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We have made strides but HIV war is not over

By Michelle Kisare | December 2nd 2017



When HIV first emerged over 30 years ago, it threw the world aback and wreaked havoc on communities, wiping away families and crippling economies.

But thanks to concerted efforts from governments, civil societies, research organisations, private institutions and international bodies, the tide has since changed. While HIV is still a major public health concern, the future for HIV eradication is no longer bleak.

World AIDS Day is celebrated every December 1st and provides an opportunity to unite globally in the fight against HIV, show support for those living with the virus and remember those who have died from an AIDS-related illness.

Today, we have increased access to life saving Anti-retroviral (ARV) drugs thus helping to drastically reduce deaths associated with the ailment. As a result, those with the disease are living much longer and leading quality lives that enable them play productive roles in their communities. New HIV infections are also on the decline even as awareness on prevention strategies increases.

Kenya’s HIV prevalence rate is now at 6 per cent which is a major drop from the 10-11 per cent recorded in the mid-1990s when the disease was at its peak in the country.

The immense progress made is laudable. But the war against this epidemic is far from over. Existing HIV management challenges need to be addressed to enable Kenya achieve the UNAids 90-90-90 targets that seek to enhance HIV diagnosis, treatment and infection control by over 90 per cent by the year 2020. This will play a major role in the elimination and eradication of the disease.

Even though access has expanded over the years, the treatment gap is still huge. UNAids estimates that about 37 million people are infected with the disease globally. Yet, only about 19.5 million (53 percent) can access treatment drugs. Whilst this is a great milestone when compared to about 7 million in 2010, access to treatment remains a major hurdle in the global fight against HIV. Locally, government statistics show that of the estimated 1.5 million Kenyans living with HIV, just about a million are on treatment.

Extremely difficult

Without the ARVs, people suffering from the disease are unable to suppress or lower virus levels in their bodies. This makes them vulnerable to opportunistic infections that can easily claim their lives. These individuals also become highly infectious, making it easier for the virus to spread.

To effectively deal with the disease, research and innovation into newer improved treatments is required to tackle the problem of drug resistant HIV that make it extremely difficult for those affected to manage the disease. Those with drug resistant HIV are forced to rely on much stronger drugs that are often more expensive hence increasing healthcare expenditure. In the same breadth, novel low-cost and easy to use treatments with minimal side effects are required to enhance adherence to ARVs.

The war on HIV/Aids can only be won if all people suffering from the disease are tested for HIV to know their status; are initiated on treatment soon after their diagnosis; and sustained on the recommended lifelong treatment.

Now more than ever, people should be encouraged to embrace regular testing so as to be aware of their HIV status at all times. It is estimated that 30 per cent (500,000) of Kenyans living with the disease are unaware that they are HIV positive since they remain undiagnosed.

Yet, research shows that the earlier those infected begin treatment, the greater the chances that they will enjoy improved treatment outcomes and live much longer with the disease. They will also suffer from fewer complications linked to HIV hence being able to lead normal lives with enhanced immunity. Knowledge of one’s HIV status also minimises the risk of HIV transmission.

While huge strides have been made in combating stigma associated with HIV, concerted efforts are still required to completely eradicate this problem, particularly in developing nations like Kenya. Prejudice, abuse or negative attitudes directed at people living with the disease compromise the HIV fight - at all levels - immensely.

Finally, as has been proven over the years, the dream of a HIV free generation will only be made possible through meaningful partnerships of all players in the entire HIV management field - from people living with the disease to those in the medical fraternity. For more information, please contact your doctor.

- Dr Kisare is the Medical Advisor HIV at GSK in Nairobi

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