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New research maps HIV prevalence for better disease control

HIV prevalence in parts of  Kenya, Malawi, Uganda, and Tanzania exceeded 10 per cent in 2017, a new research study by the Institute for Health Metrics and Evaluation (IHME) from the University of Washington, Seattle indicates.

The research paper published in Nature, is estimating that HIV prevalence among adults (aged 15–49 years) and the corresponding number of people living with HIV from 2000 to 2017 provides an important tool for precisely targeting the interventions that are necessary to bringing HIV infections under control in sub-Saharan Africa.

According to data from the Global Burden of Disease (GBD), despite the rapid scale-up of antiretroviral therapy (ART) since 2000, HIV/AIDS is still the most common cause of death in sub-Saharan Africa. In Uganda, GBD data show that HIV/AIDS was responsible for 25,920 deaths in 2017.

In 2017, the highest estimated HIV prevalence at the second administrative level in Uganda was 12.1 per cent in Bujumba county in Kalangala district. The lowest prevalence was 1.7 per cent in Aringa county in Yumbe district. The study found that the largest number of people aged 15-49 years living with HIV (PLHIV) reside in Kyadondo county in Wakiso district.

Dr John Nkengasong, director of the Africa Centre for Disease Control and Prevention (Africa CDC) in a press statement said the paper will support policy makers and health care providers to identify key areas of intervention in order to allocate meaningful resources accordingly in the continued fight against HIV/AIDS.

“Good data is critical. Data is the oxygen of a good national public health institution in Africa. Without data, a public health institution or strategy is doomed to end up not being very successful…Changing the trajectory of HIV/AIDS in Africa requires that we continue to seek better ways to know the epidemic,” he said.

He added that the paper will support policymakers and health care providers in locating hotspots of HIV/AIDS at national and sub national levels, and will help guide smart investment of scarce resources for diagnosis, prevention, and treatment.

Dr Nkengasong further called for increased advocacy, data streamlining and financing of the health sector to create a better enabling environment in the fight against HIV/AIDS.

“Today we know that about 1 million Africans die every year from HIV/AIDS which is a significant number so we have to do a couple of things in Africa. First of all, the highest level of advocacy has to be maintained, there’s no room for complacency,” he added.

According to Nkengasong, those countries have to know the epidemic, where infections are occurring, who is infecting who and use the tools that are available at our disposition that is to say have the ability to deploy ARVs appropriately based on data.

“Without financing, none of the things or instruments that is available in the menu to fight HIV/AIDS to be deployed. Unfortunately we’ve seen flatting of financing in global health over the past 10 years which is very unfortunate and speaks to complacency of the fact that progress has been made,” he said.

The call comes on the heels of the recent announcement by the ministry of Finance, Planning and Economic Development on passing the HIV trust fund to which Uganda Revenue Authority will submit 2 per cent of tax levied on drinks.

Since 2015, the World Health Organization (WHO) has recommended ART for all people living with HIV, because early treatment enables them to live longer and healthier lives and reduces the potential for transmitting the virus.

Despite the rapid scale-up of ART, 34 per cent of people in East and Southern Africa and 60 per cent of people in West and Central Africa living with HIV are not currently on treatment, according to UNICEF.

Growing population size and continued high incidence of HIV infection, combined with increased life expectancy among people living with HIV, has led to an increase in PLHIV in sub-Saharan Africa. Between 2000 and 2017, the number of people aged 15-49 years living with HIV in sub-Saharan Africa increased by 3 million, even as HIV prevalence declined.

Dr Laura Dwyer-Lindgren, lead author and assistant professor of Health Metrics Sciences, said the Global funding for HIV/AIDS has declined since 2013. 

The Bill & Melinda Gates Foundation funded the study, part of a five-year grant that enables IHME researchers and collaborators globally to map a range of health metrics at a fine local resolution.

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