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‘Fight against Aids far from over’

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By Alick Ponje:

International medical humanitarian organisation Médecins Sans Frontières (MSF) has expressed concern over the minimal decline of annual cases of death due to Aids since 2014.

In 2018, 770,000 people are said to have died from Aids-related complications worldwide, according to figures the UNAids Global Aids Update 2019 figures released in Eshowe, South Africa, on Tuesday.

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Experts in HIV research and prevention state that timely use of effective diagnostic tools and medicines to treat HIV and Aids could prevent most deaths.

MSF says while an additional two million people are reported to be on antiretroviral therapy (ART), more needs to be done by all concerned to confront killer infections driving Aids deaths, starting with tuberculosis (TB) and cryptococcal meningitis.

“In MSF-supported hospitals in the Democratic Republic of Congo, Guinea, Malawi and elsewhere, many deaths occur within 48 hours of admission,” says Gilles Van Cutsem, leader of the MSF HIV/Aids Working Group.

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“Patients arrive very ill, often with severe opportunistic infections such as tuberculosis, cryptococcal meningitis, or kaposi’s sarcoma. When they arrive, sometimes it is too late to save them. They might not have been diagnosed on time or failed to get access to a life-saving treatment,” he adds.

The World Health Organisation estimates that more than 30 percent of people who start HIV treatment worldwide have advanced disease with severe immune suppression, which puts them at a very high risk of getting opportunistic infections and, in worse situations, death.

One in three deaths linked to Aids in the world is said to be due to TB while cryptococcal meningitis affects hundreds of thousands of people infected with HIV each year and accounts for between 15 and 20 percent of all Aids-related deaths.

In countries such as Malawi, where MSF works, diagnostic tools such as the CD4 cell count, which is needed to diagnose advanced HIV disease, are reportedly often missing.

Tests which provide quick diagnosis of TB and cryptococcal meningitis also reportedly remain unavailable, particularly in primary healthcare settings where most people go for their healthcare needs.

“Many patients go first to primary healthcare centres when they feel sick. If primary care clinics are not equipped and trained to detect advanced HIV, patients at risk will remain undetected and untreated; they will deteriorate until they are terminally ill,” Van Cutsem says.

In 2016, United Nations member states endorsed the goal of cutting Aids deaths by 50 percent by 2020, to less than 500,000 per year, but less than six months to the deadline, nations are far from achieving the target.

They also agreed to UNAids’s 90.90.90 targets where 90 percent of people living with HIV know their status, 90 percent of those tested HIV positive are on antiretroviral therapy and 90 percent of people on treatment have an undetectable viral load.

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