HIV, TB, malaria deaths decline

The world’s most infectious diseases—HIV/AIDS, tuberculosis and malaria—are losing ground as a result of growing efforts to mobilise resources to combat them. Consequently, deaths caused by the three diseases have declined significantly in the past 13 years, according to a landmark study published in the Lancet. The study attributes the success to the Millennium Declaration, in the year 2000, that brought global attention and mobilised financial support to fight the diseases that previously killed millions, mainly in Africa, annually. The declaration also led to the formulation of Millennium Development Goal number 6 (MDG6), which aims at stopping the spread of HIV, and reversing the incidence of malaria and tuberculosis by 2015. “Since 2000, the upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated,” scientists who conducted the study said. There were 1.8 million new infections, 29.2 million prevalent HIV cases, and 1.3 million HIV- related deaths globally in 2013. At the peak of the epidemic in 2005, HIV caused 1.7 million deaths. Through interventions including preventing mother-to-child transmission (PMTCT) and antiretroviral therapy (ART), 19.1 million life-years have been saved, 70.3 per cent of them in developing countries, notes the study. In 2013, there were 7.5 million new TB cases, and the disease caused 1.4 million deaths worldwide. The most significant reductions in TB deaths – declining at a rate of 3.7 percent between 2000 and 2013 – occurred among people who were HIV-negative. In the case of malaria, cases grew rapidly from 1990 reaching a peak of 232 million in 2003 and 1.2 million deaths in 2004. “Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31.5 per cent. Outside of Africa, the mortality has been steadily decreasing since 1990,” the study notes. The study, conducted from 2000 to 2011 says multilaterals, bilaterals, foundations, and non-governmental organisations had invested $51.6 billion to fight HIV, $11.3 billion to combat malaria, and $8.3 billion on tuberculosis programmes. East African Community member states such as Rwanda are among the top beneficiaries of the funds. In fact, it is the global attention focused on the three diseases that led to the creation of the Global Fund in 2002, the US President’s Emergency Plan for Aids Relief (PEPFAR) in 2003, and the President’s Malaria Initiative in 2005. The Millennium Declaration also helped to strengthen the Rollback Malaria Initiative, which was established in 1998 to fight the disease. National mortality In Rwanda, statistics from the Ministry of Health indicate that the prevalence and deaths from the three diseases had been reducing drastically over the years. According to Dr Corine Karema, the Head of the Malaria and Other Parasitic Diseases Division at the Rwanda Biomedical Centre (RBC), the country has achieved significant reductions in malaria cases over the past decade. In 2005, malaria was the number one killer of children under the age of five. In 2008, it dropped to number three and by 2012, it had dropped to further to number eight. “We are still focused and closer to our goal of zero malaria related deaths by 2017,” she said. Tuberculosis mortality rate in Rwanda fell by 78 per cent since 2005, according to the RBC. Meanwhile, new HIV infections have declined by 55 percent in the last 10 Years while HIV/AIDS related mortality reduced by 77 percent during the same period, according to Dr Sabin Nsanzimana, the Head of HIV/AIDS Division at RBC. Efforts in place In February this year, the ministry signed an agreement with Global Fund, an international financing organisation that aims to attract and disburse resources to prevent and treat HIV, malaria and tuberculosis. Under this partnership, Rwanda received a grant of $204m for the National strategic plan for HIV/Aids. Nsanzimana noted that over the years, efforts have been made to improve access to ARVs, testing and counseling—hence reducing chances of mortality. “In 2010, there were 419 clinics that did testing and counseling, and 295 that provided antiretroviral therapy. By last year, the numbers had increased to 493 and 465, respectively,” he said. Dr Daniel Ngamije the Coordinator of the Project Management Unit (PMU) of the Global Fund said in an earlier interview that HIV/AIDS prevention and management had been scaled up with centres for prevention of mother to child transmission increasing from 53 to 488. At the same time, the number of people tested rose from 2,633 to about 3.9 million. “The percentage of infants born to HIV-positive mothers who were infected went down to 0.9 per cent from 9.7 per cent previously.” Rwanda has also stepped up TB treatment and prevention in recent years through the grants obtained from Global Fund. In 2004, the percentage of successful treatment stood at 77 percent but it has since gone up to 89.6 per cent. Other malaria interventions include distribution of insecticide treated mosquito nets whose coverage rose from 24 to 84 percent by the end of last year. The intervention has seen 12, 151, 989 nets distributed across the country, according to information from the health ministry.