The Global AIDS Policy Watch, from Brazilian Interdisciplinary AIDS Association (ABIA), recognizes that the expansion of access to treatment is an important step towards reducing the number of deaths in the fight against the world’s HIV and AIDS epidemics. This has been demonstrated by the latest report of the Joint United Nations Programme on HIV/AIDS (UNAIDS).
We celebrate the news, highlighted in the report, showing that an estimated 17 million people (46% of total) ended 2015 on antiretroviral treatment. However, we question how those people without access to treatment (the remaining 54%) will receive it. This is a significant number of non-treated individuals and we cannot once again let decades pass before we begin to think about how to provide access to medicine for those without it.
We agree that the expansion of HIV treatment coverage in South and East Africa is very positive, given that these are two of the regions most affected by the epidemic. We stress, however, that increasing access is not some sort of magic solution to the epidemic.
We remind readers that syphilis has been effectively treated with drugs, worldwide, since 1927. In many countries, however, the number of syphilis cases continues to grow. Disinvestment in widespread prevention programs has led to the reappearance of syphilis and particularly of congenital syphilis. This disease is now the eighth leading cause of stillbirth in Brazil.
Furthermore, the UNAIDS report fails to discuss the growing inequalities in access to treatment. Who has access to the latest medications? Which side effects are less harmful? The drugs that are available today in some countries (such as Brazil) are considered obsolete by many in the international scientific community and have serious side effects in the medium and long term.
Richer countries have better treatments with newer drugs. We demand quality treatment, equity and access to modern medication. We emphasize the need for political mobilization in order to reduce prices by changing national and international patent laws.
We also remind readers that the fight against HIV and AIDS requires consistent and integrated policies in order to prevent treatment from being abandoned. For us at ABIA, biomedical answers cannot replace the social and political responses to the epidemic. The struggle against HIV and AIDS will not be won without addressing social and structural problems such as stigma, prejudice and discrimination.
The UNAIDS report recognizes the problem posed by stigma, but fails to provide a way to overcome it. Furthermore, it does not link the struggle against this problem to the promotion and defense of human rights. In order to address stigma, we need to develop prevention programs and policies that are based on education and defense of human rights.
Finally, the UNAIDS report does not indicate that any great strides have taken place in preventing the occurrence of new infections throughout the world.
We emphasize that the report shows positive results. However, we feel that we still need to fight for more resources, more prevention, more and better drugs and – most importantly – for aligning programs to the permanent exercise of solidarity in facing this serious epidemic.
Rio de Janeiro, June 10, 2016
Global AIDS Policy Watch/Brazilian Interdisciplinary AIDS Association