Using trends in the rate of new HIV infections in east and southern Africa we assess the current state of the epidemic and evaluate the future prospects for controlling it. If we let an incidence of 1 per 1,000 people represent a control threshold then this has been reached, or will probably be reached by 2020, in East Africa and is reachable by 2020 in those southern African countries that do not have strong social and economic ties to South Africa, if they continue to scale up their treatment programmes. South Africa, Lesotho, Mozambique and Swaziland could reach the control threshold by 2030 with sufficient political will and commitment to ‘treatment for all’.
Diseases – like the examples of trypanosomes and HIV/AIDS – are not only perceived as causing negative effects; they also create jobs for people. Hence some people get nervous about what they are going to do when these diseases are under control. And is the latter actually going to happen?
This article is based on the presentation given by John Hargrove at the NRF Science for Society Lecture entitled Ending HIV/AIDS in South Africa held on 1 December 2016 in Stellenbosch. He argues that the proactive use of ART (Treatment as Prevention or TasP) provides a powerful weapon for combatting the HIV epidemic, and that we also have the tools for monitoring and evaluating the progress of that programme. Mathematical modelling has played an important role, both in suggesting appropriate interventions, and in developing new monitoring methods, but we are still in for a long journey.
We assess here the potential effect of expanded HIV treatment for the prevention of AIDS-related deaths. We analyzed the available UNAIDS data to describe AIDS-related deaths, ART coverage and new HIV infections in 30 countries with the highest AIDS mortality burden and compared it with data from eight high-income countries. For illustrative purposes, we also explored the potential impact of reaching international treatment expansion targets in South Africa and Nigeria- two countries with the largest HIV epidemics, but with different trends of AIDS-related deaths over time – through the examination of four treatment expansion scenarios.
According to the President’s Emergency Plan for AIDS Relief (PEPFAR), an AIDS-free generation entails that first, no one will be born with the virus; second, that as people get older, they will be at a far lower risk of becoming infected than they are today; and third, that if they do acquire HIV, they will get treatment that keeps them healthy and prevents them from transmitting the virus to others. We argue that an AIDS-free generation is possible in Southern Africa, but not unless the high rates of incident infections in key populations are reduced.
SACEMA presented modelling work on e.g. incidence and prevalence of HIV at the two recent HIV and AIDS conference.
Brown International Advanced Research Institutes (BIARI) represents a unique professional development initiative to provide a platform for outstanding young faculty and practitioners from the global south and emerging economies to engage in a sustained, high-level intellectual and policy dialogue with leading scholars in their fields. The institutes will be held June 8-22, 2013. To learn Read More
In the SACEMA Quarterly we regularly report on issues (effects, costs) related to universal access to antiretroviral treatment (ART) or treatment as prevention (TaP). A recently published article focuses on the human resources needed for this approach. This because availability of human resources may now be the most important barrier to achieving universal access to Read More
In December 2011 Jon Cohen published an article in which he discussed the prospects for halting the epidemic of HIV/AIDS (1). He highlights the important observation that, due to recent evidence on effective interventions to prevent HIV, we have for the first time the means by which to end the AIDS epidemic, provided of course Read More
Scientists at SACEMA have been in the forefront of those arguing that the time to end AIDS is now and the way to do this is through the strategic use of potent anti-retroviral therapy (ART). The road ahead will be long and hard and much still needs to be done. If we are to increase the number of people in the world who are on ART from the present 5 million to 15 million by, say, 2015 and to 30 million by 2020, many operational challenges will have to be understood and met. Here we outline the most important issues that need to be explored if treatment-as-prevention is to become a reality and if we are to end AIDS.