How close are we to a world without Aids?
01 December 2015, 09:18
Since 1981 when HIV and Aids were first discovered, the world has made drastic strides in tackling disease prevention, treatment and management but how much work is still needed before we can prevent Aids altogether?
These days, the phrase "HIV is no longer a death sentence" is frequently used in the media. Medications are now more accessible than they have been in the past as a result of the successful implementation of HIV programmes across the globe.
South Africa has the biggest antiretroviral programme in the world, spending around $1 billion each year, AVERT explains.
As a result, more and more Africans living with HIV or Aids are receiving antiretroviral treatment (ART). Currently 15 million people, 40 percent of the people living with HIV/AIDS have access to life-saving anti-retroviral treatment, a UN report reveals.
The efficacy of ART means that the life expectancy for those who adhere to their treatment regimens is only 20% lower than that of the average, healthy person.
Is the end of Aids in sight?
All these positive statistics have contributed to the idea that the end of Aids is approaching.
UNAIDS has set an ambitious target, 90-90-90, aimed at bringing Aids to an end by 2015. The goal is for 90% of people living with HIV to know their status, with 90% of people with HIV on continuous antiretroviral treatment. Of those on ART, 90% should have viral suppression.
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With 2020 just over four years away, there is much work to be done before we witness the end of Aids.
Challenges to the 90-90-90 target
In order to eliminate Aids, people need to begin ART as soon as possible after being diagnosed with HIV, in line with the most recent World Health Organisation’s guidelines. For this to be possible, people need greater access to regular testing.
Consistent treatment remains another challenge. HIV patients need to adhere to their treatment to prevent the disease from progressing.
In the US, it is estimated that only 28% of people living with HIV stay in care and adhere to their treatment.
In sub-Saharan Africa, where accessibility is even more difficult and drug shortages are frequent, adherence remains a significant challenge.
What would it mean to have a world without Aids?
If the world could achieve the 90-90-90 goal and eradicate Aids, healthcare providers would be able to focus on managing HIV as a chronic illness and addressing new HIV-related complications that have emerged, an article published in The Lancet explains.
Antiretroviral treatment does not fully repair damage to the immune system. While people with HIV are living longer than they have in the past, they also face a greater risk of related-complications such as cancer, liver disease, osteoporosis and cardiovascular disease.
These HIV-associated diseases are linked to accelerated ageing, with patients at greater risk of frailty including reduced mobility, muscle weakness, fatigue, weight loss and lower levels of physical activity.
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These new HIV-associated medical conditions will require a drastic change in healthcare services, including retraining of medical staff on the management of the condition. Government would be required to reallocate resources in order to adequately provide an ageing population with quality chronic healthcare services.