June 15, 2021
Francis F.M.Harding
For the sake of the world, we must act now as Human Inmmuno Virus (HIV) affect our home, community and the world. Our world has changed 10 month ago, in Leo France; the world was celebrating the success of the global fund. Successful replenishment fourteen billion dollars not just the largest ever funded raising for the global fund but the largest ever funded raising for the fund but the largest ever fund raising on the global earth. This fund success means the Global Fund can increase country allocation for the next three year or grant circle by 23.4% as a way 50% of the money is going to the fight against HIV.
In 2020 it was an excited prospect of stepping up the fight in getting back on track for ending the epidemic by 2030 scaling up prevention programmes reinforcing different service provision tackling human rights related violence to access, accelerating the role out of innovative approaches such as self-testing.
The world was preparing to come to aid in 2020 with an ambitious optimistic analysis of what Global Fund needed to do to meet the 2020 goals for HIV and break the back of the Aids pandemic and then came COVID-19 and everything changed. In the same way that Aids changed the world of global health decades ago. COVID-19 is changing it now.
The Global Fund was a product of that extra ordinary moment of global solidarity that boast of energy and leadership in a unique global public private partnership to fight HIV, to fight TB and to fight Malaria.
The three biggest infectious disease now with the fight against HIV are yet unfinished as we have been confronted by a new pandemic. The direct impact of COVID-19 is scary enough. In the last six months of 2020, COVID-19 has killed over five hundred thousand people across the world.
Most of us have seen the analysis from UNAIDS and other reports from development partners on the potential effect of COVID-19 other than that from HIV and other diseases. The potential increase in Aids-related deaths due to HIV treatment disruption resulting from COVID-19 in Sub-Saharan Africa double in 12 months (532,000) compared to 2018 as a result of the COVID-19 pandemic. Statistically that will take us back to the level of deaths in 2008, 12 years ago.
All the resources wasted, all the lives, all those billions of dollars, this will be disaster, the Global Fund cannot let it happen, and they must continue to step up the fight.
There is too much at stake. It is not just the one hundred thousands of lives we might lose over the next twelve months is the many more lives we would lose, families destroyed, community ravaged over the years.
In the fight against HIV, every step is a hard one, we cannot go backwards, and the longer time consequences become stark evidence when you consider the potential impact of prevention of mother to child transmission programme.
Analysis by HIV/AIDS Modeling Consortium suggest the ending of Prevention of mother-to-child transmission (PMTCT) key activities can see the number of new child infections increase by + 37% in Mozambique, +78% in Malawi, + 104% in Uganda. Other analysis suggests interruption prevention programme could see new infection speak by 25%.
To be able to cater, this potentially catastrophe knock on impact from COVID-19. Global Fund is working over one hundred countries , the latest result that is 15th June, 2020 suggest 80% HIV programmes they are supporting are suffering from disruption.
Let take a look at Zimbabwe 19% of people diagnosed with HIV have not been able to get an ARV refill or have only been able to get a partial refill. 12% of decline in HIV testing services in Q1 2020 compared to Q1 2019. 70% decrease in monthly HIV testing average in April, 2020 the period in which the lockdown was instituted, compared to the first three months of 2020. 78% decline in PrEP initiations among adolescent girls and young women and key population. 19% of people on ARV are unable to get complete ARV refill. 21% decline HIV testing in the first Q. 70% further reduction during lockdown.
That is for Zimbabwe a country with one of the most affected and successful HIV/AIDS programme in Africa.
The Global Fund has reacted swiftly to support countries and communities in responding to these challenges. In April, 2020 the Global Fund launched the COVID-19 mechanism known as C19RM and Global Fund has made available for ninety six countries and eight regional programmes have used three hundred and sixty nine dollars across this mechanism. The Global Fund support is based on four areas: helping countries, communities adopt HIV, TB and Malaria programmes, to mitigate the impact of COVID-19 safeguard programme, helping protect front liners and health workers through providing personal protective equipment and training, reinforcing system for health so they don’t collapse, and helping countries fighting COVID-19.
All of these four elements are crucial to protecting against and sustain the momentum in the fight against HIV.
HIV prevention, testing and treatment programme need urgent redesigning including changing treatment, distribution model, shifting to multi-month dispensing and direct delivery of ARVs to minimize exposure to infection. Adopting digital solution for service delivery, reducing dependence on face-to-face interaction.
We have to expand on the self-testing and community-based testing, front-line workers, including community volunteers serving key populations, must get protective equipment and training.
We need to fix up week health system for example laboratory already over stretch with a viral testing, TB diagnose are been swap with COVID-19 testing. Containing the spread of COVID-19 is key to avoiding the whole health system being overwhelmed which will be disastrous to those with HIV. A viral testing, when positive is the extraordinary innovation courage are creativity we are saying particularly in community led responses.
The Global Fund is supporting civil society partners to swap ideas, implement best practices, and accelerate the reduction of new tools such as self-testing and on live consultation.
To recognize and ensure how much the COVID-19 response depends on the infrastructure capacity put in place to fight HIV. We must ensure that in the fight against COVID-1 9 has much as in the fight against HIV. We live no one behind. The Global Fund releases a report on mitigating the impact of COVID-19 on countries affected by HIV, TB and Malaria.
Finally, I hope that the Global Funding can and should play a significant role in delivering this response as the history mandate of the Global Fund is unique in place to ensure they respond to COVID-19 leverages the capabilities and lessons from the fight is fought mitigate on HIV. Not when the fight are best fought as one, fight simultaneously tackling this two formidable adversaries’ when no one can be sure how this global health crisis will unfold. A lot of people are saying that seeing with your own eyes is better than hearing a thousand reports.
The official statistic from UNAIDS in 2016, Sierra Leone had 5300 (2200 – 12 000) new HIV infections and 2800 (1900 – 4100) AIDS-related deaths. There were 67 000 (43 000 – 100 000) people living with HIV in 2016, among whom 26% (15% – 42%) were accessing antiretroviral therapy. Among pregnant women living with HIV, 87% (54% – >95%) were accessing treatment or prophylaxis to prevent transmission of HIV to their children. An estimated <500 (<200 – 1400) children were newly infected with HIV due to mother-to-child transmission. The key populations most affected by HIV in Sierra Leone are: Sex workers, with an HIV prevalence of 8.5%., Gay men and other men who have sex with men, with an HIV prevalence of 14%., People who inject drugs, with an HIV prevalence of 8.5%., Prisoners, with an HIV prevalence of 2.2%. Since 2010, new HIV infections have increased by 7% and AIDS-related deaths have increased by 6%. We should not leave anyone behind weather to HIV, COVID-19, TB or Malaria. But a commitment to make everyone is safe to finishing the fight. No one is safe until everyone is safe.