Less than half of people who need HIV treatment receive it

Published Jul 12, 2016

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What is the state of play as the world returns to Durban 16 years after the historic 2000 Aids conference? It is simple: less than half of people who need HIV treatment have access to it.

About 17 million people living with HIV are receiving antiretroviral therapy, 20 million are not. They are at increased risk of developing tuberculosis and cancers – even if some of them still have high CD4 counts. Providing those 20 million people with treatment will help prevent many new HIV infections.

It is clear – we need to make sure an additional 20 million people have access to treatment. On this score most researchers, doctors, diplomats, policy-makers and activists gathering in Durban will agree. We have all the slogans and all the right rhetoric. We all agree that 90-90-90 is the way to go.

But 20 million when all we’ve achieved so far is 17 million?. Is it not madness to think we can get another 20 million on treatment? Is a reality check overdue?

If we are ever to get near an additional 20 million, then Durban has to be a turning point.

What should we be getting serious about? First, to find the healthcare workers to support an extra 20 million people on treatment. Second, we have to stop pretending we can end Aids without dealing with the widespread dysfunction in our healthcare systems. Third, we have to get serious about how we are going to produce and pay for the medicines needed to treat an extra 20 million people. Last, we need detailed, fully funded plans to make treatment a reality.

Getting serious also means never again wasting money in the way money was wasted on, for example, abstinence-only programmes.

It means standing up to the moral Mother Grundys and providing young people with proper sex education and access to condoms. It means asking “Why are we so quick to stigmatise ‘sugar daddies’ but so slow to ensure young people have easy access to condoms?”

Getting serious means addressing the political obstacles to fixing our healthcare systems – it means dealing with corruption, mismanagement and patronage in our healthcare systems. It means not turning a blind eye when healthcare systems are wrecked by people who are politically well-connected.

It also means acknowledging that while Pepfar giveth, the US trade representative taketh away – by bullying poor countries into trade deals that compromise access to medicines.

Getting serious also means not tiptoeing around cruel and inhumane legislation such as the anti-gay laws in many countries. We must say what Nigeria and Uganda are doing is unacceptable.

Getting serious that UNAids must stop talking about an end to Aids while there are 20 million people who still need treatment. We must not spread complacency just because we want to tell a positive story. Complacency is our greatest enemy. We are morally obliged to change this in Durban.

We have to say to the governments of high burden countries: “You have to invest more. You have to do better.”

We have to say to rich countries they have a moral responsibility. If governments don’t do their part we must name and shame them and stop the quiet diplomacy. Welcome to Durban 2016, let’s roll up our sleeves and get serious. We have 20 million more people to treat.

Anele Yawa is the general secretary of the Treatment Action Campaign. This article is part of a series that will appear in Spotlight www.spotlightnsp.co.za – a TAC and SECTION27 publication.

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