Authors: Martha Powell, Future Science Group
Data from the US President’s Emergency Plan for AIDS Relief (PEPFAR) have suggested that control of the HIV epidemic could be in sight in Lesotho. These findings have added to prior surveys in Malawi, Swaziland, Zambia and Zimbabwe from the last 9 months, all demonstrating progress towards controlling the HIV epidemic in these countries.
The results come from Population-based HIV Impact Assessments (PHIAs), supported by PEPFAR, which have been carried out in six countries to-date. The latest results from Lesotho have been very positive, for example, HIV viral load suppression was reported to have reached over 67% among all HIV-positive adults aged 15–59, suggesting the country could be on track to achieve epidemic control by 2020.
Building on the progress observed thus far, US Secretary of State, Rex Tillerson, has announced a new PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017–2020), which outlines plans to accelerate implementation in 13 high-burden countries. The strategy will involve collaborating with host governments, in addition to charities and other partners.
Ambassador, Deborah L. Birx, who is US Global AIDS Coordinator and Special Representative for Global Health Diplomacy, commented: “With five African countries approaching control of their HIV epidemics, we have the extraordinary opportunity to change the very course of the HIV pandemic over the next three years. […] PEPFAR is poised to deliver on it, showing that what once seemed impossible is now possible.”
Despite demonstrating good progress the PHIAs also highlight gaps in HIV prevention and control. For example, in the six surveys that have been carried out all demonstrated that individuals under 35 years of age are less likely to know their HIV status and be seeking treatment.
“The findings from the six countries provide a report card on the global and local efforts in confronting the HIV epidemics while at the same time help in shaping a blueprint for their future course as they continue their quest to stem this epidemic,” explained Wafaa El-Sadr, from Columbia University (NY, USA).
“The gaps identified in reaching young women and men are relevant to many other countries around the world, and addressing them is critically important to achieving the ultimate goal of ending this epidemic.”
Going forwards it is hoped that an additional seven countries will complete PHIAs on a rolling basis between 2017 and 2019, allowing officials to chart and validate their progress towards epidemic control by 2020.
Director of the Centers for Disease Control and Prevention (CDC; GA, USA), Brenda Fitzgerald, concluded: “CDC is so pleased to contribute to the global HIV response, working with ministries of health and other partners on science-based solutions that are transforming some of the world’s most severe HIV epidemics. National surveys are critical to show the impact of efforts and to chart the path to fully achieve HIV epidemic control.”