US ambassador: AIDS still ‘not under control’ in Africa

Despite all of the recent gains and progress made in the fight against HIV/AIDS in Africa, the situation is still “not under control,” according to U.S. Ambassador Deborah L. Birx, MD, global AIDS coordinator and special representative for Global Health Diplomacy at the State Department.

Speaking this month at the Congressional Black Caucus Foundation’s annual Africa BrainTrust event, Birx, who also oversees the implementation of the President’s Emergency Plan for AIDS Relief (PEPFAR), said the epidemic continues to ravage populations throughout the continent.

Deborah L. Birx

“HIV/AIDS began as a plague that spread across the world with over 30 million that have died, but today as we sit here, many think that HIV/AIDS is under control … that it’s been contained,” Birx said. “This week while you are here in Washington, 34,000 new infections will occur, 7,000 of them in young women. Twenty thousand adults will die, and [so will] 4,000 children.”

According to Birx, Africa represents nearly 70% of the global burden in HIV, and prior to the establishment of PEPFAR in 2004, life expectancy had dropped from 60 years old to 40 years old in “country after country” in sub-Saharan Africa. All gains of immunization had been diminishing, she said, and the prevalence of HIV/AIDS rose to one-in-two people.

In response, PEPFAR has invested nearly $750 million per year into the health systems of developing countries, which are then expanded and sustained by the individual countries, Birx said.

While the situation is improving, the objective is far from over.

“So we are not at control, but we have made tremendous progress, and I think PEPFAR shows today what can happen with bipartisan support,” Birx said. “[It is] a program that was begun under President [George W.] Bush and expanded under President Obama; a program that was begun in Congress with extraordinary bipartisan support that has been reauthorized twice. But it’s only happened because of the long-term continuous diligence of the Congress.

“Today we can talk about an AIDS-free generation because President Obama said it was possible in 2013, but imagine the health system that you need that finds the pregnant mom no matter where she lives, how far from a road she resides, and says, ‘We will find you, help you — fine if you have HIV — protect you, so you can thrive and protect your baby from HIV.’”

According to Birx, another major hurdle to treating HIV/AIDS in Africa and other parts of the world is the stigma against and the discrimination of victims and patients.

As long as patients are shamed out of receiving the treatment they need, efforts to curb the epidemic will not be successful, she said.

“Today despite our health care advances, populations around the globe at risk for HIV are highly stigmatized and discriminated against,” Birx said. “So unless we address the rights — the rights of young women and the rights of LGBTI — we will not reach the goals we need to, collectively.” – by Jason Laday