Addressing inequalities key to ending AIDS in the Caribbean: PAHO

The Pan American Health Organization (PAHO) is marking World AIDS Day on Thursday, Dec. 1 with a call for regional countries to address the inequalities that prevent progress towards ending AIDS as a public health threat by 2030.
This year, the theme of the day is “Equality.”

PAHO said around 2.5 million people live with HIV in Latin America and the Caribbean.
In 2021, it said about 120,000 people became infected with the virus and a further 35,000 lost their lives from AIDS-related causes.

“Access to testing and the implementation of innovations for early diagnosis, prevention and timely treatment continue to be affected by inequality, which is slowing our progress towards eliminating AIDS,” PAHO Director, Carissa F. Etienne said. “This is unacceptable given the powerful tools at our disposal to make AIDS a public health problem of the past.”

While 82 percent of people living with HIV in Latin America and the Caribbean know their status, PAHO said only 69 percent receive antiretroviral treatment, and 63 percent have a suppressed or undetectable viral load, “which is essential for maintaining good health and preventing transmission of the virus to others.”

PAHO said among the tools available to eliminate AIDS are self-administered tests, drugs to prevent infection in people at substantial risk (Pre-Exposure Prophylaxis, or PrEP), and new drugs that are more effective and easier to take for those already living with HIV, such as dolutegravir, recommended by the World Health Organization (WHO) as a first line of treatment.

But PAHO said while several countries in the region are accessing these tools through its Strategic Fund, “this access remains inequitable, and many in most affected populations continue to miss out.”
Currently, PAHO said only 14 countries in the region have HIV self-testing available, 25 countries have introduced dolutegravir, and only a very limited number of people at substantial risk of HIV infection receive PrEP.

“To change course, we need an integrated response, extended to all communities at risk,” Dr. Etienne said. “We must address stigma and discrimination to broaden access” to diagnosis, prevention and treatment for all.
The PAHO director also called on countries to address the challenges posed by COVID-19, which impacted the HIV response, and recognized the work of health workers and authorities in the region in implementing alternatives to face-to-face care and drug delivery during the pandemic.

“The end of AIDS and many other infectious diseases can only be achieved if we tackle the barriers that prevent access to services and tools for those who need them the most,” she said.

Meantime, UN Secretary-General António Guterres has called for an end to the inequalities, “which are blocking progress towards stopping the pandemic, and eradicating the virus.

“The world has promised to end AIDS by 2030”, said the UN chief in his official message, but “we are off track.”
“Today, we risk millions more new infections and millions more deaths”, he added, calling on governments everywhere to make the “Equalize” slogan a reality.

He said the “proven practical solutions” exist that can help end AIDS, such as more funding to boost the availability, quality and suitability of services for HIV treatment, testing and prevention.

“Better laws, policies and practices to tackle the stigma and exclusion faced by people living with HIV, especially marginalized populations. Everyone needs respect and to be welcomed,” Guterres said.

He said the many-layered inequalities that perpetuate the pandemic can and must be overcome: “We can end AIDS. If we Equalize.”

Echoing the UN chief’s call to action, and his own core theme for the year, the President of the UN General Assembly Csaba Kőrösi said the AIDS crisis was “ripe for solutions based on science, solidarity and sustainability.”

“We need urgent measures to end inequalities that make people vulnerable to infection,” he said. “If the international community acts, 3.6 million new HIV-infections and 1.7 million AIDS-related deaths will be prevented this decade.”
Kőrösi called on all UN member states and stakeholders to renew their political and financial commitments to ending AIDS by the ambitious deadline.