We are on course to realise Aids-free generation by 2030 - UNAids

George Kimani, a mechanic in Nairobi, remembers the years past, when testing HIV-positive in East Africa was equivalent to being handed a death sentence.

“Before 2001, antiretroviral drugs cost a fortune,” he said, “so having HIV meant almost certain death.”

The 55-year-old, who tested positive in 1998, said that were it not for non-governmental organisations, friends and relatives, he would have been long dead.

“I had to sell some of my property to raise money to pay my medical bills since I was always in and out of hospital. There were times I would go for weeks without working due to opportunistic diseases,” he said.

In 2001, brand name ARVs cost $10,000 per person per year, which was beyond the reach of many people like Mr Kimani, whose income was below $200 per month.

It was a time when the pharmaceutical companies had a tight grip on prices.

Today, if you adjust for inflation, a one-year supply of the same drugs would cost about $14,000, which would still be out of the reach of millions of people living with HIV.

Jimmy Gideyi, 60, has also lived with the disease for 11 years. Mr Gideyi contracted the disease in 2004, when discrimination and stigmatisation of people living with HIV was still very high in East Africa.

“At that time, even employers did not want to employ HIV-positive individuals, fearing they would be a burden and would transmit the disease to others,” Mr Gideyi said.

Luckily for him, MSF Belgium put him on a treatment regime, from which he still benefits.

As result of stigmatisation, many kept their HIV status secret, preferring to suffer in silence.

Mr Gideyi, a former soldier, is one of the people credited with breaking the silence and making their HIV status public. The move helped demystify the disease and change the negative attitude towards Aids patients.

“Seeing the suffering that Aids patients were undergoing, my friends and I decided to make public our HIV status as one way of fighting stigmatisation and discrimination. I am proud of what we achieved in the fight against Aids,” he said.

Recently, the Joint United Nations Programme for HIV/Aids, UNAids, documented the global achievements made in combating the disease.

The achievements range from reduction of new infections, increase in funding for HIV/Aids programmes, fighting stigmatisation and making ARVs accessible, among other advances.

So, is the world heading towards a generation free of Aids?

Yes, says UNAids in its latest report How Aids Changed Everything.

The organisation believes the target can be met by 2030. Apart from the cost of ARVs declining by more than 90 per cent, to around $200 per patient per year, the world has managed to halt and even reverse the Aids epidemic.

In the past 15 years, for instance, new infection rates have dropped by 35 per cent. The number of new HIV infections dropped from 3.1 million to 2 million.

Aids-related deaths declined from 2 million to 1.2 million between 2004 and 2014. The deaths are expected to decline further to 0.2 million by 2030.

Tuberculosis-related deaths have also declined from a high of 520,000 in 2001 to 348,000 in 2014.

In fact, the world has managed to achieve the Aids targets of Millennium Development Goal 6.

“Fewer than 700,000 people were receiving antiretroviral medicines in 2000; today, some 15 million people have access, meaning that we have reached one of the most important treatment goals in history,” says the UN secretary-general, Ban Ki-moon, who also believes the realisation of a generation free of Aids is possible.

READ: Goal to end AIDS epidemic by 2030 "ambitious but realistic" - UN chief

According to UNAids executive director Michel Sidibe, had the world remained complacent, 30 million more people would have been infected with HIV, 7.8 million would have died and 8.9 million more children would have been orphaned.

In Kenya, 850,000 people are benefiting from free ARV programmes funded by the government and non-governmental organisations.

The turning point that made it possible to put millions on ARV treatment, according to Mr Sidibe, was when Brazil and Thailand started manufacturing generic antiretroviral medicines.

“They did something very smart: They revealed that the pills were relatively low cost to make. This took the wind out of industry claims and opened the door for UNAids to start negotiations with companies to bring down prices — which they did,” he said.

As a result, the life expectancy of a person living with HIV increased from 36 years to the current 55 years, and the average number of pills taken dropped from eight to one per day. This is expected to go down to one pill per three months by 2030.

HIV testing has been made easier; it now takes 30 minutes to confirm a result, unlike in the past when one had to wait for three days.

ALSO READ: HIV testing in infants to cost less across the globe

“Rapid diagnostic testing has made it possible for millions of people in the world to know their HIV status in the shortest time possible, and this has also helped governments to plan better for those in need of treatment,” said Nicholas Muraguri, Kenya’s director of medical services.

But before the world leaders pop champagne, experts warn that meeting the 2030 target will not be a walk in the park, especially for African countries.

Already, there is concern that an Aids fatigue is slowly creeping in and the seriousness that the world leaders showed in handling the disease is slowly fading away.

According to Dr Muraguri, discrimination and stigma remain a major challenge for developing countries and must be tackled.

High risk groups, mainly commercial sex workers and homosexuals, still experience hostile rules and regulations that bar them from accessing health services.

“Hostile legal frameworks serve to alienate certain groups, creating barriers to their accessing health services and sexual and reproductive health and rights, leading to an increase in transmission among key populations,” says UNAids.

As at last year, there were 76 countries in the world criminalising same-sex relationships, making it difficult for such individuals to get access to available HIV/Aids services available.