By Lerato Matheka
Lesotho’s HIV incidence has decreased by almost 50 percent in the last few years, the America-based Aids Ambassador Deborah L Birx revealed this week.
A world renowned medical expert and leader on HIV/Aids issues, Dr Birx is the coordinator of the United States Government Activities to Combat HIV/ AIDS and Special Representative for Global Health Diplomacy.
Speaking during a teleconference interaction with journalists in the African continent on Tuesday, Birx observed Lesotho was making positive strides against the pandemic.
The meeting was organised to commemorate 15 years of the US President’s Emergency Plan for Aids Relief (PEPFAR) in Africa.
The US government’s initiative is designed to address the global epidemic and save lives of people infected and affected by the disease, primarily in Africa.
“If you look at Lesotho’s numbers, your incidence has decreased by almost 50 percent just in the last few years. That is remarkable, that is what we need to do (fighting HIV/Aids), and that is why we have been very persistent about maintaining the pressure,” the ambassador said.
Lesotho has the second highest HIV/Aids prevalence of around 25% after eSwatini.
However, a remarkable progress was first realised in the Lesotho Population-based HIV Impact Assessment (LePHIA) national survey conducted from November 2016 to May 2017 in order to measure the reach and impact of the country’s HIV prevention, care and treatment services.
Some of the key findings by LePHIA were that the prevalence stood at 25.6%, with 30.4 % among females and 20.8 % on males, corresponding to an estimated 306 000 population living with HIV/Aids.
The survey added 1.47 % was the annual incidence, with 1.74 % among females and 1.22 %. The viral load suppression among all HIV-positive adults was reported at 67.6 %.
Ambassador Birx noted eSwatini, Namibia, Botswana and Malawi were also making positive strides, while she added the pandemic remained quite a burden for other countries such as South Africa.
“There are other countries where it is known that the burden of HIV disease is quite large, like South Africa, where we’re working together to actually realize the President’s vision of getting two million additional South Africans on treatment in the next two years.
That is what it will take to really decrease what we call the community viral load – the transmission at the community level,” she said.
For years, Birx noted, there have been talks about the HIV stigma, “but it had never been measured. We have been working very closely with NIH (National Institutes of Health) and what we call the Office of Aids Research to create a stigma index with the UNAIDS group and then utilise that to collect the data country by country; community by community, to really measure where we are and do more things to show whether we are having an impact. We were doing a lot of things, but stigma in general is still very high across the continent and remains incredibly high. So that’s critically important, that self-testing, and who’s doing self-testing.”
The Ambassador pointed out PEPFAR had asked all sub-Saharan countries in Africa to embark on a self-testing programme.
“Why? Because the community-level surveys conducted in Sub-Saharan countries, although we found huge impact among women because women have access to treatment and diagnosis when they become pregnant, if you look at men, we were finding men very late.
We were only finding men when they presented as inpatients or outpatients with TB or opportunistic infections, because they didn’t see themselves during the time of the six to seven years where you’re well with HIV; they didn’t really see the immune destruction that was occurring, and so didn’t come to the clinic,” she said.
Birx indicated self-testing was only important “if we can then get the person to come to the clinic so that they can get treatment to save their lives and to decrease transmission in the community.”
The American government has, through PEPFAR, spent over M4 billion in the last ten years.