East Africa: Key Populations Left Out in HIV/Aids Fight

In the past eight years, East Africa has reduced Aids-related mortality and annual new HIV infections by 44 and 28 per cent respectively, according to the United Nations Programme on HIV/AIDS (UNAids).

The organisation seeks to eliminate Aids by 2030 and notes that globally, HIV testing services and antiretroviral therapy have been scaled up substantially.

In 2005, it was estimated that in Africa only 10 per cent of people with HIV were aware of their status and that only 12 per cent who wanted to test for HIV could do so.

Nearly 15 years later it is now estimated that 85 per cent of all people with HIV in Africa, and about 80 per cent of people worldwide know their status.

Speaking at the 20th International Conference on Aids and STIs in Africa held in Kigali from December 2 to 7, Cheryl Johnson, the World Health Organisation global technical officer for HIV testing services said East Africa is performing better in prevention and treatment than other regions.

She said that, although great strides have been taken in the fight against Aids, more effort should be put in addressing challenges like culture and social norms that lead to the exclusion of sex workers and those engaged in same-sex relationships.

Rwanda is leading other East African countries in most HIV interventions and prevention strategies, followed by Kenya, Burundi, Uganda, and Tanzania.

"Apart from Kenya and Uganda that have incorporated the gay community and sex workers into their policies, other East African countries have no interest in these groups yet they contribute over 40 per cent new HIV cases at the continent," Ms. Johnson said.

If Rwanda continues to neglect this group, they may lose the momentum to lead in the fight, Ms Johnson said.

Rwanda's Minister of Health Diane Gashumba said that although research and surveys show progress in curbing the spread and treatment, the country is slow in including key populations and adolescents that are at high risk of contracting Aids.

"We are working on strategies to include key populations and increase efforts to reach out to the adolescent population through dialogue to make sure that we understand them better," said Dr Gashumba.

Linda Gail Bekker of the Desmond Tutu HIV Foundation and former president of the International AIDS Society, said in an interview that Kenya's response and approach to HIV prevention is the best in Africa.

"Despite resource constraints, Kenya has ensured that pre-exposure prophylaxis drugs are available for free in health centres and at a lower price at pharmacies, which other countries need to embrace," said Dr Bekker.

"There is a lot we can learn from Kenya. It has taken the hotspot mapping approach to ensure that those who need the drugs are not left out, including men having sex with men," she added.

Mary Mugambe, the programme manager for HIV Testing Services, National AIDS & STI Control Programme at Kenya's Ministry of Health, said that despite the success, lack of funds to reach remote areas has slowed down the fight.

UNAids International goodwill ambassador Victoria Beckham said there have been impressive gains in East Africa, and called on governments to strengthen intervention including domestic funding.

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