What are the biggest obstacles to global treatment of HIV and AIDS today? And how does this compare to a decade ago?Posted: February 16, 2011
Great achievements have been made in the global treatment of HIV and AIDS over the past decade but issues that created the biggest obstacles when epidemic began over 30 years ago are still central to tackling the issue now.
Comparing the experience of a HIV positive patient ten years ago to the programmes and plans of organisations tackling HIV and AIDS now, stigma and financial investment stand out as key barriers to prevention and treatment.
Fred Minandi was one of the first HIV positive MSF patients in Malawi to be treated with antiretroviral drugs, over ten years ago. Speaking at an international conference on HIV/AIDS that was held in Barcelona in 2002, he recognised how keeping up his treatment and becoming healthy again removed the effects of stigmatisation and had a positive impact on him, his family, and the community.
“When I got sick, I knew I was HIV-positive but I never wanted to admit it or talk about it. My neighbours watched me weaken day by day. Of course, they knew what was wrong but no one asked questions,” Minandi said.
“Now I can talk to my children and tell them that I have AIDS. I tell my neighbours, too. I talk about my illness because I am no longer ashamed and I know that they will not reject me. A person who has AIDS and is very sick scares everyone. But once you are being treated, you feel better, you look better and people don’t reject you anymore. Treatment is the best weapon against stigmatization.”
Minandi argued that in order for stigma to become less of an obstacle, treatment has to be made affordable by the pharmacies who sell it and improving subsidies through aid.
“I believe that providing affordable treatment will also encourage more people to face their HIV-positive status than if nothing were available to them,” he said.
“I would like to appeal to the pharmaceutical laboratories that produce ARVs to reduce the price of their medicine for all poor countries, to our governments to support treatment and seek aid and to the governments of the wealthy countries to give us money so that we can achieve our goals.”
Minandi was speaking in 2002, the same year that saw the founding of the Global Fund to Fight AIDS, TB and malaria. By the end of 2009 the Global Fund were providing the same antiretroviral therapy that Minandi received to 2.5 million people worldwide. But what about stigma? Researchers, including the chief executive of the Nelson Mandela Foundation, behind a book released earlier this year argued that long term planning and financial commitment were vital in the fight against AIDS and that stigma is still an obstacle.
AIDS: Taking a Long-Term View argues that laws which make homosexual sex a crime, and the harassment of intravenous drug users, still prevents some people from seeking help. Improvements have of course been made, and should be recognised and celebrated. But, as the title of this book suggests, there is a long way to go before the biggest global health threats are eradicated. The focus now lies, argue the researchers, with long-term financial planning, commitment, and ownership of AIDS by communities and governments.