Prof Sheila Tlou, the UNAIDS Eastern and Southern Africa director, is the woman who has been spearheading the fight against the HIV pandemic in the region. PHOTO | SARAH OOKO |
What you need to know:
UNAIDS regional chief says bringing down the cost of treatment is key to winning the war against the pandemic.
Africa’s fight against the HIV/Aids pandemic in the past two decades has been long and costly.
The disease has decimated people of the productive age, nearly reversed the gains the continent had made in improving healthcare and left millions of children destitute with far-reaching social and economic consequences.
More recently, however, there have been signs that the continent is slowly beginning to climb out of the hole with statistics showing that the rate of infection is declining and those infected by the virus living longer thanks to increasing access to retroviral drugs.
Sheila Tlou, the UNAIDS Eastern and Southern Africa director, is the woman who has been spearheading the fight against the pandemic in the region.
Before joining UNAIDS, Tlou served as a professor of nursing at the University of Botswana and was later elected as a member of parliament (MP), rising to the position of minister of health.
During her tenure at the health ministry, she rolled out a successful programme for the effective prevention and treatment of HIV/Aids in Botswana that got global recognition.
Prof Tlou talked to the Business Daily about the gains that Africa has so far made and what she wants to achieve in the region in the fight against the disease.
The burden of HIV/Aids has been with us for long in this region. Is it always going to be like this?
The region has had more than its fair share of loss to the pandemic. The disease has impeded economic growth and severely afflicted the health of our citizens.
But this is also the region that has registered a significant improvement in the fight against HIV/Aids. For instance, over the last 10 years, we have significantly reduced the proportion of children born with HIV mainly because of the increase in the number of pregnant women accessing prevention of mother-to-child transmission of HIV (PMTCT) services.
Access to the services now stands at 72 per cent against the universal target of 80 per cent and above. Besides, HIV prevalence rates are also on the decline as more people get tested and begin treatment giving us real hope that the vision of zero HIV infection, no discrimination and elimination of Aids-related deaths is possible for Africa.
So, is the war on HIV/Aids already won?
We are making progress but we are not out of the woods yet. Challenges still exist that must be addressed. For instance, the region needs to address the issue of inequality because everyone has to come on board if we are to successfully fight this disease.
We should expand HIV/Aids treatment services and prevention strategies to reach the majority of the population, especially those living in rural areas.
We must also engage our communities and let them be part of this struggle. There is also the issue of gaps in the supply of essential drugs and services such as ARVs and family planning services.
Kenya recently launched the new World Health Organisation (WHO) guidelines for the treatment of HIV/Aids. Now, patients will begin taking medication when their immunity is still high at a CD4 of 500 up from the previous 350. This means the number of patients on treatment will rise and yet the country is still heavily dependent on donor funding to meet these costs. Can this be sustained in the long term?
The issue of sustainable funding for HIV/Aids interventions is a challenge that we can no longer ignore. Governments need to be prepared to stand on their own and sustain the progress already achieved in the region, even if external resources dwindle.
Consequently, the African Union Road Map of Shared Responsibility and Global Solidarity for HIV, TB and Malaria recommends that nations establish innovative financing mechanisms targeting the three diseases.
This can be achieved through public private partnerships, increasing budgetary allocation to the health sector or introducing levies that compel citizens to contribute a percentage of their income to the HIV/Aids kitty.
As we embark on this journey of sustainability, we are also advocating the establishment of HIV/Aids drug manufacturing firms in sub-Saharan Africa.
Close to 80 per cent of what we are currently using comes from outside and this has to change so that we bring down the cost of treatment as well as guarantee sustainable access to medication for those infected.
The prevalence of HIV/ Aids in Kenya has been going down over the years. It is now 5.6 per cent down from 7.2 per cent in 1997. In addition, awareness has also been rising and HIV is no longer viewed as a death sentence. But this progress has created another challenge. Many teenagers are growing up without fear of the disease and thus indulge in risky behaviour that predisposes them to infection. What is the way forward?
The major cause of this problem is laxity. There’s a tendency to celebrate good results then sit back. During the early days of HIV, there were numerous advertisements in almost all countries that passed behaviour change and prevention messages.
But as the prevalence drops, we are seeing less and less of that. Thus, these young ones may not be exposed to a high level of information as we did in the past. This is where the health sector should partner with the private sector to sustain the pressure.
Companies like Coca-Cola continuously advertise and market their products even when the sales are high. They cannot take chances as they are all too aware that even the slightest bit of laxity can reverse all gains made.
We must do the same with HIV/Aids. The fight against the pandemic is not yet over so we can’t afford to relax.
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