This year’s World Aids Day celebrations marked the fourth decade of the war against the pandemic. For those with interest in the early days of the disease, the movie And the Band Played On sheds light albeit briefly on the chequered history of the journey towards bringing anti-retrovirals or ARVs to people living with HIV.
Lots of strides have been made in regard to civil society organisations, scientists, governments, and pharma working together.
However, there is room for improvement. A persisting culture is continuing competition as opposed to collaboration among those delivering HIV/Aids interventions.
In retrospect, this chequered history focused around funds and attention may have begun from the poisoned chalice of competition between Luc Montagne and Robert Gallo, the two scientists credited with the virus’ discovery.
At present, despite the extensive scientific breakthroughs in efficacy, quality and costs of ARV drugs overall care for patients is still suboptimal for our time. Given the vast resources allocated to HIV, this shouldn’t be the case. This is especially true for people living with HIV in rural, informal settlements and peri-urban areas.
Looking at the pandemic from an economic perspective, few efforts and resources seem to be used on prevention measures. For every new infection, it would cost much less to prevent: a curious scenario given the proven efficacy of post exposure prophylaxis (PEP) and pre exposure prophylaxis (PrEP).
These two approaches are the next best alternatives to abstinence and condom use.
It was thus encouraging for one global player to acknowledge this gap and recommend three possible solutions.
The first one is roping in private sector players in the fight. Stigma on the public side is still big, fuelled by the grouped care model and may cause barriers to access. Incorporating HIV care into mainstream hospital services could improve ARV uptake. The organisation also notes that people living with HIV have certain preferences on how their care should be. Privacy, confidentiality and anonymity being recurrent themes we see in our daily practices.
New funding cycles of HIV care should be geared towards collaboration among implementers, strengthening data fidelity, optimising cost of care, and delivering new preventive based adherence approaches.
With dwindling HIV donor support, counties should start working towards optimising expenditure. Otherwise the cost of running care interventions will balloon. Global HIV funder PEPFAR’s new vision of financing grassroots organisations is commendable. Ultimately though, behaviour change efforts need to be ramped up to reach those currently without testing services, treatment and lacking knowledge on the same.
Let us work together in fighting HIV for best results.