Columnists

HIV epidemic control by 2020 possible

FOOTE

Analysis: DANIEL FOOTE
SINCE 2003, the United States has provided over US$3.5 billion to HIV/AIDS programmes in Zambia.Together with the Zambian government, we have saved over one million lives. Despite our extraordinary progress, we now face the ultimate challenge: epidemic control of HIV across Zambia.
In 2014, the United Nations Programme on HIV/AIDS set targets to help control the HIV epidemic.  The targets call for countries to diagnose 90 percent of people living with HIV, to treat 90 percent of those diagnosed, and to ensure 90 percent of those on treatment are virally suppressed by 2020.
We now face the most critical period in Zambia’s fight against HIV over the next 18 months. As the country aims to reach HIV epidemic control by 2020, we must continue to apply innovative approaches to prevent new infections, and to reach people living with HIV (PLHIV), who lack diagnosis. Over the past year, the US government has worked closely with the Zambian government to roll out two new initiatives: pre-exposure prophylaxis (PrEP) and self-testing.
On August 14, the Zambian government launched the 2018 National HIV Testing, Counselling and Treatment campaign: ‘My Family, My Nation, My Responsibility’, which highlights the importance of providing PLHIV with life-long antiretroviral therapy (ART) for the health of individuals, families, and as part of a broader strategy for achieving HIV epidemic control by 2020.  Through the US President’s Emergency Plan for AIDS Relief, or PEPFAR, we continue our 15-plus-year collaboration with the Zambian government in the fight against HIV.
Together, we currently provide ART to almost 75 percent of the 1,200,000 PLHIV in Zambia.
HIV prevention requires a combination of behavioural, structural, and biomedical interventions that address the complexity of HIV risk.
As a daily medication regime, pre-exposure prophylaxis is intended for those who are at high risk of contracting HIV. When taken correctly, PrEP can reduce an individual’s risk of contracting HIV by over 90 percent.  Working together with the Zambian government, we intend to reach at least 8,000 individuals across Zambia over the next year.
As we try to close the HIV treatment gap, we need to challenge ourselves to figure out ways to find undiagnosed cases of HIV, especially for those who visit health facilities less frequently.  We believe that the ability to test privately for HIV will help us reach that goal, especially for men and young people.
We have purchased 800,000 self-test kits to support this initiative, and over the next several months, we will support the Zambian government’s ‘Test Yourself Now’ campaign, which will take place in Lusaka, Ndola, Kitwe, and Livingstone.
It is incredible to imagine that we have reached a point in the fight against HIV where we can change the course of the epidemic without a cure or vaccine. As we work together to meet the ambitious goals of closing the treatment gap and significantly reducing new infections, creative thinking and innovative approaches, such as pre-exposure prophylaxis and self-testing, are potential game changers.
HIV epidemic control by 2020 is possible, and ultimately depends on you. I urge every Zambian to know your HIV status, to start and remain on treatment if positive, to ensure your partners are tested and treated, and to contribute to a society free from stigma and discrimination.
The author is United States Ambassador to Zambia.


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