Stepping Up the Response to AIDS

from IPS News

The International AIDS Conference opened in Mexico Sunday. Here is a report on the first day. - Kale

The extraordinary mobilisation of economic and human resources against the HIV/AIDS pandemic has borne fruit, but efforts must be stepped up to continue fighting the disease, Mexican expert Jaime Sepúlveda said Monday, one of the plenary speakers at the first session, on the "State of the Epidemic".

According to the 2008 "Report on the Global AIDS Epidemic" by the Joint United Nations Programme on HIV/AIDS (UNAIDS), an estimated 33 million people were living with HIV worldwide in 2007, and two million died.

Sepúlveda also noted that last year, three million people living with HIV in low and medium income countries were receiving antiretroviral therapy, just 31 percent of those in need of treatment, while 2.7 million new cases were registered.

Half of those living with the AIDS virus worldwide are women, and sub-Saharan Africa accounts for more than 60 percent of all cases.

What is the state of the epidemic? "The numbers are growing, but slower than before," Professor Geoff Garnett, one of Monday’s speakers, told IPS.

He added that while there are many new cases, the rate of infection has been curbed by anti-AIDS efforts and campaigns.

However, there are major problems when it comes to measuring the number of new infections each year, which makes it difficult to gauge just how effective the prevention strategies implemented up to now have really been, said Garnett, from the Imperial College of London.

Besides, "we haven’t done enough to evaluate the social, structural and biological variables" involved in high-risk behaviour, he said.

More financing for research on the disease and for the assessment of treatment and prevention is needed, said Sepúlveda, who is now with the Bill & Melinda Gates Foundation.

"What works? In what population groups?" asked Sepúlveda, the founder of Mexico’s National Council for AIDS Prevention and Control (CONASIDA).

Garnett called for an expansion of "combined prevention interventions," including aspects like access to antiretroviral treatment, consistent condom use, male circumcision and the integration of HIV/AIDS education into family planning.

The expert also called for reforms in institutions that fund the fight against HIV/AIDS, like UNAIDS, the Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank and the U.S. President's Emergency Plan for AIDS Relief, and urged them to "work as a team."

At the opening session of this week’s conference Sunday, U.N. Secretary General Ban Ki-moon asked wealthy donor countries to provide more funds for the fight against AIDS, in order to achieve universal access to prevention and treatment by 2010.

But most experts believe these goals, adopted at the 2001 U.N. General Assembly Special Session on HIV/AIDS, will not be met.

"The responses to HIV and AIDS require long-term and sustained financing. As more people go on treatment and live longer, budgets will have to increase considerably over the next few decades," said Ban.

Dr. Alex Coutinho of the Infectious Disease Institute of Makerere University, Uganda underscored the need for systems to fight AIDS in rural and other hard-to-reach areas, as well as outreach to and support for marginalised and at-risk communities, like immigrants.

He also advocated greater involvement in prevention by people living with HIV as a catalyst for change, and said the best way to support AIDS orphans is by keeping their parents alive.

Elisabet Fadul, with the Dominican Network for Youth Rights/Global Youth Partners, pointed out that 40 percent of new infections worldwide occur among young people between the ages of 15 and 24, and said that is why "evidence-based" sexual health plans are needed to provide access for young people.

These actions and policies, she said, should engage youth, and must take the problems they face, like poverty and unemployment, into account. "Are the current prevention strategies effective? Are they based on evidence?" she asked.

Fadul congratulated the ministers of education and health of 33 Latin American and Caribbean nations who agreed on intersectoral strategies for integral sex education and promotion of sexual health on Aug. 1 in the Mexican capital.

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