Despite the decrease in new HIV infections in many countries, the struggle is far from over. And with less than 1000 days left to reach global Aids targets, now the ultimate fight is to increase access to ARVs, and prevent new infections.
UNAIDS reveals in its 2012 report that new HIV infections have dropped by over 50% across 25 countries, including South Africa, Zimbabwe, Malawi, Swaziland, Zambia, Botswana, Namibia and Swaziland.
The Geneva-based organisation says it is self-satisfied that the number of people accessing antiretroviral therapy increased worldwide by 63% in the last 24 months, reiterating that the pace of progress is quickening.
In Senegal, an HIV/Aids success story country, access to antiretroviral therapy (ART) reached 74% of people eligible in 2011, according to UNAIDS.
UN Aids agency executive director Michel Sidibe has commended Senegal for stablising the epidemic and keeping HIV/Aids rates low (only 0.7 percent). Senegal has 60 000 people HIV-positive, while globally 34.2 million are living with the virus, UNAIDS says.
Strong leadership (both political and religious), prevention and socio-cultural attitudes are said to have helped the country of Sembene Ousmane and Rokhaya Niang to keep HIV/Aids rates low.
UNAIDS says Senegal began putting in places preventive measures early in the 70s, and these measures include reinforcing the national blood supply, which had been systematically tested for syphilis and hepatitis since the 1970 in order to prevent HIV transmission through blood transfusions.
UNAIDS has urged countries to reduce the cost of second and third-line treatment, and explore new ways of expanding and sustaining access to treatment, including domestic production of medicines and innovative financing.
Dr Karim Diop, national coordinator of Esther Senegal, tells Moon of the South: “First-line treatment is the first phase of the antiretroviral treatment. But it happens sometimes that after a few years this treatment becomes ineffective or drug-resistant, the patient will then go for a second-line treatment, which is much more expensive.”
First-line Aids treatment in Senegal costs 180 USD and second-line treatment costs 2000 USD, Dr Diop says, adding that there are three treatments altogether.
Esther (Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau) is a France-based non-governmental organisation (NGO) that launched Esther Senegal in 2002 to give a helping hand to Senegal’s embattled healthcare system.
Esther Senegal in October 2012 took charge of 1200 Aids patients’ treatment, including diagnosis and treatment of opportunistic infections (parasitological and bacteriological analysis).
Esther spent 3.85 million euros between 2002 and 2012 to support Senegal’s various health projects in Dakar and Saint-Louis, spokesperson Nadine Legret tells Moon of the South from Paris, where the organisation is headquartered.
Several attempts to get comment from UNAIDS country director Demba Kone drew blanks.
Senegal is set to get a grant of 33 million USD from the Global Fund to Fight AIDS for the next three years to help finance the implementation of its HIV National Strategic Plan.
Senegal health minister Prof Awa Marie Coll Seck has said that Senegal will spend 1.3 billion Fcfa (2.6-bn USD) on ARVs, adding that her country has the means to prevent and reduce new infections.
However, despite having one of Africa’s lowest HIV/Aids infection rates, the US Centers for Disease Control and Prevention says Senegal’s vulnerable groups such as sex workers and gay men, have higher HIV prevalence, putting the number of sex workers in Senegal at 21%.
One ‘clandestine’ sex worker operating in and around Dakar tells Moon of the South on condition of anonymity that she does go for HIV test every six months.
“Of course, there is always a temptation from some rich customers to go skin-to-skin with you by offering you a lot of money,” the 28-year-old skinny woman says.
Despite having over 1000 VCT (voluntary counselling testing centres), few people, including would-be husbands and wives, go in there for an Aids test, many residents of Dakar tell Moon of the South.
Marriage counsellor Aminata Ba says: “This is still a very conservative society deeply entrenched in traditions, religious and cultural beliefs, where people trust each other too much and most people marry through family connections. In most of the cases, a woman and a man have no say in the marriage issue.”
Ba adds: “I think this traditional way of doing things has saved Senegal from becoming like a stadium of Aids.
“The elders go to consult the family of a woman to ask her hand in marriage for their son, and the date is set for the event, no complications occur and no HIV test done.
“The only problem is that a woman can be a virgin or clean, but the man might have done some stupid things when he was single.”