Much has been done on HIV, but challenges remain: UNAIDS report

The UNAIDS says although much has been done to combat the spread of HIV, there are still important milestones to reach, barriers to break and frontiers to cross to free the world of the disease.

According to a 2016 report launched in Windhoek Monday, UNAIDS says the world has agreed to meet a set of global targets by 2020 as part of the fast-track strategy meant to end the AIDS epidemic as a public threat.

Some of the targets are that by 2020, the number of new infection should be scaled down from 2.1 million in 2015 to half a million, while that of people on treatment increases to 30 million from the current 18 million.

The number of AIDS-related deaths too should be reduced from 1.1 million in 2015 to half a million by 2020, while the number of new infection in children goes down to 50,000 from the 150,000 of 2015.

There are key challenges though, the report says, among them the difficulty countries face in testing pregnant women; preventing mother-to-child transmission; low levels of pediatric diagnosis and slow initiation of treatment.

According to the report, the gold standard in high-incidence setting requires routine HIV testing of pregnant women during the first antenatal visit and then retesting them in the third trimester as well as during breastfeeding.

This, the report further says, is not possible in some countries because of inadequate health care infrastructure and lack of awareness of the importance of routine HIV testing.

It also says some countries lack adequate test kits due to poor procurement and supply chain system as well as traditional beliefs, cultural practices, stigma and discrimination.

Furthermore, the report says although many countries emphasizes the importance of providing antiretroviral medicines during pregnancy and delivery, most do not take measures to ensure that mothers living with HIV get the support to adhere to treatment.

"As a result, infants are exposed unknowingly to HIV during breastfeeding, with half of all mother-to-child transmission occurring during this period," the report says.

In addition, many women living with HIV are not aware that they need to remain on treatment while breastfeeding and opportunities to reinforce the adherence messages and resupply medicines are fewer once they give birth.

The report points out that although AIDS-related deaths among children have reduced dramatically in recent years, the vast majority of them still occur during the first five years of life.

In this regard, according to the report, early HIV diagnosis and antiretroviral therapy greatly reduce infant mortality and HIV progression.

"Without antiretroviral therapy, 50 percent of children living with HIV die before their second birthday," the report states.

Even when infants are tested early, ineffective transport and poor communication systems may result in prolonged turnaround times between blood sample collection at clinics and the return of results, says the report.

Despite all these challenges, nothing is lost since there are ways on how gaps can be closed using cheaper ways and forms of confronting them.

The report identifies four such way: the pre-exposure prophylaxis (PrEP) for pregnant and breastfeeding women; simpler and cheaper diagnostic tools; testing infants at birth; and linking mother-infant pairs.

PrEP is an additional HIV prevention option for pregnant and breastfeeding mothers in settings with continuing high incidence.

The shortage of testing kits can be solved by the use of portable point-of-care systems that run on battery are rugged enough for use in mobile laboratories.

There has also been developed a faster way of sending results by short messages that takes about 17 days. Endit