According to UNAIDS, approximately 1 million people in Malawi were affected by HIV/AIDS in 2017, with a prevalence rate of 9.6% among individuals aged 15-49. Sex workers and gay men are particularly vulnerable, with HIV prevalence rates of 60% and 17% respectively. However, there has been progress in combating HIV/AIDS in Malawi and between 2010 and 2017, AIDS-related deaths decreased by about 50%.
Malawi aims to have 95% of people living with HIV aware of their status by 2025. Despite the reduction in AIDS-related deaths, the country still has one of the highest HIV prevalence rates among adults aged 15 to 49.
With 13 million people living below the poverty line out of a population of 21 million, STD-related health care is often unaffordable for those facing financial hardships. Moreover, disparities in health care resources contribute to the lack of a rapid HIV/AIDS response, with rural areas having limited access to treatment compared to urban areas.
Prioritizing Testing and Treatments
According to 2017 data, out of the 1 million individuals who live with HIV/AIDS in Malawi, 90% receive antiretroviral therapy. However, a 2020 study revealed that antiretroviral therapy failure and drug resistance are common among those undergoing HIV treatment.
A 2020 observational study led by the London School of Hygiene & Tropical Medicine, University of Malawi College of Medicine and the University of Cambridge found that antiretroviral therapy failure and drug resistance are common among those receiving HIV treatment.
Recent research published in the Lancet found more than 80% of patients have resistance to two or more HIV antiretroviral drugs and 95% of patients have undetectable HIV loads as of 2020. The study also revealed that patients with resistance to multiple HIV drugs were 70% more likely to experience a clinical death within two months of checking into the hospital compared to those without drug resistance.
With one-third of patients failing to receive therapy fast enough, timely diagnosis and switching patients to alternative antiretroviral therapies have contributed to better patient outcomes in Malawi.
Barriers to HIV/AIDS
Despite significant reductions in HIV infections, individuals living below the poverty line in Malawi continue to face the greatest impact. Malawi is one of the poorest countries across the globe.
As one of the poorest countries globally, Malawi’s higher HIV prevalence may be attributed to inconsistent detection rates stemming from differences in surveillance and registration centers. This marked difference may also be related to Socioeconomic factors, such as poverty and limited emphasis on screening programs and public health services such as the NHS, which contribute to health inequalities.
The unequal distribution of health care resources exacerbates the challenges in combating HIV/AIDS in Malawi. Urban areas, where individuals are more likely to afford private health care systems, have better access to resources compared to rural areas, resulting in lower treatment rates for the latter.
However, barriers to HIV-related health care extend beyond poverty and finances. Stigma and prejudice surrounding HIV deter individuals from seeking care and concerns about confidentiality at testing sites further discourage communities from accessing services.
Gay men in Malawi experience a disproportionate impact from HIV/AIDS. The Ministry of Health estimated that 35% of men in Malawi had not been tested for HIV/AIDS in 2017. Addressing this disparity requires additional support and funding for home testing initiatives.
Progression in Malawi
Awareness surrounding sexual health and faster screening techniques has improved the health of Malawians with HIV/AIDS over the last two decades. Antiretroviral therapy coverage has significantly increased, with an estimated 91% of those living with HIV receiving treatment in 2021 compared to only 43% in 2012. There were 78,000 AIDS-related deaths in 2005 compared to 13,000 in 2020, a decline of around 83%. Overall, increased funding and implementation support has resulted in a marked improvement in HIV in Malawi from previous years.
Helping the Cause
While Malawi’s government has continued to provide treatments and support for HIV/AIDS, an organization founded in 1972 named Action Aid helps those from marginalized groups across rural and urban communities in Africa. Action Aid works alongside local communities, governments and institutions for people living with HIV/AIDS.
The organization advocates for improved access to HIV/AIDS-related health care, including antiretroviral drugs and good nutrition. Through partnerships with local communities, governments and institutions, Action Aid advocates for improved access to HIV/AIDS-related health care, including antiretroviral drugs and good nutrition. Collaborations with organizations like the Makerere Women’s Development Association (MWDA) and the Kuluhiro (Hope) support group ensure psychosocial therapy, counseling and access to antiretroviral treatments, as well as economic opportunities through farm projects.
What is Next?
An Oxford Academic report suggests that continued foreign aid is essential for widespread testing and comprehensive HIV/AIDS programs, as 99% of HIV funding comes from international financial support. Foreign aid plays a crucial role in sustaining and expanding efforts in combating HIV/AIDS in Malawi.
– Rupinder Kaur
Photo: Rawpixel