Fighting HIV: What is your role today?

Today is World Aids Day. You, me, Dr Binagwaho, Ban Ki-moon and every living person of age is supposed to use this day to reflect on the dreaded incurable killer and what we can do to ensure a zero HIV/Aids world as scientists turn test tubes and other equipment on their heads to find the cure to the three-decade old disease. To date, there are an estimated 35.3 million people living with HIV – human immunodeficiency virus. Between 1981 and 2012, Aids - acquired immune deficiency syndrome – had killed 36 million people worldwide. The theme of today’s Day is “Focus, Partner, Achieve: An Aids-free generation” to highlight the need for governments and health officials, NGOs and individuals to address Aids prevention and treatment. And that is where the dilemma comes into play. How are we going to achieve an Aids-free generation in a time when the disease burden is creating more orphans than war is doing today? How can it even be plausible when drugs continue to ruin countless youth, leading them into getting infections? Although there are no ready statistics of orphans of HIV/Aids in the country, it is estimated that over 52 per cent of all orphans in the country are those from the burden of the killer disease. The Government of Rwanda defines an orphan in the National Policy on OVCs as: “a child who has lost one or both parents” and vulnerable children as: “children under 18 years exposed to conditions that do not permit fulfilment of fundamental rights for their harmonious development”. These children are included in 15 categories, namely children living in households headed by children, children in foster care, street children, children living in centres, children in conflict with the law, children with disabilities, children affected by armed conflict, children who are sexually exploited and/or abused, working children, children affected/infected by HIV/Aids, infants with their mothers in prison, children in very poor households, refugee and displaced children, children of single mothers, children who are married before the age of majority. Worldwide, it is estimated that 17.8 million children under 18 have been orphaned by Aids and that the number will rise to 25 million by 2015. Around 15.1 million, or 85 per cent of these children live in sub-Saharan Africa. In some countries that are badly affected by the disease, a large percentage of all orphaned children - for example 74 per cent in Zimbabwe, and 63 per cent in South Africa – are orphaned due to Aids. The scale of the orphan crisis is somewhat masked by the time lag between when parents become infected and when they die. This is because children whose parents are living with HIV often experience many negative changes in their lives and can start to suffer neglect, including emotional neglect, long before they are orphaned. Eventually, they may suffer the death of their parent(s) and the emotional trauma that results. In this case, they may then have to adjust to a new situation, with little or no support, and may suffer exploitation and abuse. An HIV-free generation Achieving this milestone despite seeming failure to contain the rate of HIV infection is not itself an impossible mission. There have been so much stride in the fight against the deadly disease that this new campaign is not beyond reach. The Ministry of Health says by strengthening the capacity to plan, lead, manage and deliver quality health services, it will be possible to significantly reduce the burden of HIV on the youth. A key priority, the ministry says, is to strengthen civil society, particularly community-based organisations, to reach prevention, care and treatment goals and foster sustainability. The biggest ‘asset’ Rwanda commands in awareness campaigns such as this one on HIV/Aids is that of community-based health workers. Such efforts have fostered a lot of concerted efforts have made reaching the grassroots effective, and the delivery of messages as intended almost stellar. For instance, according to the Embassy of the US in Kigali, as part of this effort, Pepfar Rwanda established the self-help programme for HIV/Aids. The programme offers financial support that enables community-based organisations to implement small-scale development projects that promote HIV/Aids prevention among targeted populations, and provide care and support to people living with HIV/AIDS (PLHA) and orphans and vulnerable children (OVC). The Self-Help Program for HIV/AIDS is not intended to fund private profit-making activities.Stigma among youth Meanwhile, stigmatisation among children living with HIV/Aids is still one of the biggest challenges that needs to be tackled as the world commemorates the World Aids Day. The Executive Secretary of the Youth Association for Human Rights Promotion and Development, Enock Nkurunziza, said a lot more needs to be done to fight against discrimination of people living with HIV/Aids. He said HIV-positive people need to be supported adding that discrimination leaves them in a very difficult position to move on. “Such cases are not common now with our organization, but we are trying to use more efforts in sensitising the community and schools so that we can overcome such challenges,” he said. Peter Dusabirane, the president of the association of children affected and infected with HIV, said they have many children who have at one time rejected education because of stigma in schools. “We had some students that we had to change from one school to another due to stigmatisation by students after realising they had HIV, they feared that they would infect them, this is mainly in boarding schools,” he said. They are rendered useless in society, restricted from participating in family activities and sometimes rejected by their family members which is so dangerous for people infected by the virus. health@newtimes.co.rw ************************ Facts about HIV/Aids Aids is one of the most important global public health issues in recorded history. Caused by infection with HIV, a person may experience a brief period with flu-like symptoms, before a long period with no symptoms. It renders the patient susceptible to infections like tuberculosis and certain cancers. In the final stages of Aids, lung infections and a type of cancer known as Kaposi’s sarcoma are common. HIV is primarily transmitted via unprotected sexual intercourse, contaminated blood transfusions, hypodermic needles, and from mother to child, via pregnancy, delivery or breastfeeding. Sub-Saharan Africa remains most severely affected, with nearly one in every 20 adults living with HIV and accounting for nearly 71 per cent of the people living with HIV worldwide. There are around two million deaths from Aids each year, of which about 270,000 are children.At the end of 2013, 11.7 million people were receiving ART in low- and middle-income countries, which is around 36% of the 32.6 million people living with HIV in these regions. Since the beginning of the epidemic, around 78 million people have been infected with the HIV virus. HIV is treated with antiretrovirals, which work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage. Patients tend to take three or more types of antiretrovirals – known as combination or antiretroviral therapy. Antiretroviral therapy prevents the onward transmission of HIV. Progress has also been made in preventing mother-to-child transmission and keeping mothers alive. In 2013, nearly seven out of 10 pregnant women living with HIV – 970 000 women – received antiretrovirals. – WHO *********************