The challenges of responding to HIV in western and central Africa have been outlined in a new report from Médecins Sans Frontières (MSF). The report, Out of focus: how millions of people in west and central Africa are being left out of the global HIV response, describes how stigma and discrimination, stock-outs of diagnostics and medicines, and unaffordable or poor-quality facilities are presenting major hurdles to access to HIV testing and treatment services.
Around 6.6 million people are estimated to be living with HIV in western and central Africa, more than half residing in Nigeria alone. The region accounts for one in five new HIV infections globally, one in four AIDS-related deaths and close to half of all children newly infected with the virus worldwide. An estimated 5 million people living with HIV in western and central Africa do not have access to life-saving HIV medicines.
UNAIDS is working with countries in the region to identify the locations and populations where HIV services need scaling up. Data from the region show that many people affected by HIV in western and central Africa live in and around city areas and that people at higher risk of HIV infection, include men who have sex with men, sex workers and people who inject drugs.
“The world will only end the AIDS epidemic by 2030 through an intelligent and focused deployment of resources that identifies the people and places most in need,” said UNAIDS Deputy Executive Director Luiz Loures. “We must reach people affected by HIV wherever they live and whoever they are, including in western and central Africa.”
UNAIDS is helping countries in western and central Africa to build the foundations for a better coverage of services to match needs. UNAIDS is also working with countries on a Fast-Track approach over the next five years to end the AIDS epidemic as a public health threat by 2030.
The Fast-Track approach includes achieving the 90–90–90 treatment target for 2020, whereby 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing antiretroviral treatment and 90% of people on treatment have suppressed viral loads. Other Fast-Track Targets include zero infections among children and that 90% of women and men, especially young people and people living in high-prevalence settings, have access to HIV combination prevention and sexual and reproductive health services.
To achieve the targets, a rights-based approach that reaches everyone in need will be essential, particularly to overcome the barriers of stigma and discrimination that continue to prevent people from accessing HIV services. Global solidarity and shared responsibility will also be critical to respond to the particular challenges faced in western and central Africa to ensure that no one is left behind.
“Closing the treatment gap in western and central Africa will happen either now or never,” said Mit Philips, health policy adviser at MSF. “But it is unrealistic to think they can break the deadly status quo alone.”
