Madam,
The latest Joint United Nations Programme on HIV/AIDS (UNAIDS) Global AIDS Update Report shows that the path to ending AIDS is not just a concept or idea but a reality. It is a political and financial choice, and the countries and leaders who are already following the path are achieving extraordinary results. Encouragingly, Eswatini, Botswana, Rwanda, the United Republic of Tanzania and Zimbabwe have all met the UNAIDS ‘95-95-95’ targets. It refers to 95 per cent of the people who are living with HIV who know their HIV status; 95 per cent of the people who know that they are living with HIV are on lifesaving antiretroviral treatment and 95 per cent of people who are on treatment being virally suppressed. While commendable progress has been made in reducing new HIV infections and AIDS-related deaths, the decline in incidence varies significantly across countries and populations.
Unfortunately, the overall decrease in HIV rates is not yet occurring at a pace sufficient to attain the 2025 targets. Ongoing social and economic inequalities within countries and between them are prolonging pandemics and exacerbating their impact on the poor and the most vulnerable. Adolescent girls and young women, children and key populations, especially, are the most affected. Adolescent girls and young women aged 15 - 24 years are at inordinate risk of HIV infection. Many adolescent girls and young women lack sufficient decision-making power about their sexual relations, contraceptive use and healthcare. Creating safe societies for young women and girls is vital in protecting their health. Empowering them with knowledge, agency and access to comprehensive sexual and reproductive health services is crucial in curbing HIV.
Inequalities
Programmes must address gender inequalities and economic vulnerabilities, prevent violence, provide quality education, healthcare and food security – which increases their ability to adhere to HIV treatment. By empowering them with economic skills, entrepreneurship training and access to resources, we can create pathways for economic independence and reduce their vulnerability to HIV. At UNAIDS, we have seen the value of multi-level collaboration to address the multiple needs of adolescent girls and young women. ‘Education Plus’ is one such collaboration. It is imperative that we prioritise investments such as the Education Plus Initiative, which aims to accelerate efforts to prevent HIV, violence and teenage pregnancy by providing young women and adolescent girls with equal access to quality secondary education and key education and health services. We also need to secure the well-being of our children to combat AIDS.
Consistent adherence to treatment can truly eliminate mother-to-child transmission. Botswana and Malawi have significantly reduced their vertical HIV transmission (direct transmission from mother to child in utero, during delivery or through breastfeeding) rates by 83 per cent and 74 per cent, respectively, and these successes are a testament to the importance of fostering strong partnerships with other health programmes, such as child immunisation and sexual and reproductive health services. By leveraging these collaborations and actively engaging with communities, it becomes possible to ensure universal screening of all pregnant women for HIV, as well as treating the children of women living with HIV. The route map set out in UNAIDS’ new report shows that it is possible to end AIDS in this decade. It takes collaboration – South and North, government and communities, UN and member states together – bold leadership and informed action.
Anne Githuku-Shongwe