Latest results released by UNAIDS show that Africa has made greater strides in the fight against Aids and is on track to achieve set targets if investments are increased. The results come at a time of many competing development priorities and the levelling of development assistance for health.
The AU is pushing for increased domestic investment in health in the context of impressive rates of economic growth in many African countries. “The progress particularly in our eastern and southern Africa region demonstrate that the political commitments of African countries and the global community are being translated into tangible action. However, it is too early to celebrate as we need to engage with the issues that we are off track including addressing HIV in children, young people and regions that are lagging behind” said Her Excellency Amira El Fadil, the commissioner for social affairs at the AU Commission.
During the July 2017 summit in Addis Ababa, heads of state and government commended the significant progress made in the reduction of mortality and new rates of HIV infection on the continent but committed to further pursue initiatives to build strong human resources for health including harnessing the role of community health workers and endorsed the 2m community health workers initiative that seeks to create a new cadre of health workers to further strengthen community health systems. To harness Africa’s demographic dividend, the summit underscored the importance of addressing the unmet needs of young people and adolescents and raised concern that the west and central Africa region is lagging behind and endorsed the emergency catch up plan to accelerate the HIV response.
The eastern and southern Africa region which has been most affected by HIV globally has achieved the most progress. Since 2010, Aids-related deaths have declined by 42%. New HIV infections have declined by 29%, including a 56% drop in new HIV infections among children over the same period, a remarkable achievement resulting from HIV treatment and prevention efforts that is putting the region on track to end Aids.
Global solidarity and shared responsibility to stop new HIV infections among children has produced results. Around 76% of pregnant women living with HIV had access to antiretroviral medicines in 2016, up from 47% in 2010. New HIV infections among children globally have halved, from 300,000 in 2010 to 160,000 in 2016. Five-high burden African countries – Botswana, Namibia, South Africa, Swaziland and Uganda – have already met the milestone of diagnosing and providing lifelong antiretroviral therapy to 95% of pregnant and breastfeeding women living with HIV.
However, in west and central Africa the data shows that only 42% of the 6.1m people living with HIV in the region knew their HIV status and only 35% were accessing HIV treatment and only one in four people living with HIV were virally suppressed in 2016.
Similarly in the Middle East and North Africa, just over half of the people living with HIV knew their HIV status, with less than half of those on HIV treatment. Only one out of five people living with HIV was virally suppressed.
Some of the key challenges that Africa needs to address include addressing New HIV infections that are not declining fast enough, increase TB testing for people living with HIV, accelerate treatment for children living with HIV and address HIV issues for young
people and adolescents. The data also shows that as many as two thirds of children under two years old are diagnosed late and start treatment with advanced immunodeficiency, resulting in a high mortality rate.
A revitalised and energised response remains critical for ending Aids by 2030 and create a solid foundation to achieve Africa’s journey towards socio-economic transformation as espoused in Agenda 2063.
Also, the AU has commended new results in responding to Aids, TB and malaria – the Global Fund to Fight AIDS, TB and Malaria has announced new results that show an up-scale in the live saving programmes of the global financing mechanism. The Global Fund-supported programmes play an important role in supporting national Aids, TB and malaria programmes across Africa as well contributing to strengthened health systems.
“The new results announced by the Global Fund to Fight AIDS, Tuberculosis and Malaria demonstrate impact in the fight against the three biggest diseases on the continent” said El Fadil. “It is critical that we continue with our advocacy efforts to ensure that the political commitment to fund the mechanisms remains”.
Many countries have levelled their support to the Global Fund over time, indicating a high commitment to the Global Fund and the three diseases relative to other global health and development priorities. However, in the context of many competing development priorities the AU Commission is pushing for its member states to increase its domestic financing to health programmes.
According to the report in the second half of 2016, an additional 953,000 people were put on antiretroviral therapy (ARV) for HIV in programmes supported by the Global Fund, a 9.5% increase, bringing the total to 11m people. The results, based on data from the end of 2016, also show that programs supported by the Global Fund partnership provided 4.3m pregnant women with antiretroviral medicines to prevent the transmission of HIV to their unborn children.
Four countries account for about 50% of the 6-month increase, Nigeria (22%), Tanzania (11%), Uganda (10%) and Myanmar (10%). The full national result from Kenya is now included in Global Fund reporting. In previous years the Global Fund captured 50% of the national result. An additional 375,000 pregnant women were reached with services to prevent of mother-to-child transmission of HIV, representing a 9.7% increase from mid-2016. Counselling and testing for HIV rose by 7.8% to reach 579m sessions.
The latest results show progress in the response to the tuberculosis epidemic with 826,000 new smear-positive cases detected and treated in the second half of 2016, an increase that brings the cumulative result to 17.4m. People treated for multidrug-resistant TB (MDR-TB) rose by 11.9% compared to the six-month period ending June 2016. In the second half of 2016, about 82m mosquito nets were distributed for the prevention of malaria, an increase of 11.5%, to reach a cumulative total of 795m. Over the same time span, the number of cases of malaria treated increased by 6.7% to reach 668m. The highest number of nets was distributed in Tanzania, the Democratic Republic of Congo, Guinea and India. Together, they accounted for 70% of the increase from June 2016.