AIDS Today: Where Has the Aid Gone for AIDS?
How dangerous is AIDS today?

While many wealthy nations have found ways to manage HIV, neither it nor AIDS had yet been eradicated.

Since the epidemic began in 1981, over 70 million people have been infected with the HIV virus, and upward of 35 million have succumbed to AIDS.

In 2015 alone, 1.1 million people died of AIDS or of an AIDS-related illness. Sub-Saharan Africa houses a majority of the AIDS infected population. One in every 25 adults is infected with the disease.

Sub-Saharan Africa accounts for nearly 70 percent of the worldwide infected population, while the other 30 percent are dispersed primarily throughout Western and Central Africa, Asia and Latin America.

Despite these substantial numbers, investments in HIV prevention research have decreased. Many donors were met with a slew of competing funding demands. Others no longer see the retrovirus as posing a current threat. Much of the world views HIV and AIDS as medical relics — diseases of a time long gone. Yet every day nearly 5,753 people are infected with HIV. That is about 240 people every hour.

HIV is transmitted from person-to-person through unprotected sexual intercourse, transmission of contaminated blood and from mother to child during birth or through breastfeeding. There is no cure for HIV, but the virus can be treated to almost a complete halt with antiretroviral therapy.

However, marginalized groups of people are not granted access to this therapy. As of December 2015, more than 60 percent of people living with HIV did not have access to antiretroviral therapy.

For the first time since the beginning of the AIDS epidemic, scientists believe we are in reach of an entirely AIDS-free generation. Since 2000, the United Nation’s International Children’s Emergency Fund estimates that about 30 million new infections have been averted, eight million lives have been saved and 15 million people who would not otherwise have access are now receiving treatment.

The International AIDS Conference is a biennial meeting held for people working in fields actively related to the prevention of HIV. This year, nearly 18,000 delegates and 1,000 journalists showed up. Many of those in attendance were policymakers, people living with the disease and others committed to putting a stop to the epidemic. This year’s theme was “Access Equity Right Now.” It focused primarily on the ways in which the world can refocus global efforts on HIV/AIDS today and hopefully making treatment readily available to everyone.

But why should we stop there? With access to birth control and prenatal care, better sex education and sterile medical equipment, it is conceivable that we could live in a world that is entirely HIV-free — a world where AIDS really is history.

Kayla Provencher

Photo: Flickr

In celebration of World AIDS Day, the Pan American Health Organization (PAHO) and the World Health Organization (WHO) have announced that 17 countries and territories have likely eliminated the vertical transmission of HIV from mother-to-child through screening and intervention efforts.

Cuba was the first nation to be certified as transmission free by the WHO. At least 17 other nations are close behind or have already achieved the same success. The elimination of mother-to-child HIV transmission is a part of the United Nation’s campaign to end the AIDS epidemic, which has claimed the lives of 39 million people since it began.

Marcos Espinal, Director of PAHO/WHO’s Department of Communicable Diseases and Health Analysis, said, “If we want to end HIV by 2030, we need to accelerate action for prevention and access to treatment, focusing on key populations and increasing investment and resources.”

There is now strong evidence that an increased investment in preventative measures could make vertical transmission a thing of the past on a global scale. Carissa Etienne, Director of PAHO/WHO, said in a news release “The countries of the Americas have made tremendous efforts to reduce mother-to-child transmission of HIV, cutting new infections by half since 2010.”

Despite steps in the right direction, the transmission of HIV from mother to child is still a critical issue for millions. Transmission can occur during pregnancy, birth, or during breastfeeding.

To combat mother-to-child HIV transmission, pregnant women are given HIV medication throughout their pregnancies. For those who have not received treatment throughout the course of their pregnancies, an IV-administered antiviral called zidovudine can be given during labor, the point at which infants are most exposed to infected blood and bodily fluids.

The IV treatment enters the infant’s bloodstream via the placenta, rendering the infant immune to HIV infection, regardless of the level of the mother’s infection.

Due to the many risk factors associated with mother-to-child HIV transmission, the eradication throughout an entire nation is an impressive feat.

This success in the Americas signals a new phase of hope in the preventive medicine game.

Claire Colby

Sources: AIDS info, A Plus
Picture: Google Images

Thailand: An Experiment in Family PlanningIn Thailand in 1974 most families had seven children each, establishing an average growth rate of 3.3 percent. Having upwards of seven children put many women at risk for pregnancy-related deaths and often led to many children being raised in mother-less homes. With such a high growth rate, much of Thailand’s population was quickly descending into poverty as there was not enough money and there were too many mouths to feed.

In order to combat this decline, Mechai Viravaidya decided to start at the root of the issue ⁠— the women who had no control over how many children they would bear. After discussing family planning with several women, they decided that providing a pill was a great option for some women. However, this only covered around 20 percent of the population.

This did not hinder them.

Adapting the Coca-Cola model, Viravaidya and his team sought out well-respected individuals in each community to provide locals with family planning advice and devices, primarily birth control pills and condoms. It was the condom that took off. They were sold at local stores, on floating markets, handed out by the police, given to children in school, handed out in key chains, they were taking the nation by storm.

Soon, the team met some push-back from the religious community, but after talking with leaders, several monks actually blessed the condoms and contraceptives with holy water, thus making them something that everyone could utilize without feeling as if they were sinning. They then went to the military, which helped to advise local populations on the risks of HIV and AIDS, and they handed out condoms at traffic stops. Mechai became Thailand’s own “Mr. Condom.”

They soon went to the schools to educate children on the risks associated with unprotected sex, but they made it enjoyable. The team developed games that promoted family planning initiatives and condom balloon competitions, and in five years trained over 300,000 teachers in family planning methods. This meant that students now had people to talk to should they have any questions, and were thus able to advise their own parents on proper methods of family planning.

By 2000 the average amount of children per family was 1.5 and the growth rate had dropped to 0.5 percent, which meant that there were fewer individuals living in poverty and more children with greater opportunities for education and work in the future.

As the AIDS epidemic hit Thailand, their contraceptive commotion kicked into high gear, they were providing education on safe sex throughout all the villages, targeting high school students who then taught younger students, who then taught their parents. Thanks to the safe-sex brigade, Captain Condom and several other key players, the AIDS rate in Thailand went down by 90 percent, and the World Bank estimates that 7.7 million lives were saved because of this.

Thailand should act as an example for the rest of the world. Currently, sex and contraceptives have such a taboo upon them that several kids are petrified to even ask questions about basic safety precautions. They are afraid of judgment from store clerks and doctors, but if we normalize sex as a part of culture, we allow people to be more open and thus safer. If we take away the taboo associated with sex and perhaps even hand out free condoms and have free consultations with nurses and midwives about pills, we can reduce the rates of teenage pregnancy and STDs in our own nations. Although Thailand is a relatively small nation, it has shown us that small changes can make a huge difference.

Sumita Tellakat

Sources: TED talks, Advocates for Youth
Photo: Flickr

Surrounded on all sides by its neighbor South Africa, the little country of Lesotho is the largest enclave in the world; larger than its only rivals Monaco, San Marino and Vatican City.

Essentially a landlocked island amidst African highlands, Lesotho also features the lowest point of any country in the world, measured at 1400 meters or 4,953 feet. However, it has another, less fortunate distinction; it places third on the list of countries with the highest HIV/AIDS prevalence.

In total, nearly one-quarter of the population lives with HIV, which accounts for 360,000 people. Close to 26,000 new HIV infections and 14,000 AIDS deaths were recorded in 2011. Of these infections, 40,000 are in children while around 60 percent of adults with HIV are women. On top of these harrowing figures, 42 percent who need treatment cannot access it.

Lesotho’s first reported incidence of HIV occurred in 1986 and accelerated rapidly into a national epidemic. While the government made attempts to monitor and treat the illness, the proved insufficient due to poor finances and infrastructure. Just six years later, in 1992, 3.2 percent of pregnant women between the ages of 20 and 24 had HIV. By 1996, the figures had exploded; in just four years, a quarter of the same demographic was living with HIV.

The sheer extent of this illness has had a detrimental impact on the development of Lesotho. The most productive age group in the country is also the most infected. This has compromised their ability to work and sustain themselves and their families.

For the Basotho people, family is vital. For centuries, extended relatives have supported one another through any hardship. However, AIDS/HIV has eroded this support system by orphaning 220,000 children. This has left children as the head of families in which the working generations are debilitated or have died.

One can notice the extent of the AIDS epidemic by looking at the data. It has significantly shortened the life span of the average Basotho to just 48.3 years from nearly 60 years in 1990.

Moreover, the two main statistics most indicative of development, GDP and the Under Five Mortality Rate have worsened. Since 1990, the Under Five Mortality rate has risen from 85 in 1000 to 100 in 1000. While from 1970 to 1990 the average annual growth rate of Lesotho stood at 3 percent, it fallen to 2.6 from 1990 to 2012.

With such a widespread influence throughout Lesotho, the nation’s government, along with international aid groups has made efforts to tackle the AIDS crisis. The first step was to provide universal testing for the entire country. Beginning in 2004, the program called “Know Your Status” involved training thousands of health care workers to perform swift HIV testing. However, the government has only trained one-quarter of the required workers, failing to meet its objective of universal coverage.

Besides testing, the government has implemented a variety of campaigns to confront the epidemic, but with mixed results. It introduced HIV/AIDS awareness to the curriculums of both primary and secondary schools. A ‘road show’ was also planned to inform communities about AIDS/HIV while providing both entertainment and HIV testing. Despite the efforts, only 29 percent of 15 to 24-year-old males and 29 percent of females from the same demographic had an understanding of HIV prevention.

Unlike awareness efforts, the distribution of cheap condoms has also served as an effective mainstay of HIV intervention in Lesotho. In 2001 affordable condoms began selling throughout communities. The sales spiked, with the number of distributors tripling and the number of condoms bought doubling.

In order to help those already infected with AIDS, the government has worked to provide better access to antiretroviral treatments. Since 2004 the government of Lesotho has sought to make antiretroviral treatment free to those in need. With only 89 trained medical professionals in the whole country, the program lagged behind at first. But since expansion in 2008 coverage has expanded to around 86,000 people, or close to 60 percent of those needing treatment. Still, only a quarter of children in need receive antiretroviral treatment.

While Lesotho has become closer to controlling its AIDS epidemic it has come at the cost of the nation’s development. Despite its aspirations, the country’s inadequate infrastructure, health care and budget have hindered its efforts. With more foreign assistance, Lesotho has the capacity to get back on its feet.

– Andrew Logan

Photo: NY Times

After years of struggling to get proper treatment to HIV/AIDS patients in Africa, there finally seems to be some progress, and furthermore, some hope.

Different aid and relief groups have struggled with treating people in Africa that have contracted the HIV or AIDS illness because of uncooperative governments, and a lack of financial means. However, despite seemingly discouraging statistics and results in the past, the United Nations Aids agency has thus far made a significant impact on the small communities throughout impoverished Africa.

The overall goal was to treat about 15 million people by 2015—a goal that was set in 2010. Targeting people in wealthier and more developed countries has not been an issue when it comes to spreading the treatment for HIV patients. Unfortunately, it has been significantly more difficult to provide treatment to poorer regions of the world, such as in Africa where there is the highest concentration of cases of HIV in the world. The region of Sub-Saharan Africa alone accounts for 66 perecnt of the cases of HIV around the world.

Despite obvious obstacles, the United Nations has been able to successfully provide treatment to many impoverished people in Africa. The goal previously set by the UN to provide treatment to 15 million people has already been reached and is now being surpassed. Since 2000, when the number of people being treated for the illness was only 700,000, the number of new cases per year around the world has decreased from 2.6 million to 1.8 million a year, a drastic drop.

Because these goals were met so quickly and efficiently, the UN has now set even more optimistic goals. The UN AIDS agency now is working to create more sustainable and long term treatment for patients living with HIV especially in poor countries. Furthermore, the UN is aspiring to end the AIDS epidemic entirely by the year 2030.

Alexandrea Jacinto

Sources: BBC, Avert
Photo: Direct Relief

In its continued, seemingly amplified crusade against HIV, the WHO spoke out from convention by advising nations all over the world to reform their laws that inadvertently enable the spread of HIV/AIDS. Most notably, the WHO advised for the decriminalization of drug use, especially intravenous drugs, and protections for sex workers.

The report, titled “Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations,” was released in July 2014 and contained the following declarations:

• “Countries should work toward developing policies and laws that decriminalize injection and other use of drugs and, thereby, reduce incarceration.”

• “Countries should work toward developing policies and laws that decriminalize the use of clean needles and syringes (and that permit needle and syringe programmes) and that legalize opioid substitution therapy for people who are opioid-dependent.”

• “Countries should work toward decriminalization of sex work and elimination of the unjust application of non-criminal laws and regulations against sex workers.”

• “Countries should work towards legal recognition for transgender people.”

• “Countries should work toward developing policies and laws that decriminalize same-sex behaviors.”

Each of the groups addressed in these statements, including sex workers, drug users, homosexuals and transgendered people, falls into the category of “key populations” at risk for HIV/AIDS. These populations also typically face laws and cultures that ostracize their lifestyles, leading to cycles of abuse and incarceration.

These factors create a formula that consistently punishes populations most in need of sound medical counseling, preventative education and medical treatment. As stated in the report, the key populations in question are “disproportionately affected by HIV in all countries and settings.”

Another notable aspect of the WHO’s report lies less in the substance of the text itself, but more so in the fact that it directly opposes the United Nation’s stance on the same issues. According to The Economist, the U.N. still holds to the 1988 position that every nation should dictate the criminalization of intentional possession and use of illegal narcotics under domestic law as it sees fit.

The U.N. Office on Drugs and Crime shares the dissenting attitude toward the WHO’s report, as well, the idea that rehabilitation and societal reintegration tactics should be considered as alternatives to criminal sanctions.

Carefully worded, the report does not call for the legalization of activities such as drug use, but urges legal reform that focuses on rehabilitation versus criminalization.

In a statement to the Huffington Post, the senior adviser on strategy, policy and equity in the WHO’s Department of HIV Dr. Andrew Ball stated, “The guidelines recommend decriminalization of a range of behaviors of key populations…on public health grounds, so as to improve access to and utilization of health services, to reduce the likelihood of the adoption of riskier behaviors and to reduce incarceration rates.”

The HIV/AIDS world crisis is one of those issues that transcend border lines and cultures. The WHO has noted an increase in the number of cases in large cities in the United States, Europe, Asia and Africa. However, the poorest countries with the harshest incarceration laws, prominent cultural stigmas or least resources available are positioned to strongly heed the WHO’s reform considerations as they apply to each nation individually.

Edward Heinrich

Sources: io9, Washington Blade, The Economist, Huffington Post, PRI
Photo: io9

Having become part of France in the 17th century and nowadays administered as part of France just like Aquitaine or Brittany, French Guiana has one of the highest living standards in South America. Interestingly, as a consequent, it is also part of the European Union despite being located in the Americas. In spite of this, the overseas department is one of France’s poorest regions and has long been suffering from youth unemployment.

In the 1990s, street violence with its origin in youth unemployment broke out on the streets. Even nowadays, unemployment in general remains above 20%, while in the rest of France, that figure is, even with the Eurozone Crisis and recent recession, 10.4%, half the regular unemployment rates in French Guiana. The Guianese population has 25 percent of its citizens living below the poverty line, the highest among France’s overseas departments.

The economic situation of France’s overseas departments in the Western Hemisphere, which, aside from French Guiana, also include the picturesque Caribbean islands of Martinique and Guadeloupe, has been the cause of much discontent towards Paris. As living costs rise, the wages remain stagnant and the economies, relying heavily on La Métropole’s subsidization, the people of the overseas departments took to the streets to participate in that most French of activities: les grèves—strikes.

In France, this department also has the infamy of the AIDS epidemic. For every 100 pregnant women, one of them is HIV positive. The department also holds the record for the highest number of children per woman both in France and within the E.U.—four children per woman. Also, terrifyingly, the infant mortality rate of French Guiana is at 11.8 per 1,000 live births, whereas in the rest of France, the average is merely at three.

These are vexing numerical figures for what is supposed to be part of an industrialized and prosperous Western European country.

There is also quite a noticeable discrepancy between the department’s mines and natural wealth and its socio-economics. Despite being peppered with gold mines, rich with natural resources and also being home to the E.U.’s space agency, the aforementioned figures resemble those from certain corners of the underdeveloped world. Perhaps because of the central government’s long negligence due to the department’s distance and its tiny population of only a little bit less than 250,000 people—almost half of that of the much smaller island Guadeloupe—French Guiana has been allowed to languish in poverty and relative underdevelopment.

However, this state of poverty can also be attributed to the department’s own micro-economic character and the fact that its two main economies are the said space agency and gold mining. These two activities can hardly benefit the population at large. Lastly, being part of, though non-contiguous to, a very prosperous nation world-renown for its high quality of life, French Guiana’s abject poverty often gets looked over by the figurative radars of NGOs and aid organizations.

With the large gross domestic product per capita gap between French Guiana and Metropolitan France almost nearing $30,000 difference per annum, the issue of poverty in this overseas department, thus, should demand more attention in order find a solution.

– Peewara Sapsuwan

Sources: BBC, The Guardian, Minorites, Institut National de la Statistique et des Études Économiques, McGill Research Group Investigating Canadian Mining in Latin America, Pan American Health Organization, CNN, World Bank
Photo: Top 10 List