Dr. Prajjwal Pyakurel / Dr. Tara Nath Pokhrel

World AIDS Day was recently marked as an international day to raise awareness on the AIDS pandemic caused by the spread of HIV infection and pay tributes to those who have died of the disease. The acquired immunodeficiency syndrome (AIDS) is a life-threatening condition caused by the human immunodeficiency virus (HIV). The HIV virus attacks the immune system of the patient and reduces resistance to other diseases.

Major barriers
The theme of World AIDS Day 2021 was “End inequalities. End AIDS”. Inequality persists everywhere whether be it in prevention, treatment or services. Decades of evidence and experience in HIV research, prevention and treatment has shown that inequalities are the major barriers to achieving the global targets for HIV prevention in 2020. The main reasons behind inequalities are the stigma, discrimination and HIV related criminalisation. These factors enhance people’s vulnerability to acquire HIV and make people living with HIV more likely to die of AIDS-related illnesses.

Globally, 37.7 million people were living with HIV in 2020. The new HIV infection was seen in 1.5 million populations with 680,000 people suffered AIDS related death. At the end of December 2020, some 27.5 million people were accessing antiretroviral therapy up from 7.8 million in 2010. New HIV infections have been reduced by 52 per cent since the peak in 1997. AIDS-related deaths have been reduced by 64 per cent since the peak in 2004. The SAARC region has an estimated 2.35 million people living with HIV with India alone bearing an estimated 2.1 million. HIV epidemic in the SAARC Region is a collection of different epidemics in the Member States with their own characteristics and dynamics. In Nepal, HIV prevalence is 0.13 per cent with 790 new infections in 2020. Programming data shows that the clients of sex workers had the major transmissibility of HIV infection (31.6 per cent). Similarly, male population and age group of 25-49 years had the highest number of HIV cases in 2020.

The international community has committed for ending the AIDS epidemic as a public health threat by 2030, an ambitious target of the 2030 Agenda for Sustainable Development adopted by the United Nations General Assembly in September 2015. However, a gap still remains in various dimensions including seeking, reaching and receiving care. Education, occupation, income, home and community have had direct impact on health and HIV outcome. The lower someone’s social and economic status, the poorer their health is likely to be. Additionally, key populations such as gays and others who have sex with men, sex workers, transgender people and those who particularly inject drugs, are subject to discrimination, violence, and crippling legal and social environments. Each of them contributes to HIV vulnerability.

Global AIDS strategy document (2021-2026) prepared by the United Nation Programme on HIV/AIDS (UNAIDS), seeks to reduce inequalities that drive the AIDS epidemic and put people at the centre to get the world on track to end AIDS as a public health threat by 2030. It lays out a framework for transformative action to reduce inequalities by 2025 and to get every country and every community on track to end AIDS by 2030.
Public role is equally important towards the vision of zero new infection, zero discrimination and zero AIDS-related death. Stigma and discrimination are all the outcomes of the societies and the communities and these needs to be wiped out. The attitude of people towards those infected with HIV/AIDS needs to be changed. Support, love, care and strong family and community support are required by the patient of HIV/AIDS to live normal healthy life the society. Additionally, awareness raising campaigns such as information sessions for groups and communities, mobile voluntary counselling and testing and information support for people living with HIV/AIDS need to be carried out

Ambitious goals
We dream of AIDS free world. However, we have to be equally precise to achieve those ambitious goals. All the stakeholders, including the government, public or different organisations and institutions involved in HIV/AIDS prevention should to play their role from their respective sides with honesty, integrity, dedication and commitment. Human values and human right approach should be kept as a priority. Discriminatory laws, rules and policies regarding HIV/AIDs should be addressed besides nullifying stigmas and discriminations. Seeking, reaching and receiving of care for HIV/AIDS should reach each and every corner.

It has been said that whenever AIDS has won stigma, shame, distrust, discrimination and apathy was on its side. Every time AIDS has been defeated because of trust, solidarity and human perseverance through finding new paths and solutions. So, let us join hands and play constructive role from our side to make this world free from AIDS.

(Dr. Pokhrel is Director while Dr. Pyakurel is Research Officer at SAARC Tuberculosis and HIV/AIDS Centre (STAC).)