“We missed the 2020 targets for treatment, prevention of vertical transmission and prevention generally – and we have been set back by Covid-19 and now also have the uncertain impact of the Ukrainian war so not only do we need to up our game to get on with the 2025 and 2030 targets but we have also got some catch-up to do”.
This is how a leading HIV/Aids researcher and Chief Operating Officer of the Desmond Tutu HIV Foundation, Linda- Gail Bekker, summed up South Africa’s ongoing struggle against the scourge.
In an interview with People’s Post on the cusp of World Aids Day, celebrated on Thursday 1 December, she said: “There have been a number of reports to show that the laser-like focus on (Covid-19) has had an impact on other areas of public health such as TB, HIV, Malaria and immunisation, for example.”
According to the 2017 findings of the South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, South Africa has the highest number of people living with HIV in the world.
Of the estimated 7,9 million people the survey estimates, 85% of people living with HIV aged 15 to 64 years old have tested for HIV and know their status, 71% of this group are on antiretroviral treatment (ART) and 86% of the group on ART are virally suppressed.
Bekker says the outbreak of the Covid-19 pandemic disrupted the country’s efforts to bring the situation under control.
“There have been good reports to show that testing rates went right down. I think around the region it is clear people may have avoided going to clinics leading to disengagement from care or delayed linkage to care. TB screening rates also went right down. I think our differentiated service delivery for ART meant that fewer people were not able to get their ARVs if they were stable and in care, because multimonth dispensing and off-site pick-ups continued to function- which is an important lesson for future pandemics,” she says.
While she could not describe the influence Covid-19 had on the country’s numbers in relation to new infections, deaths and defaulting, she believes the coming months will be crucial.
“I think this is still playing out and will come through in the months to come,….but the global fund has written some “gap” reports on this that are worth looking at”.
She warned of ill-informed narratives around the pandemic and dismissed the notion that the country had won HIV/Aids fight.
“There is a premature narrative that the epidemic is under control because in a few advanced settings we are seeing fewer infections due to universal treatment and effective prevention (parts of Europe and some cities in the USA and Australia) – but this misplaced complacency is premature and the epidemic is still very much alive in parts of the world and among particular groups of people…..people who are at risk but are often ignored or not catered for in our services. 1,5 million new infections occurred last year. The UNAIDS In danger report describes this very well,” she warns.
As the nation continues to fight the battle, Bekker is appealing for the scaling up of services.
“We need to scale up effective and differentiated primary prevention alongside universal test and treat strategies everywhere where the HIV virus is circulating. The test, prevent, treat, suppress continuum should be offered to all in a person-centred way that is differentiated and tailored to ensure ongoing linkage and retention in services. The services should be both in and outside of traditional health settings, ie also in the community where almost certainly community structures will assist to optimise and take these offerings to scale,” she concludes.
