Getting to the point where HIV and AIDS are no longer global health threats: that’s the goal experts want to achieve within seven years. How realistic is that?
Even though HIV and AIDS have increasingly disappeared from the public focus in recent years, the associated dangers for those affected are still real. HIV has certainly been pushed off the global political scene thanks in part to the Covid pandemic. But on the other hand, it is also the bane of its own success. “We are struggling to make sure that AIDS stays on the political agenda. This is also because of our successful work,” explains Christine Stegling, Deputy Executive Director at UNAIDS at this year's World Health Summit in Berlin. And a lot has indeed happened in terms of AIDS research and prevention.
Decades of research and innovation have turned the once fatal diagnosis into a disease you can live with. But that is precisely the problem with AIDS prevention today, according to Florence Riako Anam, Co-Executive Director of the Global Network of People Living with HIV and a patient herself. Whereas a few decades ago AIDS was literally written all over patients’ faces, today even those affected often no longer know what the situation was like just a few years ago – and so the disease is being pushed into the background not only by those affected themselves, but also on international health agendas.
Although HIV and AIDS can be treated today, 1.3 million people still contract HIV every year. Marginalized groups are particularly affected. These include young women, adolescent girls, sex workers, homosexual people and drug addicts. “In Sub Saharan Africa, 517 girls acquire HIV every day and 85 % of new HIV infections are in young people aged 15–19. Women and girls accounted for 46 % of all new infections in 2022,” reads a statement from the World Health Summit. But why are women at such a disadvantage here?
Gender inequality is still enormous in many HIV hotspot countries. This increases infection rates, and reduces the ability of female patients to cope with the disease. Moreover, women are rarely perceived as people and patients in their own right, but only as HIV carriers. Anam tells from her own experience: “Can you please look at us as people? It’s a mind thing, all we are asked is: Do you have a partner? Have you disclosed? Are you pregnant? Are you breastfeeding?” Anam goes on to talk about her first visit to a doctor where she was asked about cervical cancer screening. “For me to go into a medical facility and be asked a question about me? That sounds like nothing but for me it feels like everything. I’m being seen.”
So, what can be done to continue to help these young women specifically? How to continue to advance the already great medical achievements in AIDS research to ultimately achieve the UNIAIDS goal of AIDS no longer being a public health threat by 2030?
“There will be no point where we say: now it’s over. But we want to get to a point where AIDS is no public health threat – meaning few people are dying and infection rates are going down,” Stegling explains the UNIAIDS goal. But is this goal realistic? After all, there is still neither a vaccine nor a cure. “We also need to acknowledge what it takes to have a pathogen under control without these things,” says Dr. Mamadi Yilla, Deputy Global AIDS Coordinator for Multilateral Engagement.
In addition to medical achievements, research and innovation, the economic component should not be underestimated. One of the goals, according to Stegling, is for countries to be able to pay for their own AIDS prevention and treatment as well as successfully raise awareness among their own communities. “Before we hit covid, many countries were on this path. Now we hit a severe death crisis and the number of countries that are able to do this is sinking,” Stegling says. Yilla adds: “We still need science to save the day, but [...] it is the community that helps people accept the scientific changes.” Peer-to-peer education is therefore particularly important. It is also essential not to hope for one big medical breakthrough. Stegling says: “Whenever there is an innovation there are reports that this is the ONE thing, that’s going to make a difference. [...] We have to layer different interventions to make it work. We need to get away from the thought that we need that one invention that’s going to do it for us.”
The experts also appeal to pay attention to the populations in which studies are conducted. Only with appropriate inclusion can it be guaranteed that the results can be transferred to the particularly vulnerable groups and are accordingly significant.
Image source: Dim Hou, Unsplash