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AIDS fight not over as deaths remain high


Ntsoaki Motaung

While the country continues to accelerate its fight against the HIV and AIDS pandemic, a high number of people living with HIV continue to die and the yearly number of AIDS-related deaths is stagnating.

There were an estimated 4,900 deaths due to AIDS in 2017 and the number declined only minimally, by 200 in 2021, a cause for concern for the National AIDS Commission (NAC).

These figures were disclosed by NAC during the second national HIV and AIDS symposium held in Maseru this week, 18 years since the first symposium was held.

The NAC Chief Executive (CEO), Lebohang Mothae, said the symposium was a response to a call for action by His Majesty King Letsie III on December 1 –World AIDS Day.

Mothae explained that the purpose of the symposium was to deliberate on the causes and effects of inequalities in HIV response and how these could be addressed.

She indicated that according to the Global AIDS Report of 2022, the HIV response is in danger as it had over the past two years, been competing with other pandemics such as COVID-19.

“Four decades into the HIV response, inequalities persist and, in some cases, are widening for the most basic services like testing, treatment, condoms, and even more so for new technologies.

“The 2022 World AIDS Day global theme, ‘EQUALIZE’, is a call for action for countries to identify and employ measures to address inequalities,” she said.

AIDS-related deaths are primarily driven by delayed diagnosis, treatment interruptions and virologic and immunologic failure among HIV treatment-experienced people.

650 000 people died of HIV-related illnesses worldwide in 2021, according to the World Health Organisation.

An estimated 420 000 people died in the African Region from HIV-related causes in 2021, which indicates that mortality has dropped by almost 55 percent since 2010.

Expanded access to antiretroviral therapy (ART) and a declining incidence of HIV infections, WHO said, led to a steep fall globally in the number of adults and children dying from HIV-related causes.

It also said that the estimated 650 000 people dying from HIV globally in 2021 were 68 percent fewer than in 2004 (the peak) and 52 percent fewer than in 2010 despite a period of substantial population growth in many high-burden countries.

“Nevertheless, there is no room for complacency. Countries need to live up to their commitment to end the AIDS epidemic as a public health threat by 2030 — a target included in the 2030 Agenda for Sustainable Development adopted by the United Nations General Assembly in September 2015,” WHO said.

It further indicated that the drop in HIV-related mortality was especially evident in the regions with the greatest burden of HIV infection, including the WHO African Region, home to over 64 percent of people dying from HIV-related causes in 2021.

Speaking at the national HIV and AIDS symposium this week, the Minister of Home Affairs, Local Government and Chieftainship, Lebona Lephema, said that the last Global Prevention Coalition meeting held in Johannesburg, South Africa, made it glaringly evident that the world had changed gears.

Lephema, who was speaking on behalf of the minister in the prime minister’s office, said the world had shifted its focus from HIV treatment to prevention.

“Lesotho, like the rest of the world, should swiftly move to prevention as well and ensure that all stakeholders put more efforts on prevention as well,” he said.

“This symposium, as the first in the longest time in the country, should come up with a roadmap and give direction to the entire HIV & AIDS response of the country,” he added.

The United Nations Populations Fund (UNFPA) Representative, Dr Marc Derveeuw, said in 2017, a global coalition of United Nations (UN) member states, donors, civil society organizations and implementers was established to support global efforts to accelerate HIV prevention.

Membership included the 25 highest HIV-burdened countries in the various parts of the globe including Lesotho.

Derveeuw said the overarching goal of the Global HIV Prevention Coalition is to strengthen and sustain political commitment for primary prevention by setting a common agenda among key policy-makers, funders and programme implementers.

“With countries and communities at the centre, it seeks to ensure accountability for delivering prevention services at scale to achieve the targets of the 2016 and 2021 Political Declarations on Ending AIDS, including a 75 percent reduction in HIV infections towards fewer than 500 000 infections by 2020, and to ending the AIDS epidemic by 2030,” he said.

The Country Coordinator at President’s Emergency Plan for AIDS Relief (PEPFAR), Andrew Pelletier, reaffirmed the organisation’s commitment to continue to work with NAC, the ministry of health, and other ministries and stakeholders such as the Global Fund, UNAIDS, and civil society to ensure that PEPFAR activities are consistent with the national strategic plan.

Pelletier disclosed that the current PEPFAR strategy focuses on two main goals. First, obtaining the 95-95-95 targets for all people living with HIV in Lesotho.

“In doing so, we want to ensure that no group is left behind. We want all children, young adult women, and key populations to receive the services that they need,” he said.

“Second, we want to begin to move towards a more sustainable model for the HIV response so that in the future, Lesotho is in a better position to manage the program with less donor support,” he added.

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