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Thirty-six million people currently live with AIDS
by UN AIDS, UNICEF, agencies
24 Aug. 2018
Experts Warn of a Return of the AIDS Epidemic. (VOA)
Thirty-six million people currently live with AIDS, a disease that claimed the lives of nearly 1 million people last year. Experts predict that by 2030, 100 million people will have been infected with the HIV virus.
Despite the alarming numbers, there have been great strides in treatment. HIV is no longer a death sentence, and researchers say people receiving treatment for HIV are able to live normal lives and do not pose a risk to others when they are being treated proactively.
But success carries a price: complacency. Funding for AIDS research and treatment has declined, and in some places, so has government interest.
“When we talk to ministers of finance, they always say to me, ‘I thought HIV was over because I don’t see anybody dying,’” said Dr. Deborah Birx, a U.S. Global AIDS coordinator who oversees the President’s Emergency Plan for AIDS Relief (PEPFAR).
J. Stephen Morrison of the Center for Strategic and International Studies, said, “We’re not reaching goals.” He added, “There’s going to be a struggle to hold ground.. There’s a widening deficit of political will and financial capacity that we face some really daunting challenges in prevention.”
Dr. Chris Beyrer, with Johns Hopkins Medicine, predicted that things will get worse if governments and civilians continue their complacency.
“We are not done with AIDS,” he said. “It is much too early to declare victory, and the risks of a resurgent epidemic are real.”
New infections are down from 3.4 million a year, but they’re stuck at 1.8 million per year. And there are 17 million people living with HIV who cannot be reached. They are in high risk groups: young women, particularly young African women; men who have sex with men; IV drug users; those in prisons and other closed settings; sex workers and their clients; and transgender people.
“Those key populations and young women account for over 50 percent of new infections, and they are really hard to reach,” Morrison said.
Though it’s relatively easy to prevent HIV transmission during childbirth, Beyrer said about 30 percent of all infants born with HIV worldwide are born in Nigeria.
In the U.S., HIV is increasingly an infection in communities with high rates of poverty and in black and Hispanic populations. The National Institutes of Health announced Aug. 20 that getting these groups into care is critical to ending the HIV epidemic in the U.S. NIH also announced an international program to reduce the stigma around the virus so more people with the disease can seek treatment.
Experts agree it is possible to end the HIV pandemic, even without a vaccine. But to do this, governments and communities need to be involved, funding needs to be continued, and everyone with HIV needs to be treated. http://bit.ly/2LAlIGy
Every three minutes a teenage girl is infected by HIV. (UN AIDS, UNICEF, agencies)
Around 1.8 million people became newly infected with HIV and around 50 countries experienced a rise in new HIV infections during last year, according to Michel Sidibé, Executive Director of UNAIDS, who was speaking at the ongoing International AIDS Conference in the Netherlands.
“Health is a human rights imperative and we are deeply concerned about the lack of political commitment and the failure to invest in proven HIV programmes, particularly for young people and key populations,” said the UNAIDS chief.
UNAIDS stressed that women and youth need targeted approaches as they are often more vulnerable and, therefore, more at risk of exposure.
Around 30 teenagers aged 15 to 19 were newly infected with HIV per hour in 2017, according to a new UNICEF report. Of these, two-thirds were girls. Every week 7000 young women (aged 15–24) acquire HIV.
“This is a crisis of health as well as a crisis of agency,” said UNICEF Executive Director Henrietta Fore. “In most countries, women and girls lack access to information, to services, or even just the power to say no to unsafe sex. HIV thrives among the most vulnerable and marginalized, leaving teenage girls at the centre of the crisis.”
Women: At the heart of the HIV response for children offers sobering statistics on the continuing global AIDS epidemic and its impact on the most vulnerable. Last year, 130,000 children and adolescents 19 and under died from AIDS, while 430,000 – almost 50 an hour – were newly infected.
Presented at the International AIDS Conference, the report says that adolescents continue to bear the brunt of the epidemic and that failure to reach them is slowing down the progress the world has made in the last two decades in tackling the AIDS epidemic. The report notes that:
Adolescents between the ages of 10 and 19 account for almost two thirds of the 3 million 0-19 year-olds living with HIV.
Even while deaths for all other age groups, including adults, have been decreasing since 2010, deaths among older adolescents (15-19) have seen no reduction.
Some 1.2 million 15-19 year-olds were living with HIV in 2017 – 3 out of 5 of them girls.
The epidemic’s spread among adolescent girls is being fuelled by early sex, including with older males, forced sex, powerlessness in negotiating around sex, poverty and lack of access to confidential counselling and testing services.
“We need to make girls and women secure enough economically that they don’t have to turn to sex work. We need to make sure they have the right information about how HIV is transmitted and how to protect themselves,” said Angelique Kidjo, UNICEF Goodwill Ambassador, in an essay featured in the report.
“And, of course, we need to make sure they have access to any services or medicines they need to keep healthy. Above all, we need to foster girls’ and women’s empowerment – and education is again often the best route to that.”
To help curb the spread of the epidemic, UNICEF – working closely with UNAIDS and other partners – launched a number of initiatives including:
“All In to End Adolescent AIDS”, which aims to reach adolescents in 25 priority countries home to the world’s highest number of adolescents living with HIV.
“Start Free, Stay Free, AIDS Free”, a framework aimed at reducing the number of new HIV infections among adolescents and young women to less than 100,000 by 2020.
The HIV Prevention 2020 Road Map, an action plan to speed up HIV prevention by focusing on structural barriers – like punitive laws and lack of adequate services – and highlights the role of communities.
These initiatives, and others before them, have led to significant success in preventing mother-to-child transmission of HIV, according to the report. The number of new infections among children aged 0-4 dropped by one third between 2010 and 2017. Now 4 out of 5 pregnant women living with HIV are accessing treatment to keep them healthy and reduce the risk of transmission to their babies.
For example, in the Southern Africa region, long the epicentre of the AIDS crisis, Botswana and South Africa now have rates of mother to child transmission of only 5 per cent, and over 90 per cent of women with HIV are on effective HIV treatment regimens. Close to 100 per cent of pregnant women in Zimbabwe, Malawi and Zambia know their HIV status.
“Women are the most affected by this epidemic – both in the number of infections and as chief caregivers for those with the disease – and should continue to be at the forefront of the fight against it,” Fore said. “The fight is far from over.”
http://www.unicef.org/press-releases/every-three-minutes-teenage-girl-infected-hiv-unicef http://blogs.unicef.org/blog/hiv-darkness-light-story/ http://bit.ly/2NKQXAd http://www.unaids.org/en/topic/gender http://genderandaids.unwomen.org/en http://www.unaids.org/en/topic/young-people/stories http://www.iasociety.org/Youth-Voices
Will fresh voices lead to better choices to help end AIDS, asks Christine Stegling, Executive Director of the International HIV/Aids Alliance on the need for honest discussions about what is and isn’t working to help end AIDS.
The question of whether or not we can end the AIDS epidemic will be asked aggressively in the days before and during the International AIDS Conference this month in Amsterdam. Three decades into the epidemic and with many years of heightened political, financial and intellectual support to address the complex issues that make up the response, it is no surprise that people are growing impatient when we tell them that it is not over yet.
But the truth is, it isn’t! In many countries in the world, HIV remains a serious issue despite all the rhetoric around ending AIDS. The figures speak for themselves: over one million people still died of AIDS-related illnesses in 2016 and over 1.8 million people got infected, which is not the sign of a diminishing epidemic.
According to UNAIDS, the risk of acquiring HIV for the most marginalized populations remain unacceptably high. For example, recent studies suggest that people who inject drugs are 24 times more likely to acquire HIV than adults in the general population, sex workers are 10 times more likely to acquire HIV.
I was confronted by this reality on my recent visit to Myanmar where the prevalence rate among drug users is 34%, as detailed in a new report from the Integrated Biological Behavioural Science. This is a mind-boggling statistic and reminds us of the urgency of the situation.
It is also heartbreaking to know that so many years into the response, globally AIDS remains a leading cause of death among adolescents aged 10-19 years and AIDS-related illnesses remain the leading cause of death among women of reproductive age (15–49 years) globally, and they are the second leading cause of death for young women aged 15–24 years in Africa.
In 2016, 64,000 young people aged between 15-24 years died of AIDS related illnesses. This is hard to fathom for those of us who have spent our lives and careers looking for solutions, gathering political momentum and bringing services and medicines to those communities that are most affected.
But we can end AIDS – not by talking about it as if it was already over but by being honest in our assessments of what is and isn’t working. We must find new allies, address other health and development issues, and listen to fresh voices – especially young voices who are least heard because of their isolation as users of drugs or sexual and gender identity – and by finally accepting that there is no magic bullet to ending AIDS.
People make up communities and it is communities that have been the key to successful AIDS responses. Whether it was gay men organising themselves in Europe and the US to raise the alarm about a disease that was ravaging their communities in the early 1980s, or communities in Asia, Africa, Eastern Europe and Latin America and the Caribbean demanding access to life-saving treatment and quality services, or campaigning for changes in laws and policies.
It is through community engagement that we have made the biggest gains. So the history of the AIDS movement is a history of people, politics, power and of bringing science and human rights together.
This is the time that we need to live up to our analysis which has told us over many years that a successful answer to this epidemic is multi-dimensional, multi-sectoral and combines structural, behavioural and biomedical interventions in a meaningful way. Above all, we need to be person-centred and focus on individual needs in everything we do.
We will only end AIDS when each of us, especially adolescents and young people, has the power to make informed choices about our own health, can access high quality, evidence-based services, and live in communities that are free from discrimination, stigma and violence.
At the Alliance, we know that delivering person-centred, human-rights based and community-led HIV, health and rights programmes is the most effective way to end AIDS. But to actually achieve this we all need to take a hard look at ourselves, assess how effective we are being, and adjust where needed.
We know what community and civil society structures are effective in responding to HIV. Our choice is to strengthen these structures to promote innovation and remove the barriers to effective HIV prevention, treatment, care and support.
We choose to bring in fresh, young and divergent voices by forming powerful coalitions at the global and country level to strengthen our power and impact to end AIDS. We will continue to strengthen youth leadership and youth-owned programmes to meet the needs of those most affected.
We choose to cut across politics of identity, power dynamics, race and gender to demand what is best for people affected by HIV. It is here that we can learn most from young people, especially those living with HIV, if we listen to them in their own words, rather than encouraging them to adopt our talk.
So yes we can end AIDS, but we need to articulate our demands differently and within a new global political context in which AIDS no longer occupies the privileged space it had for so many years. We need to link it meaningfully to other development and social justice priorities – with the knowledge that HIV affects disproportionately those who are most marginalised in society.
And we need to be loud and angry in our demands for resources and political space because, as we all know: AIDS hasn’t ended yet. The choice to make this a reality is ours for the taking. http://bit.ly/2Nso3W2 http://www.aidsalliance.org/
* Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals: the International AIDS Society-Lancet Commission: http://bit.ly/2NUa4b7
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The conflict must end: Fighting threatens to drive up hunger in South Sudan’s lean season
by Stefanie Glinski
IRIN News, agencies
2 July 2018
On Saturday, a new ceasefire came into effect in South Sudan. But within hours it had been violated – terrible news for millions of South Sudanese in the midst of their “lean season”, when food stocks are low and heavy rains can arrive suddenly, washing out roads and links to lifesaving assistance.
July marks the peak of the hunger gap, when harvests are depleted just as new crops are planted. Without food distributed by aid groups, an estimated 7.1 million people – more than half the population – would go hungry. Continued conflict makes humanitarian access to many areas extremely difficult, as well as being deadly and disruptive for civilians.
“The conflict must end,” World Food Programme Country Representative Adnan Khan told IRIN. “It’s one of the main causes of hunger in South Sudan today, forcing millions of people to abandon their land, homes, and jobs, putting them at risk of hunger. We need both peace and sustained humanitarian access to succeed.”
The civil war, now in its fifth year, has claimed tens of thousands of lives, displaced more than four million people – either to other parts of South Sudan or to neighbouring countries – and, along with poor governance, done untold damage to the oil-rich country’s economy.
On 27 June, President Salva Kiir and his rival Riek Machar agreed that a "permanent" ceasefire would come into effect within 72 hours, and that humanitarian corridors would be opened up.
But, like numerous previous ceasefires, it was violated almost before the ink dried. The latest agreement builds on a flawed 2015 peace accord that has done nothing to end the conflict, and many analysts believe it is also destined to fail.
Without lasting peace, international aid organisations fear little progress can be made to help stem hunger in the world’s newest country, which has one of the world’s worst levels of food security (access to enough nutritious food for a healthy life).
“Food security goes beyond seasonality,” explains Alemu Manni, a project manager with the UN’s Food and Agriculture Organization. During conflict, “people are not able to cultivate their land and are forced to flee the country, disrupting their livelihoods.”
During last year’s lean season, an estimated six million South Sudanese experienced severe food insecurity. According to the FAO, this number dropped to 4.8 million after crops were harvested, and the number of people living in conditions of famine fell from 40,000 to 25,000.
“All of our activities and lives revolve around food. It’s an all-consuming thought,” says Mary Amaik, a mother of six who has lived in Pibor for the past two years.
Pibor, a small town close to the Ethiopian border in eastern Boma State, lies on plains at the source of the Pibor River. It has a small market and an unpaved airstrip that fixed-wing aircraft can’t use during the rains because of the mud. So most aid is now flown in by helicopter, which is much more expensive.
South Sudan’s rains are dramatic. In just a few minutes, roads turn into streams thick with sticky mud, making it almost impossible for cars or trucks to pass. The rainy season runs roughly from May until October – just the time when people are hungriest.
Heavy raindrops hit the corrugated roof of Amaik’s home like a drum roll, the water washing off the dust and gushing into the thick, earthy soil. “During the rainy season, my garden floods and the majority of my crops are destroyed,” Amaik says. “Right now, it’s a challenge to get food.” During the wetter months, she explains, it’s impossible for traders to reach her town by road. “Even if we have money, there is no food in the market,” she says.
Agricultural yields have declined since the civil war broke out in December 2013. South Sudan is expected to produce a half a million fewer tonnes of cereal this year than its population requires, a shortfall similar to 2017.
Much of South Sudan’s food is now imported from Uganda, brought in along roads where armed attacks and looting are common. Yet even when supplies arrive, the prices keep them beyond the reach of many.
The bags of sorghum in Amaik’s house were distributed by aid agencies. Sorghum, the main crop eaten in South Sudan, has risen in price almost fourfold since 2016. During the height of the last lean season, the price peaked at 560 percent above the previous year.
Food insecurity is categorised into five “phases” of severity. The most extreme phase, “catastrophe/famine” was declared in the towns of Leer and Mayendit in northern Unity State in February 2017.
This year, limited access has made it impossible to gather the data needed to accurately assess the situation in some parts of southern Unity State. Recent fighting forced aid agencies to postpone deliveries of emergency food supplies to Unity.
“It was the hardest area to collect information from, but we know it’s an area of high concern,” says Philip Dau, director of monitoring and evaluation at the National Bureau of Statistics for South Sudan.
“We also saw indicators for food insecurity in Pibor, although these are not pointing to ‘catastrophe’. Sometimes, there are indicators – such as lack of food – but we find no evidence of crisis,” Dau explains.
Lack of access is a constant issue as the conflict fragments among more armed groups, according to Obia Achieng, chief of field operations for UNICEF in South Sudan.
“Nationally, we have conflict between the main parties,” Achieng explains. “Locally, there are dynamics between leaders, smaller conflicts linked to cattle raids, and communal conflicts which limit our access,” he says, adding that it’s difficult to deliver long-term assistance to children and women in south Unity. “But we are trying,” he adds.
In Pibor, as throughout South Sudan, women are largely responsible for planting and harvesting. “Men – even my husband – tell me that I am ‘just’ a woman and that I don’t have rights. We do all of the field work and the planting,” says Amaik. “I think that men are part of the problem when it comes to hunger. The situation is worse, because they don’t work much.”
Stefano Temporin, who heads the South Sudan office of German NGO Welthungerhilfe, says many young men are often away from their homes at cattle camps. They “only return to their families with the start of the rainy season. Others may have been drafted by the various armed groups,” he says.
Although aid agencies provide food, seeds, and farming tools, people here frequently eat only one meal a day, gathering fruit from the forest. Sometimes, they are forced to kill their scrawny cows – often a family’s only asset and also widely used as dowry payments – for what little meat they provide.
“People in some areas are employing harmful survival tactics to try to tide them through tough times, including eating less, rationing, and reducing the diversity of food,” says WFP’s Khan.
For Amaik and her family, sorghum and wild fruits are their mainstays. “During the rainy season, people migrate to Pibor from the villages, so they are not cut off from the market,” she says. “It’s better in Pibor.”
As for the people living in rural, secluded areas with little access to food, she notes: “I don’t know how they survive.”
http://bit.ly/2KLIbRF http://bbc.in/2KLOCE7 http://reliefweb.int/report/south-sudan/3-4-children-born-south-sudan-independence-have-known-nothing-war-unicef http://bit.ly/2NE6PFJ http://www.globalr2p.org/regions/south_sudan
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