Fighting the Aids epidemic in the era of the Covid-19 pandemic
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OPINION: As we have in our response to the Aids epidemic, we need global solidarity in responding to the Covid-19 pandemic.
by Dr Joe Phaahla
The global community will gather again today to commemorate World Aids Day.
This is one of the times where we also remember all those who have succumbed to the virus as well as those infected and affected by Aids.
It is also a pivotal time in which we rededicate ourselves to ending the scourge of Aids as a public health threat.
The theme for this year’s World Aids day is “End inequalities, end Aids, end pandemics,” which accurately reflects what we should be focussing on.
More notable, however, is that this year marks the second time where we observe World Aids Day while we also confront the Covid-19 pandemic, which has now been exacerbated by the impending 4th wave – fuelled by the Omicron variant.
As I write this, we await more information on the transmissibility and virulence of the new variant, as well as if it will evade the vaccines that we using.
South Africa has been thanked by the global community for our ability to identify new variants and for being transparent in informing both the local community and the World Health Organization as is required by the International Health Regulations.
We are, however, highly distressed by the response by many countries in restricting travel from our country at a time when we, particularly, look forward to welcoming tourists to our beautiful country. Their presence would have contributed to saving our battered tourism sector.
Dr David Nabarro of the World Health Organization was absolutely correct when he asked high-income countries to consider how their actions (unjustified in this case) will impact the economy in the global south.
As we have in our response to the Aids epidemic, we need global solidarity in responding to the Covid-19 pandemic.
The global response to the Aids epidemic showed us that we need to act together to solve global challenges. As well, the Aids epidemic also showed us that the weakest of us bear the brunt of these challenges – whether it be the poor or the marginalised.
These are two colliding challenges that we are facing to which we add climate change.
We cannot allow the Covid-19 pandemic to undermine our Aids response and reverse the gains we have made.
More than 90% of South Africans know their status. We have been able to initiate more than 5 million people living with HIV on life-saving treatment, and we have a large number of interventions to prevent new HIV infections, including pre-exposure prophylaxis or PrEP.
Despite the Covid-19 pandemic, we can, and we must eliminate HIV as a public health threat by 2030, if not sooner.
I fully agree with the comments by the executive director of UNAIDS, Ms Winnie Byanyima, who said that despite the disruptions caused by the COVID-19 pandemic, we must “act urgently to prevent a resurgent global Aids pandemic and to quickly recover our progress toward ending Aids”.
We welcome the efforts of UNAIDs and its partners, as well as global leaders who adopted the ‘Political Declaration Pledging Urgent, Transformative Action to Stop Global Aids Epidemic by 2030’ at the UN General Assembly in September this year.
The political declaration called for “urgent and transformative action to end the gender inequalities, restrictive laws and all forms of discrimination that fuel the global Aids epidemic”.
This statement is particularly important for our country with its high levels of sexual and gender-based violence, the continued high levels of stigma against people living with HIV as well as stigma and discrimination against the LGBTIQ community.
South Africa continues to have high levels of new HIV infections in the general population as well as in marginalised communities.
It is estimated that we have around 200 000 new HIV infections annually, with more than 150 adolescent girls and young women aged between 15 and 24 years infected daily.
The prevalence rate among pregnant women who attend antenatal care in the public sector remains at 30%, and we know that infections rates among sex workers, gay men and people who inject drugs far exceed that of the general population.
We have the means to end Aids as a public health threat in our country even as we battle the Covid-19 pandemic. We can prevent new HIV infections. This requires individuals, families, communities, government and the private sector to work together at all levels.
The government has provided millions of male and female condoms, sex and health education, HIV testing, PrEP as well as treatment for those that test positive – all of which can help us reduce the incidence of HIV.
We need to ensure that these products and services reach everyone who is at risk for acquiring HIV in the most humane way possible – ensuring the human rights of those that are vulnerable to HIV acquisition as well as those living with HIV are critical to ending the Aids epidemic.
As we have called for all those that are eligible to get vaccinated against Covid-19, we call on all those that are sexually active to get tested for HIV, and if one tests positive, to initiate life-saving treatment.
Taking ARV treatment has never been easier – it is one pill taken once a day.
There are early suggestions that people with untreated HIV and those that are not virally suppressed are more likely to contract COVID-19 and may contribute to evolving new variants.
This means that it is critical for people living with HIV to take their ARV treatment to ensure viral suppression and get vaccinated.
In this context, as of December 1, immuno-compromised people (such as those on cancer treatment, renal dialysis and on steroids treatment for auto-immune diseases) can obtain a third dose of the Pfizer vaccine and a second dose of the J&J vaccine to provide them with additional protection against Covid-19.
As we remember those that have fallen to HIV and Covid-19, I urge everyone to take the necessary precautions to protect themselves and their loved ones from HIV as well as Covid-19.
Practising what we know, including public health safety measures, will protect us from these colliding viruses.
* Phaahla is the Minister of Health
** The views expressed here may not necessarily be that of IOL.