AIDS response caught in a debt trap

Shobha Shukla (CNS)
Contd from previous issue
3) Make medicines accessible and available to all because we cannot accept an apartheid when it comes to access to medicines – human lives of those in Global South are not regarded as having the same value as those in the Global North,
4) Support communities as they know best, and
5) Reject hate and choose love."
Affordable and accessible health choices for everyone
Study results in June 2024 showed that a new long-acting medicine called Lenacapavir helps protect young girls and women from HIV 100% (when used as a Pre-Exposure Prophylaxis or PrEP – and taken twice yearly - one injection every six months). But the price of this medicine is over US$ 40,000 per person per year.
However, generic manufacturers may be able to make Lenacapavir for less than US$ 100 per person per year, shares Winnie. “GILEAD and other patent holders of long-acting treatments and PrEP HIV prevention tools need to grant generic licensing using the UN-backed Medicine Patents Pool and make those generics available for all people in Africa, Asia Pacific, and Latin America,” said Winnie.
“Many technical innovations are only transformative if they are available for those who need them,” she added.
We can make AIDS a history: But will we do so?
“Latest UNAIDS report proves that all of us can make history (by making right decisions to progress towards ending AIDS by 2030),” said Dr Nittaya Phanuphak, Executive Director of Institute of HIV Research and Innovation (IHRI) in Thailand.
“I am saying this because now we have the tools to do so. We have a range of HIV combination prevention options including PrEP, testing, treatment and care. But we have to make the right choices – such as, choose to bring down the price of long-acting Cabotegravir or soon-to-come Lenacapavir which can play a crucial role in enhancing prevention and treatment uptake.”
Let communities lead
“We need a commitment from world leaders to support the community leadership - to bring these science- and evidence-based tools (for HIV prevention, testing, treatment and care) to the people who are so much in need of them. We must also get rid of all punitive laws that severely impede HIV responses,” said Dr Nittaya.
Thailand was the first country in Asia Pacific region to be validated for the elimination of vertical transmission (vertical transmission refers to parent to child transmission of HIV) in 2016. “We are on track for reaching the 2030 targets for HIV testing and treatment. We are also the first country in the world to pilot the community-led same day test and treat, and PrEP services.
As of last year we had more than 82% of PrEP users in our country receiving PrEP from these community-led PrEP services,” she added.
“Two decades of our research at IHRI has proved that we can only be successful in ending AIDS if we let the communities lead. UNAIDS 2024 report proves this as well. But sometimes our leaders can take a wrong turn.”
Despite demonstrated stellar evidence from Thailand that community-led interventions are successful in reaching the HIV key populations manifold with quality services, there were a few decisions by Thai government in the end of 2023 which resulted in not-allowing community-led clinics to dispense PrEP and other services.
Even doctors associated with non-profits like IHRI were barred from prescribing PrEP.
Dr Nittaya calls for integrated services. “Integrated community-led services go beyond HIV testing and treatment, and include services for STIs, viral hepatitis, sexual and reproductive health, mental health, stigma and discrimination reduction, and addressing other forms of human rights violations.”
Winnie Byanyima sums up well: "The fraying of solidarity between and within countries is putting progress in danger, but the path that ends AIDS is a path that has been proven, and is a path that leaders have promised to take. Whether leaders fulfill their pledge to end AIDS is a political and financial choice. The time to choose the right path is now."
Citizen News Service