Global fight against HIV doomed to fail if West & Central Africa are ignored

MSF calls for a fast-track plan to scale-up HIV treatment in West and Central Africa, if UNAIDS targets are to be met.

Tuesday, April 19, 2016 — Fight against HIV doomed to fail without urgent focus on West and Central Africa

Brussels, April 20th 2016 – Globally agreed goals to curb the HIV epidemic by 2020 will not be met unless the HIV response is drastically accelerated in West and Central Africa, where people living with HIV continue to suffer needlessly and die silently, the international humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned in a new report released today.

MSF calls for UN agencies, European donor agencies, the Global Fund and PEPFAR, as well as affected governments and civil society, to develop and implement a fast-track plan to scale-up life-saving antiretroviral treatment (ART) for countries where ART coverage reaches less than one-third of the population in need, particularly in West and Central Africa. 

MSF’s report (URL LINK) “Out of Focus: How millions of people in West and Central Africa are being left out of the global HIV response” explores the causes of the treatment gap in a vast region comprising 25 countries, with detailed case studies on three contexts: Central African Republic, Democratic Republic of Congo and Guinea. 

“The needs in West and Central Africa remain enormous with three out of four people in need not accessing HIV care – that’s five million out of the 15 million new people worldwide who should be started on treatment by 2020”, says Dr Eric Goemaere, MSF’s HIV referent.  “The converging trend of international agencies to focus on high-burden countries and HIV ‘hotspots’ in Sub-Saharan Africa  risks overlooking the importance of closing the treatment gap in regions with low antiretroviral coverage. The continuous neglect of the region is a tragic, strategic mistake: leaving the virus unchecked to do its deadly work in West and Central Africa jeopardizes the goal of curbing HIV/AIDS worldwide”.

The West and Central Africa region is considered as having a low HIV prevalence with 2.3% of the population living with the virus. However, it is three times the worldwide prevalence of 0.8% and pockets in the region have more than 5% of their population living with HIV, the threshold defining high prevalence. Despite this deceptively low average prevalence, the region accounts for one in five new HIV infections globally, one in four AIDS-related deaths and close to half of all children born with the virus. This is due to a very low antiretroviral treatment (ART) coverage that barely reaches 24% of the population in need.

MSF’s report finds that in West and Central Africa needs are underestimated and little priority is given to HIV as a health issue in the region. The route to obtaining HIV treatment is an obstacle course for people living with HIV with barriers such as stigma, stock outs of diagnostics and drugs, patient fees, and unaffordable, burdensome and poor quality services. Recurrent crises following violence or epidemics compound already existing challenges to accessing HIV care. The report recommends major changes in policies and models of care reflecting both lessons learned from progress in the fight against HIV elsewhere as well as innovative approaches specially tailored to contexts with low ART coverage. 

“Closing the treatment gap in West and Central Africa will happen either now or never. Countries with low antiretroviral coverage need to take advantage of the renewed ambitions worldwide to accelerate scale up of their HIV response”, says Dr Mit Philips, health policy advisor at MSF. “But it is unrealistic to think they can break the deadly status quo alone. If the world is serious in its goal of defeating AIDS, it is time to correct a too narrow focus of the Fast Track strategy and, as a matter of priority and urgency, to bring lifesaving ARVs to some of the most neglected victims of HIV/AIDS”.

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Note to editors:

The international humanitarian organization Médecins Sans Frontières (MSF) has been working on HIV/AIDS since the late 1990’s. It currently supports treatment for over 200,000 patients in 19 countries, primarily in Africa. This includes HIV programs and activities in West and Central Africa: DRC, Guinea, CAR, Chad, Niger and Mali as well as other countries with low ART coverage such as South Sudan, Yemen and Myanmar.

The full report is available in English and French at URL LINK.

West and Central Africa is composed of 25 countries: Benin, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Cote d’Ivoire, Democratic Republic of the Congo,

Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger,

Nigeria, São Tomé and Príncipe, Senegal, Sierra Leone, Togo

 

Kinshasa, DRC: Jean-Pierre Lingombe suffers from AIDS and Tuberculosis. He was hospitalised at MSF’s HIV-AIDS hospital in Kinshasa and treated for HIV and AIDS. That is where he met Marie, a former patient at the MSF HIV-AIDS hospital who later provided palliative care there to AIDS patients. Jean-Pierre and Marie now live together in a small house just outside the city of Kinshasa. Jean-Pierre is now followed by the Roi Baudouin Hospital in Kinshasa for his tuberculosis treatment. However, at the time of the visit of the photographer, he had not received his TB drugs because of a drug stockout at the hospital. Credit: Peter Caesar
Kinshasa, DRC: Elise, 12, was infected by the HIV virus during her mother's pregnancy. She has been taking antiretroviral treatment (ARVs) for six years. <br/><br/>Elise received her treatment erratically in the early years because of her mother's lack of knowledge on how best to care for an HIV positive child. As a result Elises developed a resistance to the first set of antiretroviral drugs. She had to switch to an alternative set of ARV drugs which have had stronger side effects and are much more difficult to digest, making it an even bigger challenge for her to fully benefit from the life-saving medication.<br/><br/>Elise's fight against HIV became more difficult and painful each day and she lost the battle and died a few days after these pictures were taken. She passed away in the loving care of her mother and MSF's medical team. Her mother Agathe wanted MSF to publish these pictures. « It cannot help Elise, but it may help others in the country », she said.  Credit: Rosalie Colfs
Kinshasa, DRC: At the Centre Hospitalier de Kabinda (CHK) in Kinshasa, MSF has observed an excessively high number of patients arriving with serious complications resulting from lack of treatment. The number of HIV-positive people in DRC is currently estimated at more than one million, 350,000 of whom could benefit from ARV treatment. However, only 44,000 are receiving treatment at this time. This represents a 15 percent ARV coverage rate, one of the lowest in the world (of all African countries, only Somalia and Sudan have similar rates). Credit: Mario Travaini
Kinshasa, DRC: The arm of a Julia a patient ill with advanced AIDS at the Centre Hospitalier Kabinda. At the Centre Hospitalier de Kabinda (CHK) in Kinshasa, MSF has observed an excessively high number of patients arriving with serious complications resulting from lack of treatment. The number of HIV-positive people in DRC is currently estimated at more than one million, 350,000 of whom could benefit from ARV treatment. However, only 44,000 are receiving treatment at this time. This represents a 15 percent ARV coverage rate, one of the lowest in the world (of all African countries, only Somalia and Sudan have similar rates). Credit: Mario Travaini
Kinshasa, DRC: At the Centre Hospitalier de Kabinda (CHK) in Kinshasa, MSF has observed an excessively high number of patients arriving with serious complications resulting from lack of treatment. The number of HIV-positive people in DRC is currently estimated at more than one million, 350,000 of whom could benefit from ARV treatment. However, only 44,000 are receiving treatment at this time. This represents a 15 percent ARV coverage rate, one of the lowest in the world (of all African countries, only Somalia and Sudan have similar rates). Credit: Mario Travaini/MSF
Kinshasa, DRC: André, 42, photographed in the HIV-AIDS ward of the Centre Hospitalier Kabinda in Kinshasa, DRC, 24 january 2012.<br/><br/>MSF has observed an excessively high number of patients arriving at the Centre Hospitalier de Kabinda (CHK) in Kinshasa, with serious complications resulting from lack of treatment. The number of HIV-positive people in DRC is currently estimated at more than one million, 350,000 of whom could benefit from ARV treatment. However, only 44,000 are receiving treatment at this time. This represents a 15 percent ARV coverage rate, one of the lowest in the world (of all African countries, only Somalia and Sudan have similar rates). Credit: Mario Travaini/MSF
Kinshasa, DRC: André, 42, photographed in the HIV-AIDS ward of the Centre Hospitalier Kabinda in Kinshasa, DRC, 24 january 2012.<br/><br/>MSF has observed an excessively high number of patients arriving at the Centre Hospitalier de Kabinda (CHK) in Kinshasa, with serious complications resulting from lack of treatment. The number of HIV-positive people in DRC is currently estimated at more than one million, 350,000 of whom could benefit from ARV treatment. However, only 44,000 are receiving treatment at this time. This represents a 15 percent ARV coverage rate, one of the lowest in the world (of all African countries, only Somalia and Sudan have similar rates). Credit: Mario Travaini/MSF