UNAIDS: The fight against HIV is in jeopardy

A new report from the Joint United Nations Program on HIV (UNAIDS), released this week, warns that the response to the AIDS virus is under threat as resources dwindle. More gratifying, the WHO has for its part announced the imminent circulation of self-tests at 1 dollar each, intended for low- and middle-income countries.

According to the report, titled ‘At Risk’, over the past two years of the Covid-19 crisis, progress against the HIV pandemic has faltered, resources have shrunk and millions of lives are at risk.

The publication of this document coincides with the 24th International AIDS Conference, which is being held from July 29 to August 2 in Montreal, Canada.

Asia and the Pacific, an “alarming” increase in infections

Globally, the number of new infections fell by just 3.6% between 2020 and 2021, “the smallest annual decline in new HIV infections since 2016”, according to the document.

Eastern Europe, Central Asia, the Middle East, North Africa and Latin America have all seen increases in annual HIV infections over several years, while in Asia-Pacific, the world’s most populous region, UNAIDS data show that new infections are rising in areas where they have previously fallen. The rise in infections in these regions is described as “alarming”.

In Eastern and Southern Africa, the rapid progress of previous years has also slowed considerably in 2021.

The global response is in grave danger

While some positive news can be counted, such as the notable declines in new infections in West and Central Africa and in the Caribbean, they should be put into perspective because even in these regions, the response to HIV is threatened by a decrease in resources.

For the Executive Director of UNAIDS, Winnie Byanyima, “these data show that the global response to AIDS is in grave danger. If we don’t make rapid progress, we will lose ground, as the disease finds thriving ground with the Covid-19 pandemic, mass population displacements as well as other crises. Let us keep in mind these millions of preventable deaths”.

$1 HIV self-tests

An encouraging sign is that HIV self-tests will soon be available to the public sector in least developed and middle-income countries at the cost of $1 per test. This amount makes these self-tests, among those approved by the World Health Organization (WHO), the cheapest ever offered on the market.

This initiative, announced Wednesday by the WHO, is the result of a partnership between the Clinton Health Access Initiative (CHAI), MedAccess and Wondfo Biotech Company.

Despite the availability of affordable diagnostics and treatment, an estimated 5.9 million HIV-positive people worldwide are unaware of their status.

Those most at risk are sex workers, men who have sex with men, transgender people, people who inject narcotics into a vein, and prisoners and their partners. They represent the majority of new HIV infections.

Adolescent girls and young women are three times more likely to contract HIV than their male counterparts.

Self-tests acclaimed by populations at risk

Many people, among people from these key populations and among young people, consider HIV self-diagnosis as a practical and confidential option for HIV testing, notes the WHO in a dedicated press release.

“The announcement of the new pricing is an important step in making HIV testing for diagnosis and prevention monitoring available worldwide,” said Dr. Meg Doherty, director of global programs at the WHO on HIV, hepatitis and sexually transmitted infections. “This will facilitate, she said, access to self-tests in public health establishments, as well as in community and private establishments”.

The WHO recommends HIV self-testing as a “safe, accurate and effective” way to reach people who might not otherwise get tested.

To date, the agency has prequalified six HIV self-tests, both saliva- and blood-collecting products, ensuring the quality and usefulness of these products.

“Quality-assured self-testing is essential for efficient healthcare systems. The addition of a new self-test to the list of prequalified in vitro diagnostic products helps ensure access to safe, appropriate, affordable and good quality tests,” said Rogério Gaspar, Director of the department Regulation and WHO prequalification.

Globally, many countries have developed national policies in support of self-diagnosis, and the practice is advancing rapidly.

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