Dr. Andrew Pinto
Dr. Andrew Pinto writes…The latest update on the epidemic from UNAIDS contained a mixed message. While the “overall growth of the global AIDS epidemic appears to have stabilized” and “there are fewer AIDS-related deaths”, it is apparent that “new infections overall are still high” and the number of people living with HIV worldwide continues to increase.
What does this mean? Clearly, access to antiretroviral therapy (ART) has helped turn the tide of the AIDS pandemic and there is reason to celebrate. We should always remember that these lifesaving drugs became affordable and accessible due to community mobilization and civil society advocacy. Also essential was the development of innovative mechanisms to deliver these medications, developing and implementing new cadres of health care workers (such as the clinical officers I had the privilege to work with in Malawi) and continually holding policymakers to account. People living with HIV/AIDS were central to these efforts – a key reason why there have been many successes.
Yet, much work remains to be done. Certain groups face barriers to ART and are systematically missed. In both high and low-income countries this can include the poor, those with lower educational attainment and stigmatized groups, such as men who have sex with men in low-income countries. The current global financial crisis – created by the actions of individuals in wealthy countries – has led to reductions in assistance. In 2011, we saw donations fall for the first time ever. Worryingly, the implementation of International Monetary Fund trade regulations in India could affect the supply of generic drugs to millions in poor countries.
Despite all this, ending the pandemic is possible and should continue to be the explicit goal. This will require action globally to ensure that low-income countries have strong, sustainable health systems – that are not undermined by a “brain drain” of professionals to the North. It may seem implausible today, but countries hit hard by the epidemic should not be at the whim of the economic policies of wealthy countries. It is evident that much important work is needed in high-income countries. Canadians who want to make a difference should aim to influence policymakers at home – in an act of real solidarity with all those living with HIV/AIDS.
Andrew Pinto is a family physician and public health and preventive medicine specialist in Toronto. The views presented here are his own.