(TriceEdneyWire.com/GIN) – Swaziland – the country with the world’s largest HIV prevalence – is showing signs of getting the epidemic under control, as more people access treatment and become virally suppressed.
New infections have fallen by nearly one half (44 percent) since 2011, while 73 percent of all people living with HIV in Swaziland, both diagnosed and undiagnosed, now have an undetectable viral load – meaning they cannot transmit the virus to others. Such progress in containing the spread of HIV/AIDS was presented at the International AIDS Society (IAS) Conference on HIV Science in Paris this past month.
But experts say clouds are on the horizon. The U.S. and other international donors are pulling back critical healthcare funding at the same time as a phenomenon known as antimicrobial drug resistance is on the rise. HIV drug resistance develops when people do not adhere to a prescribed treatment plan, often because they do not have consistent access to quality HIV treatment and care. Individuals with HIV drug resistance will start to fail therapy and may also transmit drug-resistant viruses to others.
The level of HIV in their blood will increase, unless they change to a different treatment regimen, which could be more expensive – and, in many countries, still harder to obtain. Under the so-called “global gag rule”, renewed by President Trump in his first days in office, funding for overseas organizations that perform work in any way linked to abortion including HIV will be cut. “Everybody is worried because of the global gag rule,” said Dr. Moses Okilipa in an office in Uganda’s Mbale district.
The Botswana Family Welfare Association (Bofwa), expects to lose about 84 percent of the funding it currently receives from the US, and will have to close clinics in three of the eight districts it works. More than 30 percent of the population of Botswana are HIV-positive. Bofwa is the only health NGO working across the country. Lesotho Planned Parenthood Association expects a third of its services to be hit, and about 10,000 young people in one district left without HIV, family planning and sex education services.
In Mozambique, more than 10 percent of 15- to 49-year-old Mozambicans are HIV-positive, giving the country the eighth highest infection rate in the world. Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, commented: “We need to proactively address the rising levels of resistance to HIV drugs if we are to achieve the global target of ending AIDS by 2030.”
A new five-year Global Action Plan calls on all countries and partners to join efforts to prevent, monitor and respond to HIV drug resistance and to protect the ongoing progress towards the Sustainable Development Goal of ending the AIDS epidemic by 2030. In addition, WHO has developed new tools to help countries monitor HIV drug resistance, improve the quality of treatment programs and transition to new HIV treatments, if needed.