Reinvigorate response to HIV among challenges posed by pandemic : WHO

 On World AIDS Day, World Health Organisation (WHO) cautioned countries in South-East Asia region against slow-down in services for HIV prevention, testing, and treatment, saying this could leave many vulnerable populations at greater risk of HIV infection and AIDS-related death.

Addressing a virtual meeting of ministers of Health and heads of National HIV programmes of member states today, the regional director of WHO South-East Asia Region Dr Poonam Khetrapal Singh said that the theme for this year’s World AIDS Day, Global Solidarity – resilient services is very relevant. “It’s a timely reminder that we must continue to work together and ensure that HIV services remain an integral part of our response to Covid-19,” she said, adding that this year they must take stock of their response to HIV, learn from what has worked and accelerate those efforts to reach the goal of ending AIDS as a public health threat by 2030.’

Between 2010 and 2019, the region has taken large strides in its response to HIV, according to the WHO. Epidemiological trends show that both new infections and HIV-related deaths are continuing to decline, with the number of new HIV infections dropping by an estimated 23.8 per cent and the number of AIDS-related deaths coming down by 26.7 per cent. In 2019, an estimated 38 million people were living with HIV globally, of which 3.7 million were in the WHO South-East Asia region.

However, Dr Singh pointed out that the rate of decline has plateaued over recent years and also that the region and across globe, we are lagging behind on 90-90-90 targets to be achieved by 2020. These targets mean 90 per cent of all people estimated to be living with HIV will know their HIV status, -90 per cent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90 per cent of all people receiving antiretroviral therapy will have viral suppression.

According to the UNAIDS 2020 Global AIDS Report, nearly 98 per cent of new HIV infections in the Asia- Pacific region are occurring among key and vulnerable populations. “Acting on the insights and advice of key populations is a precondition of success,” said the regional director.

Further, the Covid-19 pandemic, which took a huge toll on essential health services, has also affected access to HIV prevention, testing, and treatment services, the WHO press note reads. “There is a clear and present danger of many vulnerable populations finding themselves at greater risk of HIV infection and AIDS-related death.”

“The Covid-19 pandemic has given us the opportunity to learn from adversities,” Dr Khetrapal Singh said at the high-level meeting. “The examples of differentiated service delivery, reaching out to people at facility nearer to them or outside of health facility, dispensing of drugs for 3 months as against existing practice on monthly dispensation, tasking shifting dispensation of drugs by nurse, community workers to stable patients, and use of e-medicine for consultation, virtual interactions have led to greater comfort levels among service providers and clients,” she said, adding that this is a step towards strengthening HIV prevention, one that can help and re-invigorate our response to HIV.

Highlighting the role of community participation, she said, “We must harness the rich experience of communities affected by HIV.”

By empowering communities to prevent, detect and treat HIV, countries can make full use of a range of new tools such as pre-exposure prophylaxis and community-based and HIV self-testing, as well as better antiretroviral drugs such as Dolutegravir, she added.

At the virtual meeting, countries in the region took the opportunity to share experiences and best practices on HIV service delivery amidst the pandemic, and the need to build even more resilient health systems to ensure rights-based HIV services continued to be available to people. Member states also outlined what was required to integrate HIV programmes within Universal Health Coverage.

“As we stand at the last 10 year stretch of achieving the Sustainable Development Goals, our response to HIV in the Region remains critical and central to the goals of 2030,’ Dr Khetrapal Singh said.