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HIV AIDS Epidemic in South Africa

South Africa has the world’s largest HIV/AIDs epidemic. The government has issued numerous HIV prevention programs in an effort to educate the public, reduce the annual number of new infections, and, eventually, eliminate the disease.

History of the HIV/AIDS Epidemic in South Africa

South Africa’s first reported cases of the Human Immunodeficiency Virus, or HIV, emerged in 1982 among homosexual men amidst Apartheid. Due to the political upheaval and repression by the government during Apartheid, HIV was ignored, thus allowing the virus to spread rapidly throughout the homosexual community among men. HIV was almost exclusively diagnosed in gay men until 1987 when there was a sudden increase in women being infected with the virus. The opportunistic microbial infection was credited with being spread as a result of poverty, limited primary health care, lack of education, and sexual exploitation and violence against women. It was not until the early 2000’s that the government recognized HIV/AIDs as a major issue after HIV rates with pregnant women soared from 1 percent in 1990 to over 30 percent by the beginning of the next decade.

Prevalence of HIV/AIDs Epidemic in South Africa

In 2018, the HIV/AIDS epidemic in South Africa rose to an estimate of 7.1 million South Africans affected by the disease, with 240,000 new diagnoses, and 71,000 AIDS-related illnesses. The disease is most prevalent among marginalized groups: sex workers account for 57.7 percent of HIV cases, gay men at 26.8 percent, and drug addicts at 1.3 percent. Additionally, there is an estimate of 280,000 children who have contracted the disease from their mothers; HIV prevalence is four times greater in women and young girls due to gender-based violence and transgender women are twice as likely to be infected by the virus than gay men.

Solutions to the Epidemic

Despite the initial negligence to the HIV/AIDs epidemic of South Africa from the government, South Africa aims to reduce the number of new infections to under 100,000 by 2022. The government has made great efforts to resolve the issue by executing awareness campaigns, encouraging HIV testing, distributing condoms, and implementing HIV prevention programs. In 2018, the HIV/AIDS epidemic in South Africa rose to an estimate of 7.1 million South Africans affected by the disease. There have been large improvements in the choice of antiretroviral medicines and the widespread accessibility of the Prevention of Mother-to-Child Transmission, or PMTCT, program. As of 2016, mother-to-child transmission rates have fallen from 3.6 percent to 1.5 percent between 2011 to 2015, meaning the country is on track to completely eliminating MTCT.

Due to the 2010 national HIV Testing and Counselling (HTC), campaign and the 2013 HTC Revitalisation Strategy—which focused on encouraging people from the private sector, rural areas, and higher education to test—more than 10 million people in South Africa get tested for HIV every year.

As of 2016, only 5 percent of South African schools provided sex education, but the government has committed to increasing this number to over 50 percent by 2022—especially in high-risk areas. The government has adopted UNAIDS 90-90-90 strategy: By 2020, 90 percent of all people living with HIV will know their HIV status; 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90 percent of all people receiving antiretroviral therapy will have viral suppression. Thus far, 90 percent of South African’s know their HIV status, 68 percent are on treatment, and 87 percent are virally suppressed. Factually, South Africa has made significant progress in reducing HIV amongst the population, and they are on track to eliminate the HIV/AIDS epidemic in South Africa.

– Arielle Pugh
Photo: Wikimedia

PEPFARThe United States President’s Emergency Plan for Aids Relief (PEPFAR) has saved more than 17 million lives in the past 15 years. George W. Bush started PEPFAR in 2003 as a response to the global HIV or AIDS academic. The hope is to make a small difference in the lives affected and to educate the world about the epidemic. In turn, this provides HIV prevention medications to millions that would otherwise not have accessibility.

Children at Risk

Globally, about 36.9 million people are currently living with HIV and 1.8 million of the HIV-affected population is children. The number of children affected would be even higher, but statistics show that 80 percent of children born with HIV or AIDS who are left untreated die before their fifth birthday. Around 950,000 people around the world have died from HIV or AIDS-related causes. However, PEPFAR has significantly contributed to positively impacting the HIV or AIDS epidemic over the last 15 years.

PEPFAR has put much of their efforts into preventing mother-to-child transmission, the leading cause for children contracting HIV or AIDS. The plan provides lifelong antiviral treatment for current breastfeeding mothers and pregnant women. PEPFAR has contributed to 10 percent of all program funds preventing children from being affected by HIV or AIDS. Its efforts have resulted in more than 2.2 million babies being born HIV-free.

Ending the Epidemic in African Countries

PEPFAR is currently working in over 50 countries and has made a large impact on those who are affected by the HIV or AIDS epidemic in sub-Saharan Africa. Only 50,000 people living in Africa were being treated for HIV or AIDS at the start of PEPFAR. The program has now provided more than 14.6 million people with antiviral medication. It also offers worldwide counseling. As a result, the United States’ contributions are on track to help control HIV epidemics in up to 13 of the highest HIV-prevalent countries by 2020.

PEPFAR is Reducing the Effect of HIV

According to the CDC, PEPFAR’s mission is to “deliver an AIDS-free generation with accountability, transparency, and impact.” Its priorities include working with partner countries, organizations, and people with or affected by HIV or AIDS in order to combat the disease. But years later, PEPFAR now also focuses on granting services for families with vulnerable children, orphans, adolescent girls and other neglected populations around the world. As a result, PEPFAR has contributed to giving more than 6.4 million vulnerable children and orphans the care and support they need. It has gifted 85.5 million people HIV tests. This has influenced the amount of HIV diagnoses which is declining 25 to 40 percent in adolescent girls. PEPFAR has also helped support the training of almost 250,000 health care workers to deliver HIV health services to those in need around the world.

PEPFAR started out as a proposal by George W. Bush in 2003. Only 15 years later, the plan has saved more than 17 million lives. The plan to invest almost 2 billion dollars, this year alone, will empower women and girls around the world. If PEPFAR’s impact on those who have HIV/AIDS remains steady, the global epidemic will continue to decrease to a point of no existence.

– Paige Regan
Photo: Flickr

HIV_and_Syphilis

With education and preventative measures, sexually transmitted diseases such as HIV and syphilis can be stopped. For unborn children, however, a voice is not heard and a choice cannot be made. Cuba has eradicated the transmission of these diseases from mother-to-child.

The World Health Organization (WHO) has validated Cuban success in eliminating mother-to-child transmission of HIV and syphilis, making it the first country in the world to do so, and, according to WHO’s director-general Margaret Chan, one of the greatest public health achievements possible.

HIV/AIDS is a disease that affects the human immune system. AIDS is the final stage of Human Immunodeficiency Virus (HIV). Syphilis is a sexually transmitted disease that can cause damage to the infected person’s internal organs. Both conditions without treatment are deadly and have a high likelihood of transmission from the mother-to-child during birth.

It is estimated that every year globally, 1.4 million women infected with HIV give birth to children. If left untreated, the rate of disease transmission from mother-to-child during birth is 15-45%, resulting in thousands of children born only to have their lives cut short by a debilitating virus that with proper care could be prevented.

The diseases are transmitted during pregnancy through labor, delivery or breast feeding, but can be greatly reduced with the administration of antiretroviral medicines to both mothers and children throughout the stages when infection can occur. In fact, the transmission rate plummets to just over 1%. Since 2009, rates of transmission have been cut nearly in half, dropping from 400,000 cases to 240,000 cases in 2013, still well over the global target of just 40,000 by 2015.

Worldwide, nearly a million pregnant women live with syphilis, which can cause a spectrum of dangers for the mother and child including early fetal loss and stillbirth, neonatal death, low birth weight infants and serious neonatal infections. By early screening and treatment with medications such as penicillin, most complications can be wiped out.

As a part of an initiative, Cuba has worked tirelessly with the WHO, ensuring widespread HIV and syphilis testing for both pregnant women and their partners, early access to preventative and prenatal health care, Cesarean deliveries and breastfeeding substitutions, successfully curbing the disease transmission rate. In 2013, only two babies were born with HIV in Cuba, and only three babies were born with congenital syphilis.

The services are a part of an accessible and universal health care program in Cuba, and according to Pan American Health Organization (PAHO) Director, Dr. Carissa Etienne, “Cuba’s achievement today provides inspiration for other countries to advance towards elimination of mother-to-child transmission of HIV and syphilis.”

The WHO’s validation process is outlined in its 2014 publication Guidance on global processes and criteria for validation of elimination of mother-to-child transmission of HIV and syphilis. In Cuba, the process consisted of an international cooperative mission in March 2015 involving experts from Argentina, the Bahamas, Brazil, Colombia, Italy, Japan, Nicaragua, Suriname, the United States and Zambia.

Cuba should serve as a model to the rest of the world, demonstrating the potential of accessible healthcare and the power of humanitarian efforts. As the rest of the globe tries to catch up, Cuba, a small speck of an island off the coast of one of the greatest policy-leading countries on the planet, can enjoy the results of their hard work and HIV-free children for years to come.

Jason Zimmerman

Sources: The Health Site, WHO 1, WHO 2
Photo: YouTube

mother_to_child_transmission

This past week, Cuba has been a hot topic in the media. News about bridged U.S.–Cuba relations has taken over the news circuit. But Cuba has also recently reached a public health milestone in the fight against AIDS. Cuba has virtually eliminated HIV and syphilis mother-to-child transmission.

Health officials in the country credit a combined task force from the World Health Organization and the Pan American Health Organization. These organizations implemented programs aimed at improving prenatal care, sexually transmitted infection and HIV testing for pregnant women and their partners, treatment for mothers and babies, Cesarean section deliveries and substitutes for breastfeeding. These services were provided through a universal healthcare system to increase accessibility and affordability, two huge components of any health-related intervention program.

Worldwide, over 1.4 million women with HIV become pregnant, which if untreated, puts 15 to 45% of their babies at risk of infection at birth. However, by providing antiretroviral medicines to pregnant women and children after birth, the risk of transmission to their children can be reduced to a mere 1%. Reducing transmission rates is largely a case of improving accessibility and affordability. Through Cuba’s integration of maternal and child health programs with HIV and sexually transmitted infection programs, they can combat the problem on all fronts. By providing services through a universal health system, more women from varying income levels and geographical locations were able to take advantage of them.

The success brings hope in a long fight against HIV/AIDS. The case in Cuba is an encouraging step towards eradicating AIDS, despite not having a cure. The success also serves as an example for countries around the world to analyze and model programs after in their individual battles against the AIDS epidemic. The evidence supporting universal healthcare has gained new support from the Cuba’s success and as other countries continue to try to reduce transmission rates, they may be more compelled to imitate Cuba.

Emma Dowd

Sources: CNN, Global Research, Time, Washington Post
Photo: Time