Aids advances under threat in sub-Saharan Africa
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Every year some 2.5 million people are infected with HIV, even as drugs have cut the death rate and virus-carriers live longer than ever, according to a global Aids study issued on Tuesday. But the latest figures show an increase of the virus in some countries, as international funding for research and treatment falls.
Although 17 million people worldwide follow a treatment that keeps the virus at bay, there remains 36.7 million still living with HIV, meaning that fewer than half of those who need the drugs are getting them.
"South Africa is at the epicentre of the HIV epidemic," Deenan Pillay, the Director of the Africa Centre for Population Health, told RFI. "It is the country which has the most cases of HIV, it is the country which uses the highest amount of antiretroviral treatments for HIV. Yet infections keep going up. In our particular area where we work, in the province of Kwazulu Natal, a 15 year-old girl today, who is not infected has herself an 80 percent chance of becoming infected during her lifetime."
In antenatal clinics, where pregnant women go first, nearly 50 percent of women are infected with HIV.
Pillay said it is essential that HIV remains very high on governments' agendas, especially in South Africa.
Prevention is key
Whether it is the funding, the research or the cost of treatment, there are different kinds of challenges ahead.
Despite progress, scientists all agree this is far from the end of the fight against HIV/Aids.
"One of the big focuses is on insuring that everybody has access to treatment, everybody has access to prevention, everybody has access to care," says Debbie Mathew of Aids Foundation of South Africa, an NGO working on health and community development. "We still have lots of people who are still getting infected every day, so we need to improve our prevention efforts, particularly prevention amongst young women and girls."
Stigma is a major problem, she argues.
"When treatment is available, when it is paid for by the government, paid for by the state, why are people not coming forward for testing? And why aren't people coming forward in initiating treatment? Because they're afraid, afraid of being seen at the clinic or being disclosed as HIV positive. That needs to change."
The answer to HIV prevention and treatment for Aids is not exclusively medical.
Some people are more vulnerable because of their social situation, an important factor to take into account, not only in Africa but pretty much everywhere in the world.
"We have what we call key populations, where we know infection rates are very high - men who have sex with men, sex workers, persons who inject drugs, transgender people, people who are in prison. We know that migrants and mobile populations are always very vulnerable. So we have to specifically see how we can avoid transmission in these populations," Gottfried Hirnschall, the head of the World Health Organisation's HIV department, told RFI.
"We do see that key populations, in general, do not get the attention that they need to get, we do see that, even in 2016, stigma, discrimination, exclusion in many parts of the world continue to prevail. That's very concerning. We know that there are legal frameworks that criminalise these populations, the behaviour of these populations and that's obviously very difficult because we know that this is deterrent for them for seeking care and accessing the prevention treatment services."
Hirnschall said stigma was still very much a problem today.
"We are standing at a crossroads and the world needs to continue showing interest to bring about a global response and that also includes raising awareness about the virus," he concluded.