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Malawi’s HIV treatment expansion pays dividends

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New data from the Joint United Nations Programme on HIV/ Aids (UNAids) on the global HIV response has revealed that Malawi has registered a positive decline in HIV infections due to the country’s expansion of treatment.

In its report ‘In danger— UNAids Global Aids Update 2022’, which the UN agency launched in Montreal, Canada, on July 27, as part of events marking the Aids Conference, UNAids says new HIV infections in Malawi decreased by 61 percent.

“The country expanded HIV treatment with a focus on reaching both women and their partners through antenatal care,” the report says.

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According to the report, Malawi also saw a considerable decline in tuberculosis (TB)- related deaths.

Among 30 TB–HIV high-burden countries, the most significant declines in TB-related deaths among people living with HIV are said to have occurred in Ethiopia, India, Malawi, South Africa, Tanzania, Thailand, Eswatini and Kenya.

Several studies have concluded that a global challenge in HIV treatment is the urban-rural divide where people access HIV services unequally, depending on where they live.

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For Africa, the UNAids Global Aids update shows that HIV treatment disparity is pronounced in countries such as the Central African Republic, Gabon, Guinea, Ethiopia, Haiti, Nigeria and Sierra Leone.

“[However] some countries that have minimised coverage gaps between districts—such as Lesotho, Malawi and Rwanda— have also achieved some of the largest reductions in new HIV infections and Aids-related deaths,” the report says.

By 2020, Malawi had achieved 90–90–90 targets for HIV testing and treatment, alongside Botswana, Eswatini, Rwanda, Zambia and Zimbabwe for eastern and southern Africa.

In spite of such progress in ending Aids, the country also shares in the region’s faltering progress in fighting the epidemic.

In eastern and southern Africa, young women, children and key populations are said to be disproportionately affected by the virus.

In sub-Saharan Africa, sex workers, clients of sex workers and sex partners of key populations, gay men and men who have sex with men, people who inject drugs and transgender women accounted for 51 percent of the distribution of new infections in 2021.

In sub-Saharan Africa, adolescent girls and young women are said to be three times as likely to acquire HIV as adolescent boys and young men.

UNAids Malawi Country Director Nuha Ceesay said ending Aids requires concerted efforts.

“Ending Aids as a public health concern in Malawi by 2030 is not a moving target but a realistic commitment that requires predictable partnership and sustainable funding including the increased use of domestic resources,” Ceesay said.

Giving a global perspective, UNAids Executive Director Winnie Byanyima said the Aids response is in severe danger.

Among others, Malawi was one of the first countries in the world to introduce the ‘test-and-treat’ policy where those diagnosed with the virus are put on treatment regardless of their CD4 count.

The country also has a robust ‘prevention of mother to child transmission’ system that ensures pregnant women who test positive are immediately put on treatment.

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