EDITORIAL COMMENT: We are winning war against HIV/Aids

ZIMBABWE’s battle against HIV has achieved another major milestone more than a year early, the 95-95-95 target set by UNAIDS, and bringing closer the day when we not just bring the epidemic under control, but eliminate all transmission and ensure all those living with HIV are under full treatment.

The 95-95-95 achievement means at least 95 percent of all people living with HIV know their status, at least 95 percent of those who know their status are on treatment and at least 95 percent of those on treatment have viral suppression.

And this is an important achievement, especially as we reached it earlier than originally targeted. The Minister of Health and Child Care, Dr Douglas Mombeshora, noted this important milestone at the recent Aids Day commemorations.

But when we multiply that still means just over 14 percent of those living with HIV still have the active virus and are able to transmit it. These are the people who we have to find, make sure they are tested, make sure they are being treated and make sure they are taking their tablets, almost certainly for life.

In fact, it will be a smaller percentage of those living with HIV who we still have to bring to virus suppression and so end any adverse progress to AIDS and eliminate the risk of new infection.

The 95-95-95 target and achievement hides the data that some of those 95 percents are in fact higher, and in Zimbabwe’s case the percentage of those testing positive to HIV who have already started the treatment is now pushing 99 percent.

It is now routine and automatic when someone gets the bad news that they are infected with HIV that they immediately start treatment and the logistics of the treatment mean that the anti-retroviral drugs are not just available, but are practically available for every patient.

That at least stabilises the patient and stops them getting worse, while in the short term, the virus is controlled and beaten back and as time passes the patient reaches the stage where the virus is suppressed.

Admittedly, the person living with HIV has to continue taking the medication to maintain that suppression, since the virus can explode back into life if they do not, but for all practical purposes such a person with a suppressed viral load is living the same sort of life as a person who has never been infected.

Continuous medication to ensure that a person with any chronic illness lives a normal life is hardly unusual. Those with HIV and suppressed viral loads are in the same sort of boat as those with high blood pressure who need a daily tablet, diabetics who need to watch diet and take medication and many others who used to die eventually of their complaint, but now live active lives.

Moving from near 100 percent of those testing positive now on treatment to near 100 percent of those on treatment with suppressed loads is just a matter of time.

You need to take the tablets for a while as the viral load diminishes and eventually you reach that suppressed stage.

So the main battle now is to get the five percent, or perhaps just under five percent, who are living with HIV, but do not know it, to get tested.

Such tests have been routine in many cases for many years, such as for pregnant women, to allow medical staff to treat other complaints more effectively and end mother-to-child transmission of HIV.

There are people who have been in potentially risky behaviour who know they should be tested and have resisted, and who should now just take the plunge before Aids-type symptoms start appearing and the test becomes automatic.

The sooner they start the treatment the sooner they go into the suppressed state and their HIV is just a minor irritation for the rest of their life. Zimbabwe and Zimbabweans have worked hard for the early meeting of the 95-95-95 goals, fighting the infection year after year for more than two decades.

This does, of course, need resources, but we raise a fair amount ourselves, with the Aids levy of 3 percent on personal income tax, and then having our efforts backed by others. Development partners have been willing to step in to fill the resource gap because first Zimbabwe was not just sitting back and hoping for a miracle, but raising significant resources itself and then accounting for everything and having the staff and other resources to make sure the programmes work.

Partners like to help those helping themselves with proper programmes, so they know what they contribute will be used properly.

As we beat back HIV and Aids, one increasing danger is that people stop taking the virus and the risks of infection seriously.

And that would be a mistake since if we falter we will never reach the goal of having no transmission and no active infection.

That is why we still need to persuade people to eliminate or at least dramatically reduce the risks of infection, and everyone has known for years how to do that.

We also have to make sure that people can choose what sort of risk they will accept. This came up in the National AIDS Day commemoration this year, with the need to end gender-based violence which has forced some women to accept needless risk.

Our battle against HIV and AIDS has been long and unrelenting, but we are now seeing success in so many directions that we know the final victory is possible, the only question still arising being when.

The target date is still 2030, but there is no reason why we cannot get at least to the point where all living with HIV know their status and all are on medication much earlier and then just wait for the virus in the last patient to be suppressed.