By Phathizwe-Chief Zulu
MBABANE, Swaziland
Swaziland’s government has developed a blueprint to end AIDS, addressing both the government’s targets for 2022 and the UN targets for 2030.
Launching the Swaziland HIV Investment Case, a fast-track Ending AIDS Roadmap, last week – ahead of the International AIDS Conference, in Durban, South Africa – Swazi Prime Minister Sibusiso Dlamini said this is a translation of the government’s vision to achieve an AIDS-free generation.
Sounding positive, Dlamini said the roadmap is clear and achievable and with time-bound objectives that will considerably reduce new HIV infections and AIDS deaths through feasible, cost-effective, and sustainable measures.
“Ending AIDS has a broad thrust to it with two ends to the spectrum. On the one hand we have to focus where HIV has already struck and on the other, prevent it striking in the first place by reducing the rate of new infections to zero,” he said.
Dlamini said the “Three 90s” agreed to in a recent UN high-level meeting set three 90 percent targets: getting 90 percent of those who are HIV-positive to know their status, getting 90 percent of those who know they are positive on Anti-Retroviral Therapy (ART), and thirdly, achieving 90 percent viral load suppression.
“The last target means an almost entire elimination of infectiousness…in laymen’s terms that means more impact on behavior change, more people testing, and more of those on ART adhering to a strict routine with their medication, and having access to the required nutrition,” said Dlamini.
According to the program, the small landlocked country of about a million people, bordered by South Africa and Mozambique on all sides, has an HIV prevalence rate of 26 percent and an incidence rate of 2.4 percent.
Prevalence is the number of people already infected by a disease, and incidence is the rate at which people get the disease.
The country has managed to reduce the HIV incidence and AIDS-related mortality rate by more than 25 percent and 35 percent respectively in the last 10 years. And nearly half of all people living with HIV – 49 percent – are on treatment.
“Transmission of HIV from mother to child at six to eight weeks has been reduced to 3 percent, as over 80 percent of pregnant women have access to PMTCT services,” reads the roadmap, using the acronym for the prevention of mother-to-child transmission.
Dlamini said the enemy started its attack on the country 30 years ago and that for many years HIV and AIDS were the inevitable outcome.
“For Swaziland it started with fewer than 10 cases and spread like a raging fire to 200,000, a fifth of our population. The devastation, suffered by thousands of good people, young and old, our fellow citizens, was massive,” he said.
More than 100,000 children lost their parents. The extended family structure, the bedrock of Swazi society, became fractured, with many households headed by single parents, by grandparents, and sometimes even by children themselves. The economy was hit hard from the impact on the labor force.
He pointed out that the domestic economy contributes 40 percent of the country’s total expenditures fighting HIV and AIDS, while substantial support comes from the UN Global Fund for AIDS. The support has helped the country to meet Millennium Development Goals (MDGs) in 2015 which includes the goal on HIV and AIDS.
Dlamini said that at the 2015 UN General Assembly, Swaziland received a standing ovation for good work in the areas of prevention of mother-to-child HIV transmission, meeting the target for the number of people living with HIV who are on treatment.
However, Petros Malaza is not excited by either the roadmap or the international conference in Durban.
Malaza has lived with the virus for over 10 years and has formed a support group in his community at Mantabeni – 30 minutes’ drive from Swaziland’s capital, Mbabane. The group helps infected and affected people in his area. He admits that Anti-Retroviral Therapy has helped prolong the lives of patients, and they are spending valuable time with their families.
“Unfortunately, I didn’t attend the conference. Nonetheless, I hope scientists will come up with an AIDS treatment. Yes, modern science has managed to prevent mother-to- child [transmission]. But that’s not enough. Let’s have a drug that will prevent me from passing on the virus to the next person.
“If these two things can be achieved soon after the conference, I can say we are on the right track in eliminating AIDS.”
He said the roadmap has good intentions but only when it is properly implemented. But government and partners must also address the issue of malnutrition, he added, saying failure to do so would make the roadmap just a futile costly exercise.
“The weather and farming seasons have changed and we’re not that strong for farming as we used to be. If government can help us with water and fencing for vegetable gardens, we can have decent food and sell it to sustain our lives, he said.
However, there might be a glimmer of hope for Malaza’s concerns. Speaking to the South African Broadcasting Corporation (SABC), Chris Beyrer, outgoing head of the International AIDS Society, said scientists are closer than any time in history to finding the AIDS vaccine in the foreseeable future. The partnership between South African and U.S. scientists is closer to a medical breakthrough.
“The next generation of these studies is based on what we understood from that first targeted sign, so we think we’re closer than we’ve ever been, probably we’re still talking five to 10 years,” said Beyrer.
According to the roadmap, “an estimated total cost of the fast-tracking program is $1,902 million over the period 2014-2030 and $857 million between 2014-2022. This is 9 percent less than the cost of the baseline, which offers fewer infections and AIDS deaths averted.”
