Of getting to three zeros in HIV, Aids fight
To some, December 1 is just another day, but to others, it is a special day that calls on all of us to think about what we have done to reduce new HIV infections, combat stigma and discrimination and indeed to reduce HIV-related deaths. For few successive years now, the theme ‘Getting to Zero’ which focuses on getting to zero new HIV infections, getting to zero Aids-related deaths and getting to zero discrimination, has been running and it will take us up to the year 2015.
As we commemorate the World Aids Day on Sunday, there is need to consider where we have come from and where we are now as we move on to address the persistence and other emerging challenges in the HIV and Aids national response.
Malawi has come a long way in strategically managing the national response to HIV and Aids. From the time antiretroviral drugs (ARVS) were only for the privileged few to the present where over 400 000 people are on treatment. Having many people on treatment is not enough for us in the national response, but the moral and human value is more important because we know that these people are able to work, develop this country and support their families. While the cost of ARVs continues to increase, as well as the number of people that should be put on treatment, better regimes that have fewer side effects are also coming in.
The talk about ARVs and the number of people on antiretroviral therapy (ART) is exciting and worth sharing as a country. However, if we do not do anything about prevention, there will always be pressure to put more people on treatment. Our resource base at one point will be overstretched to support the ever-increasing demand for ART. That is why getting to zero new HIV infections is very important for Malawi. This means that despite the strides we have made so far, there is still more to share and more to do.
From the time Malawi was recording 90 000 new HIV infections to the current around 50 000 new infections per year, huge investments in knowledge, skills building and implementation have been done. The cost of this investment is huge and the outcomes are increased condom use, reduced mother-to-child transmission of HIV as well as faithfulness and abstinence among the sexually active population. The emergence of medical male circumcision that has the potential to reduce the risk of HIV infection by up to 60 percent, presents yet reinforcement to the prevention efforts if we talk of combined prevention. Yet the challenge of unfaithfulness in stable relationships still exists. Addressing behavioural change, such as sensitising people to the need for reducing the number of multiple concurrent sexual partners, requires concerted efforts. While moral values need to be considered in these relationships, institutions that support family values have a vital role to play in rebuilding the family as an institution where love and faithfulness has to flourish.
Even though HIV and Aids has been around for over 30 years now, it is not known why stigma still exists. People living with HIV and Aids are like any person with a long-term illness. there is no need to stigmatise against such people. We encourage people to disclose their status because we realise that the more people are open and declare their HIV status, the more society will look at HIV and Aids as any other illness. The existence of institutions that promote openness and fight stigma and discrimination create an opportunity and hope that sooner than later, we will all live together and not judge people based on their HIV status.
This year’s World Aids Day is an opportunity for Malawi, a country that has achieved a lot and still has potential to build on the achievements, to reflect on the present challenges. The goal of the current generation should be to ensure an Aids-free future generation. Indeed, we need to build a solid foundation in order to get to zero new HIV infections, zero Aids-related deaths and zero discrimination.
—The author is executive director of the National Aids Commission
