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Could Aids make a comeback?

Three months ago, Malawi was named among six territories in the world that have made tremendous progress towards eliminating HIV by 2030, through crucial policy changes for achieving the feat.

The country was the first to implement a directive on preventing mother-to-child transmission where HIV-positive women are immediately put on medication to protect their unborn babies from contracting the virus.

Several other HIV-related research projects are underway to diversify ways of cornering the virus whose ultimate cure has not yet been found.

Other studies that have resulted into execution of new policies on HIV management are also contributing to the progress that Malawi is making on curbing the epidemic.

The Aids Vaccine Advisory Coalition, in a recent report, indicated that policies such as crusades to encourage HIV testing particularly among key populations and free and easy access to treatment at diagnosis regardless of one’s CD4 count have contributed to the “tremendous” progress in HIV fight.

Voluntary male medical circumcision, post-exposure prophylaxis access and human rights-based services were also mentioned as having contributed to the success.

Still mortality remains extremely high among patients with advanced HIV and researchers maintain that early detection and treatment of opportunistic infections is hampered by inadequate diagnostic and therapeutic packages of care.

A recent report by Médecins Sans Frontières (MSF), an independent medical humanitarian organisation, concluded that Malawi is confronted with a shortfall in anti-retroviral drugs supply including $7.1 million needed to effectively implement a rapid switch to a World Health Organisation-recommended first-line treatment drug.

It adds that an additional $3.9 million is needed to enable a planned scale up of point of care viral-load testing which is crucial in the HIV fight.

While at the moment, Malawi continues to enjoy massive donor support in fighting HIV and Aids, there are fears that the growing fatigue on such aid in other parts of the country may eventually arrive here.

That is why stakeholders keep pushing for more ways of mobilising resources locally to avert a possible crisis in the event that donors decide to pull out.

But still experts argue that it would be impossible for the country to sustain on its own HIV funding due to budgetary and fiscal constraints at national level.

And a recent study published in the Lancet, a weekly peer-reviewed general medical journal, states that many low and middle-income countries are considered unlikely to manage to replace even 10 percent of the current international support towards HIV and Aids care and treatment.

In Malawi, this would leave thousands of patients on ARV treatment to pursue options such as financing their own care or stopping the treatment altogether.

Already, MSF states in its report that they are observing persistent and expanding gaps in essential prevention, diagnostic and treatment services.

They include insufficient health workers, stockouts and shortages of essential medicines and shortfalls in programmes targeting people with specific needs such as those with advanced Aids.

Generally, Aids is said to be returning in many places, globally, with at least 33 percent of HIV-positive people worldwide having very low CD4 counts when starting treatment.

In other countries, due to lack of funds, HIV testing is said to have become less available at testing centres. It would be disastrous if the same became the case in Malawi where all the gains made so far would be severely undermined.

That is why stakeholders are again calling for a robust assessment of the needs and the resource capacity of each affected country.

International donors have also been invited to share the financial burden rather than shifting it onto countries such as Malawi which are worst affected by the epidemic.

But their acts are purely out of goodwill and there may be no clear term that is binding them to support the fight against the epidemic outside their communities.

Of course, richer territories are supposed to support development interventions in poorer countries because, in a global village, one country’s tragedy might spill over to others if it is not controlled.

Malawi’s HIV prevalence rate is one of the highest in the world with an estimated one million people living with the virus and a simple slide would significantly erode the gains made and push the country into a crisis.

That is why all means necessary to ultimately win the battle must be explored quickly.

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