World AIDS Day: Accelerating the momentum in HIV prevention

Every year on December 1, the world observes World AIDS Day. On this Day, the global community pays tribute to all those who have lost their lives to AIDS, applauds progress made in responding to the epidemic and recommits to ending it definitively. In this connection, millions of people come together across the globe every year with renewed hope and determination, standing up for adherence to the human rights and empowerment of people living with HIV and those left behind and importantly also for the intensified application of pure and social sciences for ending the epidemic.The devastating economic, social and psychological costs of the HIV/AIDs pandemic have been well-documented by now. It is, therefore, satisfying to note that partly as a result of the galvanizing impact of the yearly observance of the World AIDS Day, countries have made tremendous progress over the past years towards controlling the AIDS epidemic. Recent evidence shows that since the first cases of HIV were reported in the early 1980s, about 78 million people have become infected with the disease and about 35 million have died from AIDS-related illnesses. This is no doubt a tremendous human toll but the momentum of new infections has been slowed down measurably over the past few years.In June 2016, it was estimated that 18.2 million people living with HIV worldwide were receiving life-saving antiretroviral therapy, of which 10 million were in Eastern and Southern Africa. This shows that the majority of cases are located in these two regions of Africa. However, recent evidence also indicates that despite the progress made in the fight against HIV/AIDs over the past 15 years, including the availability of proven prevention and treatment methods, the annual number of new HIV infections among adults has remained static, at an estimated 1.9 million a year since 2010. This figure translates into new daily infection rates of 5,700 among adults and children, 66% of which live in sub-Saharan Africa. The above figures also mean that globally, the decline in new HIV infections among adults has somewhat stalled. Moreover, there has been resurgence of new HIV infections among key population groups in many parts of the world. All this calls for more action for evidence – informed interventions to reach those vulnerable populations and address challenges that might constrain easy access to HIV prevention, treatment and care services. Based on this evidence, experts and scientists have decided to focus this year’s World AIDS day campaign on prevention with the theme: “Hands up for HIV Prevention”, with the aim of reducing new HIV infections. As it can be seen from this year’s World AIDS Day theme, that calls on all Governments, stakeholders, donors and community members to increase the momentum against new infections, fresh commitments include more investments in scaling up HIV prevention programmes. We believe that this is imperative if the AIDS epidemic is to be ended as a serious public health threat by 2030. Last year, in September 2015, world leaders unanimously committed to ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. In addition, in June 2016, United Nations Member States adopted a progressive, new and actionable Political Declaration on Ending AIDS that contains a set of specific, time-bound targets that must be reached by 2020 in order to end the AIDS epidemic by 2030. There is also source of hope from the fact that the scope of HIV prevention and treatment options has never been wider than it is today, and the world now has the requisite scientific knowledge and experience to reach people with options tailored to their lives in the communities in which they live. The global theme of World AIDS Day 2016 is also inviting the global community to further reflect on what is needed to strengthen HIV prevention: for instance, through more condom use, voluntary medical male circumcision, prevention of mother-to-child transmission of HIV, pre-exposure prophylaxis, testing and viral suppression. These fresh reflections should also include explorations of how to address the barriers that prevent adolescent girls and young women, who are in the most vulnerable periods of their lives, key population groups and people living with HIV, from accessing and using the new prevention commodities and services.In Rwanda, World AIDS Day 2016 will be celebrated against a backdrop of notable success in the fight against the epidemic. There is broad agreement that this success is attributable in large measure to the strong leadership and dedication of President Paul Kagame and the First Lady of Rwanda, Mrs Jeannette Kagame through her Imbuto Foundation, all underpinned by robust and innovative Government programmes, broad involvement of all the stakeholders and communities as well as adequate external support. In this regard, it is encouraging to note that since the last decade, Rwanda has succeeded in stabilizing the HIV prevalence at 3% in general population (15 – 49 years old). In June 2016 Rwanda launched the Test and Treat all programme. Current estimates indicate that about 8 out of 10 people in need of ART treatment are getting it. Additionally, evidence shows that the transmission rate of HIV from mother to child is estimated at less than 2%. This suggests that elimination of new HIV infections from mother to child is attainable in Rwanda and other countries in the region.Nonetheless, the Government recognizes the fact that important challenges still remain in the fight against HIV/AIDs in the country. Disaggregation of the prevalence rates indicates that there is significant variation between urban and rural areas as well as among key population groups. Additionally, the country will have to start confronting soon in more decisive ways the challenges of dwindling external funding through progressive reliance on domestic funding, enhancing efficiencies and tapping non-traditional financing sources such as the private sector and foundations. It is, therefore, fitting that this year’s World AIDs Day is being celebrated in Rwanda under the theme: Get up all against HIV and AIDS-It Stills there. It underscores the pressing need to double all efforts at accelerating HIV prevention. In July of this year, the First Lady of Rwanda launched the national “All In” campaign to end adolescent AIDS‬ in Rwanda, in collaboration with the Ministry of Health, the Organisation of African First Ladies against HIV/AIDS (OAFLA), the Imbuto Foundation and the One UN Rwanda Team. The objective of the launch was to mobilise and engage all national stakeholders and to bring everyone together to create awareness on the importance of reaching adolescents to end the AIDS epidemic by 2030. As we move forward towards controlling and definitively reversing the spread the AIDS epidemic we believe that it is essential to not only sustain the gains achieved so far but to further galvanise synergy and double efforts in HIV prevention, treatment, care and support. I would like to end by quoting the UNAIDS Executive Director and United Nations Under Secretary - General who stated at the occasion of this 2016 World AIDS Day that “ The successes we have achieved so far give us hope for the future, but as we look ahead we must remember not to be complacent. AIDS is not over, but it can be! Fundamental political, financial and implementation challenges remain, but we should not stop now. This is the time to move forward together to ensure that all children start their lives free from HIV, that young people and adults grow up and stay free from HIV and that treatment becomes more accessible so that everyone stays AIDS-free”. On this occasion of 2016 World AIDS Day celebration, I believe that the above words of the UNAIDS Executive Director resonate well in Rwanda and would like to commend President Paul Kagame, the First Lady of Rwanda, Mrs Jeannette Kagame, the Government and people of Rwanda for the remarkable progress the country has made in addressing the AIDS epidemic. On behalf of the United Nations System (U.N.) in Rwanda, I hereby reiterate our collective commitment to continue supporting Rwanda’s HIV response in order to sustain and expand the gains made so far. The writer is the Resident Coordinator, One UN Rwanda

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World AIDS Day: Accelerating the momentum in HIV prevention