emtriva, Epivir and Viread or their generic equivalents can reduce the effects of HIV and make normal lives possible for those infected. In fact, it is possible to live out one’s normal lifespan even with HIV thanks to these drugs.
Right opportunities
It is thus important for societies not to marginalise or discriminate against HIV sufferers and it is important to spread the message that HIV does not spread through the air or by casual contact. They can play a productive and useful role in society if given the right opportunities.
In countries such as Sri Lanka, sex is a taboo subject (not discussed at home or school) and many teachers skip the sex education section which is part of the school curricula. This means that many youngsters have little or no knowledge of safe sexual practices – what little they know comes from peers, who are equally clueless. This leads to STDs, unwanted pregnancies and other societal problems. It is therefore vital to teach youngsters about sex and also about HIV. The media too can play a role in this regard, the same way they did for Covid-19.
Frantic research
But AIDS could be a thing of the past if medical researchers and scientists have their way. Frantic research is under way on a HIV/AIDS vaccine, although it is difficult to perfect one due to the complexity of the disease. However, several companies are working on mRNA HIV vaccines – yes, the same ones that proved so effective against Covid-19. They hope to develop two types of vaccine – one will prevent the disease (this does not mean that people should forego other preventive measures such as not having unprotected sex) while the other will lessen the suffering of those already infected with HIV.
The latter has even been touted as a “cure” for HIV/AIDS that can help the infected to stay off ART for a lifetime. There is a chance that an AIDS vaccine of either type could be developed well before 2030. It has also been found that Hepatitis B vaccination can help AIDS sufferers, though it is not clear how.
A mainstream issue
In the meantime, HIV must not be thought of as a marginal health issue – it is a mainstream issue that has just not got the attention it deserves either from the public or the health authorities. This should change from this World AIDS Day and every effort must be made to educate the public on this disease in order to prevent its further spread.