World AIDS Day 2019 will be observed on December 1 and as expected, the World Health Organisation (WHO) will be highlighting the progress being made in several countries while drawing global attention to the need for broader engagement with various stakeholders, especially those at the frontline involved in providing health care and support to those affected.
Global leaders have recognised the essential role that communities play in ending AIDS and achieving health for all in the first-ever United Nations declaration on universal health coverage and the “Global action plan for healthy lives and well-being for all”, approved by Member States in September 2019.
The Human Immunodeficiency Virus (HIV) continues to be a major global public health issue that claims the lives of thousands worldwide every year. According to the WHO, in 2017, 940,000 people died from HIV-related causes globally. And in its most recent statistics, the WHO stated that of the 37.9 million people living with HIV at the end of 2018, 79 per cent received testing, 62 per cent received treatment, and 53 per cent had achieved suppression of the HIV virus with no risk of infecting others.
Also, according to the WHO, 59nper cent of adults and 52 per cent of children living with HIV were receiving lifelong antiretroviral therapy (ART) in 2017. Global ART coverage for pregnant and breastfeeding women living with HIV is high at 80 per cent. Thousands of community health workers and members of the HIV and key population networks – many of whom are living with HIV or affected by the epidemic – contributed to this success.
To reach the target of 90 per cent, an additional 7.5 million people need to access HIV testing services. It should be noted though that many more people with HIV are now receiving life-saving drugs which help to keep the virus under control. But millions of people who need treatment still do not have it. For example, Sub-Saharan Africa remains the most severely-affected part of the world, though some countries in the region have made impressive efforts in reducing fresh cases.
Caribbean countries, including Guyana, can boast of several successes in relation to our HIV response. Programmes to prevent mother-to-child HIV transmission, reduce new HIV infections and treat people living with the virus have yielded encouraging results. Additionally, the Caribbean is the only developing region that has approached the near-universal coverage of antiretroviral medicines to prevent mother-to-child transmission. According to official statistics, the Caribbean leads the world in the rates of its reduction in new HIV infections and AIDS-related deaths.
In Guyana’s case, there are some 8200 persons living with HIV. In 2018, about 500 new infections occurred mainly from key populations and young people. Of the 8200 persons living with the virus, 93 per cent of them know their status, making Guyana the only Caribbean country to achieve the first 90 of the UNAIDS’ 90-90-90 target ahead of the 2020 timeline. The 90-90-90 target aims to diagnose 90 per cent of all HIV-positive persons, provide antiretroviral therapy for 90 per cent of those diagnosed, and achieve viral suppression for 90 per cent of those treated by 2020.
When it comes to the other targets, 73 per cent of infected persons are presently on treatment and 81 per cent have so far achieved viral suppression so they can no longer transmit the infection to their partners.
The programmes that have been implemented have resulted in significant progress being made and should certainly be continued. Guyana cannot become complacent as the gains made over the years could easily be reversed. In order to sustain the advances made, the Government and other development partners need to put more money and effort towards ensuring that their HIV programmes is sustained.
That said, it would be good if the health authorities were to reassess where we are at present, what could be done differently and what sort of interventions and resources are needed to ensure that Guyana is on top of its game in meeting the relevant HIV/AIDS targets.