UNAIDS

{Photo credit: MSH staff, South Africa}Photo credit: MSH staff, South Africa

This post, first published on The Huffington Post, is part 5 in the MSH series on improving the health of the poorest and most vulnerable women, children, and communities by prioritizing prevention and preparing health systems for epidemics. Join the conversation online with hashtag .

Struck with a prolonged and worsening illness, Faith, a 37-year-old Nairobi woman raising her two children, sought help from local clinics. She came away each time with no diagnosis and occasionally an absurdly useless packet of antihistamines. Finally, a friend urged her to get an HIV test. When it came back positive, Faith wanted to kill herself, and got hold of a poison.

All epidemics arise from weak health systems, like the one that failed to serve Faith. Where people are poor and health systems are under-resourced, diseases like AIDS, Yellow Fever, Ebola, TB, Zika, Malaria, steadily march the afflicted to an early grave, decimating families, communities and economies along the way.

{Photo credit: C. Urdaneta/MSH, South Africa.}Photo credit: C. Urdaneta/MSH, South Africa.

Cross-posted from Southern Africa HIV and AIDS Regional Exchange (SHARE).

As I sat through the official opening at the 6th South African AIDS Conference (SAAIDS), I found myself wondering what the focus of the first conference post 2015 will be. Will there be a national conference after the countries are supposed to have achieved the Millennium Development Goals?

"We have fought a good fight. At last the glass is half full," declared Professor Koleka Mlisana, the conference chair, the first of many plenary speakers to outline the successes achieved in the national AIDS response. The figures from South Africa certainly are encouraging:

2012 World AIDS Day event in Port au Prince, Haiti. From left to right: Pamela White, Ambassador of the United States to Haiti; Michel Sidibe, Executive Director of UNAIDS; Sophia Martelly, First Lady of Haiti; Florence Duperval Guillaume, Minister of Public Health and Population; and Guirlaine Raymond, Director General of the Ministry of Public Health and Population. {Photo credit: C.Gilmartin/MSH.}Photo credit: C.Gilmartin/MSH.

In recent years, Haiti has endured some of the greatest misfortunes in its history, including hurricanes, floods, the devastating 2010 earthquake, and the cholera epidemic that followed. These natural disasters and public health crises have added to the harm already caused by the country’s widespread poverty, social and political unrest, and under-resourced health system. Haiti’s fragile population is further plagued by the highest HIV prevalence in the Western Hemisphere at 1.9 percent, which translates to roughly 120,000 HIV-positive individuals and 93,000 children who have lost their parents to AIDS (UNAIDS, 2011).

Malawi mother and children {Photo credit: MSH.}Photo credit: MSH.

I got a call from the resident doctor to come to exam room 6. As soon as I entered the room, I prepared myself. The little girl, 7- or maybe 8-years-old, didn't look well; she was “floppy,” combative, and not entirely aware of where she was or what we were doing to her. She was HIV-positive, and my colleague needed to get an IV line in her arm to test the latest in experimental treatments for kids with HIV– and needed the four of us interns to help hold her still.

It was 1993 during my residency in pediatrics in Cleveland, Ohio. We were at one of the best children’s hospitals in the world; it didn’t matter. The young girl died a few months later.

With the advent of antiretroviral therapy (ART) a few years later, the whole world changed. The world of HIV medicine blossomed; new drugs and drug combinations literally exploded with amazing effect. HIV-positive mothers could give birth to HIV-negative babies, and HIV-positive children and their moms could get treatment.

http://www.youtube.com/watch?feature=player_embedded&v=joX9cq692Wc

Michel Sidibé, Executive Director of UNAIDS, discusses the new UNAIDS World AIDS Day report: Results at a press conference today in Geneva.

 

 

 

Two women hold a banner at ICASA 2011: Where's the Money for HIV? Credit: MSH.

 

Last week I had the privilege of attending the International Conference on Family Planning in Dakar, Senegal, where over 2,200 family planning and global health advocates, funders, and supporters gathered to voice support for family planning.

The 16th International Conference on AIDS and Sexually Transmitted Infections (ICASA) opened today, December 5, 2011, at the newly refurbished Millennium Hall in Addis Ababa, Ethiopia, with a colorful and lively music and dance production by the Ethiopian National Theatre and Traditional Music Group and the Addis Ababa Youth & Children’s Theatre.

UNAIDS Executive Director Michel Sidibé at the 16th International Conference on AIDS and STIs in Africa (ICASA). Credit: UNAIDS/J.Ose.

UNAIDS Executive Director Michel Sidibé gave an impassioned welcome speech remembering the last 30 years of AIDS and the 24 million African lives lost to the epidemic. He called for solidarity and compassion for the 34 million people currently living with HIV.

I’d like to call attention to an important set of articles in the recent HIV/AIDS themed issue of The Lancet. Erik Schouten of Malawi Basic Support for Institutionalizing Child Survival (BASICS) has published a commentary (free registration required) about Malawi’s push to be the first country to implement a “B+” approach to reducing mother to child transmission.

During the opening ceremony of the International AIDS Conference, International AIDS Society President Julio Montaner declared “Consensus has arrived. Treatment and prevention are one thing and they are the way forward.” He went on to assert that Treatment 2.0 “is the most effective way forward to deliver on the universal access pledge.”

Later in the ceremony UNAIDS Executive Director Michel Sidibe proclaimed “Treatment 2.0 radically simplifies treatment to maximize the number of people who can benefit.”

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