Efforts to combat Aids in Africa are seriously faltering, with drugs beginning to lose their power, the number of infections rising and funding declining, raising the prospect of the epidemic once more spiralling out of control, experts have warned. Globally, 38 million people are living with HIV, 17 million of whom are now on drugs that stop them transmitting the virus to others. But the rise in infections appears inexorable.
The UN has set a target of 2030 for “the end of Aids but the reality on the ground, especially in the developing world, looks very different. Many experts believe that the epidemic will continue to spread and the Aids death toll, still at 1.5 million people a year, could begin to soar again.
1. Every year, around the world, nearly 2 million people, 60% of them girls and young women, become newly infected with the virus, despite prevention efforts.
2. In developing countries, HIV is becoming resistant to the drugs used to treat people and keep them well, which means they will increasingly need other drugs that are currently unaffordable.
3. Donor countries are cutting back on funding, in response to austerity measures, financial crises and the assumption that the epidemic is under control.
Prof. Peter Piot, the first executive director of UNAIDS and director of the London School of Hygiene and Tropical Medicine, told the Guardian: “I don’t believe the slogan ‘the end of Aids by 2030’ is realistic and it could be counterproductive. It could suggest that it’s fine, it’s all over and we can move to something else. No. Aids is still one of the biggest killers in the world.” He continued, “It is as if we’re rowing in a boat with a big hole and we are just trying to take the water out. We’re in a big crisis with this continuing number of infections and that’s not a matter of just doing a few interventions.”
Piot believes that drugs will not stop Aids and that cultural change, which is far harder to bring about, will be necessary. “We will not end HIV as an epidemic just by medical means,” he said. “People are not robots. Sex happens in a context. It is about power. Southern African girls and young women are infected by men who are much older than themselves. It’s about poverty. It’s also about a culture of machismo. There are also gay men all over the world who are discriminated against and underground, and there’s no way you can prevent infections if something is underground.”