The United Nations’ AIDS agency is hailing what officials describe as significant progress in the fight against the epidemic in eastern and southern Africa. The report says AIDS-related deaths have declined dramatically and that the number of new infections has decreased - a direct result of more available treatment. But, they warned, challenges remain.
Top health and aid officials praised the gains in the fight against AIDS in southern and eastern Africa - among them, a nearly 40 percent drop in AIDS-related deaths since 2005, and a 50 percent drop in new infections among children since 2001.
The cause, they said was simple: The number of people receiving anti-retroviral treatment has increased tenfold, from 625,000 in 2005 to 6.3 million in 2012.
But this disease, said Ethiopia’s health minister, is not about numbers. Dr. Kesetebirhan Admasu said he is still haunted by some of the patients he met when he was in practice a decade ago. At the time, he said, Ethiopian hospitals were full of suffering AIDS patients. The disease was taboo, he said, and the media portrayed it “as a horror.”
He was one of the first doctors to begin treating AIDS patients in Ethiopia. At the time, treatment was expensive and complicated.
“When we started the program, over a period of one year we only managed to put 5,000 patients on ART," he said. "They had to provide some kind of proof that they will continue to receive the treatment and pay for it. I still remember vividly a mother of six who came to my clinic to seek treatment. She was jobless, her husband died of HIV, and two of her daughters were working for the government. And she had to bring her two daughters to, you know, assure us that they will pay for her treatment.”
Dr. Kesetebirhan did not say what happened to the patient. But he said that his government is trying to make her story a rarity by implementing aggressive health-care measures, including a veritable army of specially trained health workers and free access to AIDS drugs.
It appears to have worked: Ethiopia is among seven African nations where the number of AIDS-related deaths has fallen more than 50 percent since 2005. It is also one of seven countries where the rate of new infections has halved.
The country with the world’s heaviest AIDS burden, South Africa, has also made gains. UNAIDS estimates that some 5.6 million South Africans are infected with HIV.
South African Health Minister Dr. Aaron Motsoaledi said he was optimistic, especially since the health ministry under his tenure has shifted to an evidence-based, scientific approach to AIDS.
Motsoaledi’s predecessor, who served for nearly a decade, drew international criticism for rejecting the value of AIDS drugs and touting herbal treatments for AIDS such as garlic and beetroot.
“It’s quite encouraging to realize that the tide is turning," he said. "In South Africa, I wouldn’t have said so just less than three years ago. Minister Admasu is talking about 10 years in Ethiopia. I’m sure you are aware we have had our own 10 years, which I don’t want to talk about. But at the moment, there is definitely light at the end of the tunnel.”
Motsoaledi noted great decreases in the rate of mother-to-child transmission and said more South Africans are getting tested than ever before. He also said the government would next year start vaccinating all 9-10-year-old girls against Human Papillomavirus, a sexually transmitted infection that can cause cervical cancer and also increases the likelihood of HIV infection.
But, he said, his nation’s health system is struggling to accommodate its various burdens, and needs to come up with a novel solution.
“When you add the number of people who need treatment from HIV/AIDS, those who need treatment from TB and the non-communicable diseases, our health facilities are going to be extremely overstretched," said Motsoaledi.
"So that tells us that together with all the development partners, we need to start planning and innovate new methods," he added. "So the innovation we are coming up with in South Africa which is far advanced, we are working on an innovation where these people who are very stable, on ARV treatment, on TB, even [non- communicable diseases], who do not need to see a doctor or a nurse should no longer report to health facilities but can receive their treatment in many other localities: community pharmacists, chain stores around our country, private doctors nearer to them. They must just wake up and go to the nearest facility.”
Officials also noted their remaining concerns. For example, HIV prevalence among young women was 4.5 percent in 2011 - more than twice the rate among young men. And the officials acknowledged that convincing young people to take precautions against HIV remains a major challenge.