AIDS/HIV (Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus) caught everyone by surprise nearly four decades ago. Since then, 42 million people worldwide have succumbed to complications arising from AIDS, out of around 88 million infected persons. There are around 40 million people living with HIV worldwide.
According to the latest reports, Sri Lanka has experienced a drastic surge in HIV/AIDS cases during the second half of 2024, marking the highest number of cases logged in a single quarter since 2009. Statistics released by the National STD/AIDS Control Program show 214 new HIV cases this year, reflecting an 18 percent increase compared to the previous quarter in 2023 (181 cases). Of the cases reported in the second quarter, 28 persons fall within the age range of 15-24, while the remaining persons are above 25. In Sri Lanka, 4,643 males and 1,472 females have contracted HIV since 2009.
Today (December 1), on World AIDS Day, the world will focus on the progress made so far in the fight against AIDS and the steps that should be taken to eliminate the disease. There used to be a time when HIV/AIDS meant an automatic death sentence, but these days are gone now. Remarkable progress is being made on HIV treatment.
This year’s World AIDS Day is being marked under the theme, “the world can end AIDS – if everyone’s rights are protected”. Ending AIDS needs engaging everyone who is living with, at risk for or affected by HIV – especially including people who have been excluded and marginalised.
“With human rights at the centre, with communities in the lead, the world can end AIDS as a public health threat by 2030,” says UNAIDS, the United Nations (UN) agency specialising in AIDS/HIV control.
As per UNAIDS, the substantial progress that has been made in the HIV response is directly linked to progress in protecting human rights of HIV patients and indeed, all others. In turn, the progress made on the HIV response has galvanised broader progress in realising the right to health and strengthening health systems in general.
But gaps in the realisation of human rights and Universal Health Care (UHC) for all are keeping the world from getting on the path that ends AIDS and are hurting public health, and now a surge in attacks on rights is threatening to undermine the progress that has been made.
The good news is that access to treatment, which in itself is a fundamental right, has risen significantly. As of the end of 2023, 77 percent of all people with HIV (around 30.7 million) were accessing Anti Retroviral Therapy (ART) globally. Low-cost or no-cost access to HIV treatment is the key to the global effort to end AIDS as a public health threat.
No single prevention method or approach can stop the HIV epidemic. Several methods and interventions have proved effective in reducing the risk of, and protecting against HIV infection including male and female condoms, the use of antiretroviral medicines as pre-exposure medication, voluntary male medical circumcision, behavioural change interventions to reduce the number of sexual partners, the use of clean needles and syringes, and the treatment of people already living with HIV to reduce the viral load and prevent onward transmission.
Thus access to HIV ART drugs and awareness campaigns on prevention are more important than ever. Everyone, regardless of who they are or where they live, has a right to health, which is also dependent on adequate sanitation and housing, nutritious food, healthy working conditions and access to justice.
The right to health is supported by, and linked to, a wider set of rights. Ending AIDS as a public health threat can only happen if these rights are placed at the centre of global health, so that quality health care is available and accessible for everyone. Almost all Sustainable Development Goals (SDGs) are linked to health and achieving the SDGs, which include ending the AIDS epidemic, will depend heavily on ensuring the right to health.
The right to health is firmly enshrined in our law, but even more importantly, it is deeply ingrained in the national psyche. Sri Lanka is one of the few developing countries that provide a completely free health care service. While there are no problems with regard to medical care for HIV patients, the bigger challenge is changing societal attitudes towards those living with HIV. There are still a lot of misconceptions about the disease, which have not been effaced even after sustained media campaigns.
Every attempt should be made to educate the masses on the true nature of this disease and methods of transmission to end the social stigma faced by the victims. While today’s anti-HIV drugs can prolong the lives of patients to the point where most of them can reach the full natural lifespan, scientists have not lost sight of the ultimate goal – a cure and a possible vaccine.
A greater understanding of our bodies’ complex immune systems is essential in this quest since AIDS is a disease that essentially cripples one’s immunity to disease. HIV is very adept at evading the body’s immune responses. The main way it does this is by developing mutations that enable the virus not to be recognised by a person’s immune system. At the same time it continues to replicate and reproduce itself. Controlling the behaviour of this virus will be the key to any eventual cure or vaccine.
Judging by the progress made so far in the world of medicine, where certain diseases such as polio and smallpox have been eradicated from Earth, there is no doubt that scientists will achieve the same goal vis-à-vis AIDS/HIV within the next two or three decades.
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