COVID-19 likely to push back achieving HIV targets by 10 years or more

A UNAIDS report says the pandemic could slow down progress in reducing HIV infections

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A new report by the UNAIDS says that the world will not meet its target for reduction in global HIV infections while COVID-19 risks will further slow down progress.

The report, titled ‘Seizing the moment — Tackling entrenched inequalities to end epidemics’, was released at the inauguration of the 23rd International AIDS Conference held virtually this year.

Speaking at the inauguration, UNAIDS Executive Director Winnie Byanyima, said, “Even before the onset of COVID-19, the new UNAIDS Global Report shows that the world was not on track to reach its goal of ending AIDS as a public health threat by 2030. We cannot drop the ball on HIV. We must double down and increase our efforts to hold governments and policy makers to account. Epidemics run along the fault lines of inequalities and we can and must close the gaps.”

WHO Director-General Dr Tedros Adhanom Ghebreyesus said that the survey showed that the COVID-19 pandemic has significantly disrupted access to HIV treatment across the world.

“The findings of this survey are deeply concerning. Countries and their development partners must do all they can to ensure that people who need HIV treatment continue to access it. We cannot let the COVID-19 pandemic undo the hard-won gains in the global response to this disease.”

The report notes, ‘Missed targets have resulted in 3.5 million more HIV infections and 820,000 more AIDS-related deaths since 2015 than if the world was on track to meet the 2020 targets. In addition, the response could be set back further, by 10 years or more, if the COVID-19 pandemic results in severe disruptions to HIV services’.

The Asia and the Pacific regional survey of the report notes that while HIV infections in Asia and the Pacific have declined slightly, with reductions in Cambodia, Myanmar, Thailand and Vietnam, these have been offset by sharp increases in Pakistan and the Philippines. Key populations and their partners accounted for an estimated 98 per cent of new HIV infections, and more than one quarter of new HIV infections were among young people (aged 15 to 24 years). Rising numbers of new infections among gay men and other men who have sex with men are a major concern. An overall slowing in reductions in new HIV infections coincides with a decline in political and programmatic commitment, alongside punitive laws and policies and rising stigma and discrimination that block effective AIDS responses.

Regional score cards on a number of parameters puts India in the bunch of seven countries which have rolled out pre-exposure prophylaxis (PrEP) programmes in the pilot stage. Drawing from population based surveys, the report says that the region has an average of 34.4 per cent people in the 15-49 year age group who will not buy vegetables from a shopkeeper living with HIV. For India, the figure falls between 21-40 per cent. India is also part of the small group of countries from the region which shows an improvement in the trends in CD4 level among those newly diagnosed with HIV. A higher CD4 count means a better immune system and is co-related to earlier diagnosis of HIV status. India also reports high coverage of needle-syringe programmes for drug users but offers medium coverage for opioid substitution therapy. The country also scores higher than the regional average for notified tuberculosis patients who know their HIV status.

The report notes that response to the COVID-19 pandemic can leverage the world’s learning from its HIV response. “The leadership and engagement of communities remain central features of the HIV response. Local, national, regional and international community organizations contributing to HIV responses have quickly brought their energy and experience to the COVID-19 response. Civil society groups are leading efforts to ensure that COVID responses are rights-based and gender-sensitive, and that they do not prejudice marginalized communities, such as lesbian, gay, bisexual, transgender and intersex (LGBTI) people…,” it says.

To keep the world close to its track for achieving its HIV-AIDS targets of zero transmission, zero deaths and zero discrimination, the report suggests multi-month dispensing of antiretroviral drugs and adapting services to meet the needs of vulnerable groups such as migrants, drug users, sex workers and transgender people.