In the last few years it seems as if news reports about HIV/AIDS from Africa have been dominated by South Africa’s amazing success in making antiretroviral drugs available for treatment to the public.
A story today in The Guardian serves as a reminder that sub-Saharan Africa still has a huge HIV infection problem, with adolescent girls disproportionately affected.
The recent election of Donald Trump as the next U.S. has raised anxieties that U.S. humanitarian aid to Africa, including HIV prevention, will stop.
The U.S. President’s Emergency Plan for AIDS Relief – PEPFAR – is a government initiative started in 2003 with the aim of helping “save the lives of those infected with and affected by HIV/AIDS around the world”.
An initial $15 billion was set aside to respond to HIV and TB by providing financial and tech support in several affected countries, including South Africa, Mail & Guardian reported.
“My guess is that if (the U.S.) were going to plug aid to Africa, they will cut funding to health programs,” said South African public health activist Victor Lakay. “Losing this kind of initiative would see a rollback in the advances we have made because it will not help to stem the number of new HIV infections.”
South Africa has the worst and most conspicuous HIV/AIDS epidemic in the world. An estimated 7 million people had HIV in 2015. There were 380,000 new infections and 180,000 South Africans died from AIDS-related illnesses, according to Avert, a U.K. charity founded in 1986 to provide HIV education.
South Africa also has the largest antiretroviral treatment program in the world, financed largely from its own domestic resources. The country invests more than $1.5 billion annually to run its HIV and AIDS programs.
However, HIV prevalence remains at 19.2 percent of the general population, although varying between regions. For example, HIV prevalence is almost 40 percent in Kwazulu Natal and 18 percent in the Northern and Western Cape, Avert reported.
Thousands of girls and young women are still being infected with HIV every week in sub-Saharan Africa, and urgent action is needed to help and protect them, the United Nations said, according to a report in The Guardian.
Many girls are unaware they have the virus and don’t seek treatment because they’re afraid to tell their families they have had a sex with an older man. Death rates among adolescents are high.
More than 90 percent of the adolescents infected in sub-Saharan Africa are girls. In 2015, 7,500 girls and young women age 15 to 24 were infected with HIV per week. Between 2010 and 2015, the total annual number of new infections among 15- to 24-year-old women fell just 6 percent, from 420,000 to 390,000. The U.N. target to reduce that number to fewer than 100,000 a year by 2020 is way off track, says the latest report from UNAIDS.
Girls and young women are infected by older men. Men tend to acquire HIV later in life.
The good news is that the number of people on drug treatment for HIV has reached 18.2 million — 3 million more than two years ago, according to the report. UNAIDS says it is on track to meet a treatment target of 30 million people by 2020.
The bad news? Preventing infection is proving more difficult. There were 2.1 million new infections in 2015 – the same as in each of the last three years.
“South Africa has moved from a HIV treatment-focused movement – in which we have made incredible advances – to a prevention-focused movement,” Lakay said. “(Medication forms) an integral part of this prevention armoury. And some are only funded through PEPFAR.”
Trump said in the speech announcing his presidential candidacy that the U.S. should “stop sending foreign aid to countries that hate us” and spend the funds domestically to “invest in our infrastructure… our tunnels, roads, bridges and schools,” according to Impact 2016, a non-partisan initiative by the U.S. Global Leadership Coalition to advance America’s role in the world.
On the other hand, there is one foreign aid program Trump likes, according to Likewise, Humanosphere.
Trump likes PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief. President George W. Bush established it, and it has strong bipartisan support in Congress. During a rally in New Hampshire, a voter asked whether Trump would double the number of people receiving HIV/AIDS treatment by 2020.
“Yes, I believe so strongly in that, and we’re going to lead the way,” Trump responded.