A new report restores hope that an end to this very serious public health challenge could be within reach—but that will require a major boost in commitment and resources.
The study conducted by an NIH-funded research team evaluated the costs and expected life-saving returns associated with ambitious goals for HIV testing and treatment, the so-called 90-90-90 program, issued by the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2014 . The new analysis, based on HIV disease progression and treatment data in South Africa, finds that those goals, though expensive to implement, can be achieved cost-effectively, potentially containing the AIDS epidemic and saving many millions of lives around the globe.
The 90-90-90 program pursues three main objectives: diagnose 90 percent of HIV-infected people worldwide, link 90 percent of them to treatment, and suppress the virus in 90 percent of those receiving ART. By meeting these objectives, the program aims to reduce HIV to undetectable levels in 73 percent (.9 x .9 x .9 =.73) of people infected with the virus by 2020. Current estimates suggest that the virus is suppressed to undetectable levels in just 29 percent of HIV-infected individuals globally.
Based on our own estimates in 2012 (AfA Annual Report) 61% of persons living with HIV do not have the virus under control. While fairing slightly better than global levels, we are still a long way before we reach the aim of the program. In the report, Prof Roy Chan, current president of AfA, laid out 5 strategies that we need to do to stem the spread of the infection, and they are:
- Address HIV-related stigma & discrimination
- Take a holistic approach to HIV prevention
- Evolve traditional prevention programs to provide knowledge that achieves behavioral change
- Encourage early HIV testing & improve linkage to care program
- Explore new bio-medical prevention methods
In the latest report form MOH, new HIV cases among men-who-have-sex-with-men is at its highest in 7 years, while HIV testing rate remains low is worrying. Increased funding and special attention must be given to address the concentrated HIV epidemic among men-who-have-sex-with-men in Singapore.