We can end AIDS in Africa and the world

Africa leaders are convened in Washington this week to discuss Africa priorities with President Obama and U.S. institutions.   U.S. support for HIV/AIDS programs will be an important topic of discussion.  Africa’s economic development can accelerate if Africa can have sustainable financing for its HIV/AIDS programs and stop this epidemic.  U.S. investment of $52 billion has saved Africa from economic and social disasters from HIVAIDS.  U.S. support for HIV programs through PEPFAR and the Global Fund has now put 15 million people on treatment. U.S. financing helped mobilise additional resources from European and other developed countries.

In July, the international AIDS Conference in Melbourne, Australia focussed on global commitment to end this epidemic.  The global target is to reach 20 million people with treatment by 2020 and for an AIDS free generation by 2030. The importance of innovation and new technology, accelerated development of point-of-care diagnostics, more attention to high risk groups with tests and treatment, and a need to ensure sustainable national programs, were discussed.  The world can end this epidemic but it has to be a collective effort over next several years.

Over 50 percent of the HIV infected people do not know their status.  While adult treatment has increased considerably, the treatment gap among children is huge.  Social stigma denies access to treatment to high risk groups such as young people, LGBT,  transgender, and females in restrictive societies.   The basic human rights to access to testing and treatment is not available for millions of people.

We can achieve global targets through innovative financing, technology, and a global commitment to basic human rights to universal access to treatment for all.  Each national program can generate additional resources from innovative financing such as small tax on financial transaction, transportation, etc.  A small tax of one dollar on a train ticket can generate millions of additional resources for the national programs to put more people on treatment.

When it comes to new technology, UNITAID and Gates Foundation are funding several projects to bring to market new drugs and diagnostics that are better, affordable, and can be used at homes or near patients’ homes.  This means more people will get to know their HIV status and seek treatment.  UNITAID investments in point of care diagnostics will be a game changer because tests can be done in the remotest places and in the homes of people.  The new point of care diagnostics are portable and can be operated by battery or solar power or electricity, and the results from tests can be available in less than 30 minutes.  This is a huge leap forward for rural poor who will not need to travel far to get tested or loose a day in trying to get treatment. For a poor man or woman, a loss of one day is a huge cost in terms of lost income.  For a woman in Islamic society of Sudan, for example, a confidential test is what is needed to save her life. A portable Early
 Infant Diagnostic can increase access to testing for millions of children, thus improving their survival through fast access to treatment.

UNITAID also funds Medicines Patent Pool, a Swiss Foundation, which negotiates patented drugs to be produced by generic manufacturers so that these newer, better drugs are affordable for poorer countries. Over 80 percent of drug procurement by PEPFAR and the Global Fund are from generic sources, thus making cost effective use of contributions from US and other countries. Generic drug production also helps drug manufacturers in developing countries.  Outside FDA, UNITAID and Gates Foundation funds the only global program on pre-qualification of drugs and diagnostics in Europe through the World Health Organisation in Switzerland.

African leaders must be prepared to discuss transition and sustainable financing for HIV/AIDS programs. A commitment to shared responsibility and national financing is what is needed from all.

Rahman is head of Operations for UNITAID, a Switzerland-based multi-lateral financing UN organisation focused on global health initiatives.