Tuesday, 29 November 2011

Doing More with Less


Zero new infections, zero discrimination and zero Aids related deaths
(this year's theme)

There is good news from a recent UNAIDS report released for World AIDS Day (1 Dec). www.unaids.org/en/resources/unaidspublication/2011/  New HIV infections and AIDS-related deaths continue to fall, and the number of people on treatment in the less developed world is almost 50 percent of those eligible. This has happened in spite of a decrease in finances.

Especially encouraging for us in Zambia is that access to HIV treatment has improved greatly in Sub-Saharan Africa (SSA), the region which has long been worst hit by the AIDS epidemic, making up some 68 percent or 22.9 million of all HIV-infected people.

Access to antiretroviral drugs (ARVs) has increased in SSA by 1/5 between 2009 and 2010 though 1.2m people still died of AIDS-related causes last year. Zambia has reported coverage levels of between 70 and 80 percent; nearing universal access (considered 80%).

The overall world statistics are encouraging too; while 2.7 million people contracted HIV in 2010. This represents a fall of over 1/5 since 1997.

6.6 million people are now accessing ARVs , an increase of 1.35 million in less than two years. With improved access to treatment, new HIV infections are also declining sharply.

It seems that ARVs play a role in reducing transmission of the virus to partners. Infection rates are 1/3 to ½ fewer than would have been the case without ARVs. This amounts to 2.5m people alive today who would not have otherwise been.

Changes in behaviour such as abstinence, condom-use and male circumcision are also contributing. Prevention of mother-to-child transmission is another success, where 400 000 new infections have been prevented.
To continue to do more with less, the UNAIDS Report suggests a 4- Goal Investment Framework to use funding more efficiently and effectively.

1.Maximise benefits of HIV Response

2.Use national epidemiology to ensure best allocation of resources

3.Implement programmes based on local context

4. Increase efficiency in prevention treatment care and support

This new approach in funding could prevent some 12.2 million new infections - including 1.9 million children, and 7.4 million AIDS-related deaths between now and 2020 says the report.

For universal access to HIV prevention, treatment, care and support by 2015, an estimated US$22-$24 billion annually is required.

In the past two years donor funding has been cut by 10 percent from $7.6 billion in 2009 to $6.9 billion in 2010.

Without stable funding, opportunities to prevent new infections will be missed and there is a risk that the progress gained in the fight against HIV could be lost.

Our Aids Relief Programme at the Mission Hospital here in Mwandi continues with its static clinic based here at the hospital and the 6 mobile outreach clinics. The outreach is now undertaken weekly. There are 1478 people on ART, 164 of whom are children.

We are grateful to many people for being able to look after our clients in many different ways. Starting at the top we have PEPFAR and AIDS Relief with the funding and other structural and logistical support. On the ground here we have a number of Church Partners who help such as IPC with reagents, Aiken and Goldsboro and other individuals for their contribution to the Formula Programme. There are over 250 children alive today who benefited from this programme that uses WHO guide-lines. The Church of Scotland Guild ’s Food Support programme that brings nutritional support to the Hospital and Home-based Care programmes. There are numerous churches and visitors who by buying bags and craft items made by the Mothers’ Support Group give this group a small but steady income throughout the year.

This year in Mwandi the Community will meet as usual on AIDS Day Eve for a candle-lit service in memory of those who are no longer with us and who have been lost to HIV/AIDS. At the service we will have a large number or Orphans and Vulnerable Children, a visible legacy and testimony to the destruction caused to ordinary families by this appalling pandemic. It is a sad and moving occasion but also one of joy and hope in the presence of these children.
The next day, AIDS Day, there will be a march through the village, an all-age gathering for some speeches, songs and drama; a Fun-Run and Football Match are the sporting events planned.

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