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HIV not over, warns UNAids South Africa director as infections spiral

New HIV infections are escalating at an alarming rate worldwide, it was revealed during an emergency meeting this month convened by UNAids and its partners, with global experts joining UNAids in South Africa to set targets and implement urgent programming.

There were 1.5m new HIV infections in 2021 – 1m more than the 2020 target of 500 000, UNAids said, with Eva Kiwango, its country director for South Africa, calling for global unity to lower prices for prevention and treatment tools.

UNAids and partners met HIV-prevention experts and implementers from the 28 countries with the highest rates of new infections to establish why they are failing to decline at scale, to discuss solutions and help countries set ambitious prevention targets.

Kiwango said they looked at roll-out plans for the targets set in the global Aids strategy of prevention, and the 2021 political declaration that was approved by member states.

“We did see an impact in the HIV response during COVID-19, along with the socioeconomic indicators, because dealing with Aids is not just about testing and treatment. People were worried about going to facilities and health workers were under immense strain,” she told Daily Maverick.

“During lockdown, many girls were out of school. According to Stats SA, 17m learners were out of school during closures and only about 11% of schools were offering remote learning. So, you can only imagine the implications for children, especially in rural areas … high levels of unprotected sex and teenage pregnancy. Young girls and boys were also dealing with sexual violence, as gender-based violence spiked as well.”

Kiwango said HIV treatment and prevention need integrated services, and if people weren’t accessing protection, contraceptives, nutrition and services that help with communicable diseases, this affects how the virus was managed.

She said there had been flatlining in testing and treatment before the pandemic and attributed this to people starting and stopping treatment for various reasons, including stigma and discrimination.

“But we are still trying to analyse that data and pinpoint why there was a flatline,” she said. “We are not on track to meet the 2025 target, but South Africa has had a significant decrease in cases, despite the global challenges. We are sitting at around 220 000 new cases, however, so they are not falling fast enough. They are still way too high among adolescent girls and young women. This group makes up 11% of the population in South Africa and yet it makes up 30% of new infections.

“One of our bigger challenges is vertical transmission from parents – I say parents and not mothers, because some women test negative and test positive later on in pregnancy and during breastfeeding … (causing a) high (number of) cases of children being infected.”

She pointed out that adolescent boys and young men have previously been left behind. “We are cognisant of that and have made them integral to future UNAids plans. If we do not confront HIV, then other pandemics will be hard to curb. HIV is not yet over.”


Daily Maverick article – HIV is not over, warns UNAids director for SA after emergency meeting (Open access)


See more from MedicalBrief archives:


New WHO-UNAIDS HIV strategy not feasible for Sub-Saharan Africa?


COVID-19 risks blowing HIV progress ‘way off course’ — UNAIDS


SSA makes most progress in fight against HIV — UNAIDS report


Landmark UNAIDS pricing deal to accelerate HIV treatment




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