AIDS Alert International: Sub-Saharan Africa: Two reports criticize strategies
AIDS Alert International
Sub-Saharan Africa: Two reports criticize strategies
Epidemic problems show progress and problems
Two new international reports highlight the world's continuing failure to rein in the AIDS epidemic in sub-Saharan Africa and in other economically-challenged regions. While there has been significant improvement in international funding and some declines of HIV prevalence among youths, there also are indications that any progress noted now will be short-lived.1,2
International AIDS funding has increased from $1.6 billion in 2001 to $8.3 billion in 2005, but the 2006 Report on the global AIDS epidemic estimates that international funding needs to be $20 billion annually to stop the epidemic from continuing its wide and devastating swath through sub-Saharan Africa and other poor regions of the world.
Six of 11 African countries reported declines of 25% or more in HIV prevalence among 15 to 24-year-olds in capital cities, and sex among youths declined in nine of 14 sub-Saharan nations, while condom use with non-regular partners increased in eight out of 11 countries, the report says.1
However, overall condom use is below 50%, and less than half of young people demonstrated comprehensive knowledge about HIV prevention, according to surveys. Also, only 9% of pregnant women have access to antiretroviral treatment to prevent mother-to-child transmission of HIV.1
HIV treatment has expanded from 240,000 people in 2001 to 1.3 million people in low- and middle-income countries in 2005, and drug prices have dropped significantly with greater generic availability, however access to treatment varies greatly. In Botswana, 85% of the people who are HIV infected have access to antiretroviral drugs, while in the Central African Republic, which has 20,000 fewer people infected with HIV than Botswana, only 3% of the people have access.1
Comprehensive prevention services have not been fully implemented in some countries, including in Senegal, where HIV/AIDS programming and project implementation tend to be fragmented.2
Authorities have made little attempt to integrate HIV and TB policies and services, although research data suggest the HIV prevalence rate among TB patients in at least one city was greater than 15%.1,2
In Zambia, where the HIV prevalence rate among adults 15 to 49 is 17%, prevention programs are heavily dependent on donor funding and subject to donor influence and rules. Such influence has led to a significant emphasis on sexual abstinence-only programs even though these run counter to some of the nation's sociocultural beliefs.1
Senegal's estimated HIV prevalence among adults ages 15 to 49 is among Africa's lowest at 0.9% in 2005. However, female sex workers in Senegal have a skyrocketing HIV prevalence rate, which was estimated to be 13% in 2000 and 27.1% in 2005. Likewise, the HIV prevalence rate among men who have sex with men (MSM) in Senegal was an estimated 21.5% in 2005.1
Despite the nation's low general population prevalence and very high prevalence among certain vulnerable groups, the AIDS programs are focused on the general population.2
"This lack of programmatic focus has persisted despite the fact that the HIV/AIDS epidemic in Senegal is still concentrated, so a more targeted response is warranted to reduce infection rates and to ensure enhanced access to prevention, treatment, and care services among these high-risk groups," states the Public Health Watch and Open Society Institute report, "HIV/AIDS Policy in the United States," issued in May, 2006.
Likewise, the national AIDS policy in Zambia does not mention injection drug users or MSM and does not prioritize prevention services for women and girls who are especially vulnerable to HIV infection in that nation, the report says.2
References:
- 2006 Report on the global AIDS epidemic. UNAIDS report. May, 2006. Web site: www.unaids.org.
- HIV/AIDS policy in the United States. Monitoring the UNGASS Declaration of Commitment on HIV/AIDS. Public Health Watch/Open Society Institute. May, 2006:1-76.
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