Maame Agyeiwaa Agyei
The Executive Director of United Nations Programme on HIV/AIDS (UNAIDS), Michel Sidibé has commended Ghana for the important progress she had made in the fight against HIV/AIDS. He has, however warned that the country still had a lot of catching up to do.
Speaking in an interview with The Chronicle in Abidjan recently, he revealed that out of 290,000 people living with HIV in Ghana – 100,000 were on antiretroviral treatment by the end of 2016, which resulted in a 40% reduction in AIDS-related deaths.
“New HIV infections declined in children by 46% but increased among adults by 49% with a record 20,000 new infections in 2016 – 17,000 of which were adults”, he said, adding that there has been an 18% rise in new HIV infections.
“So, there is significant progress, but a big acceleration is needed to put people on treatment and to stop new infections from occurring,” he advised.
The following is a full interview he granted The Chronicle during the recent Africa CEO’s forum in Abidjan;
The Executive Director of United Nations Programme on HIV/AIDS (UNAIDS), Michel Sidibé has commended Ghana for the important progress she had made in the fight against HIV/AIDS. He has, however warned that the country still had a lot of catching up to do.
Speaking in an interview with The Chronicle in Abidjan recently, he revealed that out of 290,000 people living with HIV in Ghana – 100,000 were on antiretroviral treatment by the end of 2016, which resulted in a 40% reduction in AIDS-related deaths.
“New HIV infections declined in children by 46% but increased among adults by 49% with a record 20,000 new infections in 2016 – 17,000 of which were adults”, he said, adding that there has been an 18% rise in new HIV infections.
“So, there is significant progress, but a big acceleration is needed to put people on treatment and to stop new infections from occurring,” he advised.
The following is a full interview he granted The Chronicle during the recent Africa CEO’s forum in Abidjan;
Q:Can the fight against HIV/AIDS be won?
A:We are seeing that the fight against HIV/AIDS can be won when we look at what has been achieved by some countries in Eastern and Southern Africa. Some of them are well on the way to achieving the 90-90-90. West and Central Africa is a region that is lagging, and we must catch up. Catching up is possible for Ghana and the rest of West and Central Africa. It is possible that all children start their lives free from HIV, young people and adults grow up and stay free from HIV, the general population is educated on HIV prevention and that testing and treatment become more accessible so that everyone stays AIDS-free.
Q:Is Ghana doing well in the fight against HIV/AIDS?
A:I would say that Ghana has made important progress in the fight against HIV/AIDS, but Ghana still has a lot of catching up to do.
Of the 290,000 people living with HIV in Ghana -100,000 people were on antiretroviral treatment by the end of 2016 which resulted in a 40% reduction in AIDS-related deaths.
New HIV infections declined in children by 46% but increased among adults by 49% with a record 20,000 new infections in 2016 – 17,000 of which were among adults. There has been an 18% rise in new HIV infections.
So, there is significant progress, but a big acceleration is needed to put people on treatment and to stop new infections from occurring.
Of the 290,000 people living with HIV in Ghana -100,000 people were on antiretroviral treatment by the end of 2016 which resulted in a 40% reduction in AIDS-related deaths.
New HIV infections declined in children by 46% but increased among adults by 49% with a record 20,000 new infections in 2016 – 17,000 of which were among adults. There has been an 18% rise in new HIV infections.
So, there is significant progress, but a big acceleration is needed to put people on treatment and to stop new infections from occurring.
Q:What gains have Ghana made in its quest to achieve realistic policy target of HIV/AIDS reduction?
A:Ghana has signed off on the Political Declaration targets and the SGDs to end AIDS by 2030. And Ghana is working to achieve the 90-90-90 HIV testing and treatment targets by 2020.
If Ghana achieves the 90-90-90 targets by 2020, this will certainly put Ghana on a path to end the epidemic by 2030.
At the end of 2016 with just four more years to 2020 Ghana had achieved only 45-34-42. So, again, I would say that Ghana still has a lot of catching up to do and when the 2017 figures, which should be published shortly, will show a significant increase.
A:Ghana has signed off on the Political Declaration targets and the SGDs to end AIDS by 2030. And Ghana is working to achieve the 90-90-90 HIV testing and treatment targets by 2020.
If Ghana achieves the 90-90-90 targets by 2020, this will certainly put Ghana on a path to end the epidemic by 2030.
At the end of 2016 with just four more years to 2020 Ghana had achieved only 45-34-42. So, again, I would say that Ghana still has a lot of catching up to do and when the 2017 figures, which should be published shortly, will show a significant increase.
Q:Is UNAIDS worried about the fact that though the HIV prevalence among adults has stabilised, new infections among new-borns are recorded daily?
A:HIV prevalence in the general population seems to have stabilized around 1.6%. However, the trend of increasing HIV prevalence (1.6% in 2014, 1.8% in 2015 and 2.4% in 2016) among women attending antenatal clinics is worrisome. HIV is then being passed on to babies.
The Mother to Child Transmission of HIV rate in Ghana is high at an estimated 17%. This is far above the elimination target of less than 5% among breastfeeding children and below 2% for non- breastfeeding children.
Since HIV is being passed on to babies, it means that all HIV positive pregnant women are not being put on treatment which is contrary to the Government of Ghana “Treat All” policy.
The implementation of the Treat All policy and the implementation of the Task Shifting and Task Sharing Policy as well as the Paediatric HIV Service Acceleration Plan will make a huge difference in these numbers.
The Mother to Child Transmission of HIV rate in Ghana is high at an estimated 17%. This is far above the elimination target of less than 5% among breastfeeding children and below 2% for non- breastfeeding children.
Since HIV is being passed on to babies, it means that all HIV positive pregnant women are not being put on treatment which is contrary to the Government of Ghana “Treat All” policy.
The implementation of the Treat All policy and the implementation of the Task Shifting and Task Sharing Policy as well as the Paediatric HIV Service Acceleration Plan will make a huge difference in these numbers.
Q:Budgetary allocations to the Ghana AIDS Commission have been dwindling for the past years and that has affected the activities of the commission. Do you think that this has the potential of undermining efforts made towards HIV/AIDS?
A:Budget cuts are the order of the day. This is happening in many places in the AIDS response. Money is important but what is most important is prioritising and organising well to be efficient, having the right policies and programmes in place, determining what activities are essential to make the biggest difference.
I think that when there are budget cuts, it is an opportunity to review operations and functions and ask critical questions like: What are the most essential services to our stakeholders or clients? What is it that we can do that no one else can do? What can we give up and have others do? So, it is an opportunity to prioritise on what will make the biggest difference.
I believe that it is also critical to identify the results you have achieved and make the case for the kind of budget that is needed based on the results. I believe that if Ghana AIDS Commission carries out this exercise, they will be able to make the case for a budget that will be funded by the government with some assistance from development partners.
I think that when there are budget cuts, it is an opportunity to review operations and functions and ask critical questions like: What are the most essential services to our stakeholders or clients? What is it that we can do that no one else can do? What can we give up and have others do? So, it is an opportunity to prioritise on what will make the biggest difference.
I believe that it is also critical to identify the results you have achieved and make the case for the kind of budget that is needed based on the results. I believe that if Ghana AIDS Commission carries out this exercise, they will be able to make the case for a budget that will be funded by the government with some assistance from development partners.
Q:What is UNAIDS perspective on the general advocacy drive on HIV/AIDS in Ghana?
A:There has been significant political advocacy by the First Lady of Ghana, Madame Rebecca Akufo-Addo. She has been a champion for the AIDS response in Ghana and UNAIDS Primer Ambassador for the prevention mother-to-child transmission of HIV and keeping mothers alive and for the empowerment of adolescent girls and boys. Her speeches and actions are frequently covered in the newspapers.
The Minister of Education has been talking about the importance of sexual education in schools and this is important for HIV prevention.
The Minister of Civil Aviation, who has responsibility for executive oversight of AIDS in Ghana, has been speaking out on HIV prevention.
But we need more people to speak out from leadership at all levels. I am concerned that because the HIV prevalence is low in Ghana, the epidemic is not so visible and people might be becoming complacent.
We think that having influential personalities as champions for HIV prevention, led by the Minister of Health, could be a game changer.
This would mean that politicians, traditional leaders, sports, media, entertainment figures, etc, speaking boldly to their constituencies on how to protect themselves from contracting HIV, the importance of HIV testing, how to care for others, where to get support, encouraging tolerance and understanding rather than stigma and discrimination and stimulating conversations of the burning issues.
The Minister of Education has been talking about the importance of sexual education in schools and this is important for HIV prevention.
The Minister of Civil Aviation, who has responsibility for executive oversight of AIDS in Ghana, has been speaking out on HIV prevention.
But we need more people to speak out from leadership at all levels. I am concerned that because the HIV prevalence is low in Ghana, the epidemic is not so visible and people might be becoming complacent.
We think that having influential personalities as champions for HIV prevention, led by the Minister of Health, could be a game changer.
This would mean that politicians, traditional leaders, sports, media, entertainment figures, etc, speaking boldly to their constituencies on how to protect themselves from contracting HIV, the importance of HIV testing, how to care for others, where to get support, encouraging tolerance and understanding rather than stigma and discrimination and stimulating conversations of the burning issues.
Q:How well does UNAIDS think Ghana has fared when it comes to the implementation of the policy of stopping cultural practices that are inimical to HIV/AIDS prevention, like Female Genital Mutilation(FGM)?
A:I think there have been improvements with both women and men talking about the harmful effects of cultural practices like FGM. It is still a problem which requires continuous conversations with traditional leaders.
Trying to understand the objective behind the practice is important. Solutions could be found to achieve the objective without maintaining the harmful practice.
For example, discussing the importance of avoiding HIV infection has helped modify the wife inheritance practice in some cultural settings, whereby the widow could be provided a home and shelter by the brother of the deceased, without marrying her.
Women are sometimes the greatest gatekeepers of tradition and therefore convincing women of stopping harmful cultural practices would be a breakthrough.
Trying to understand the objective behind the practice is important. Solutions could be found to achieve the objective without maintaining the harmful practice.
For example, discussing the importance of avoiding HIV infection has helped modify the wife inheritance practice in some cultural settings, whereby the widow could be provided a home and shelter by the brother of the deceased, without marrying her.
Women are sometimes the greatest gatekeepers of tradition and therefore convincing women of stopping harmful cultural practices would be a breakthrough.
Q:What are UNAIDS contributions to Ghana’s fight against HIV/AIDS?
A:To support the fight against AIDS in Ghana, UNAIDS is providing a range of support through its Country Office in Ghana, as well as through the 11 cosponsoring agencies.
I will mention only a few at this point:
Technical support is being provided for the estimation on the epidemic and understanding where the latest infections are occurring and why. We are also helping to improve data quality assurance and the national surveillance programme.
We are helping in the monitoring of progress across the 90-90-90 HIV cascade; Policy advice and innovative approaches to achieve HIV prevention, care and treatment.
For example, capacity building for identification and scale up of differentiated models of care.
UNAIDS is supporting the establishment of a National Coalition on HIV Prevention and the establishment of Champions to bring more attention to the urgency of HIV prevention and to meet prevention targets.
The Team has helped in the development of a Catch-Up Plan that would help address the critical gaps and bottlenecks that are impeding the achievement of treatment and prevention targets.
The team in Ghana has played a big role in Resource Mobilization: For example, technical support was provided to develop wining proposals to the Global Fund and PEPFAR. Over $63.2 million was secured from the Global Fund and US$23.7 million from the US Government.
I will mention only a few at this point:
Technical support is being provided for the estimation on the epidemic and understanding where the latest infections are occurring and why. We are also helping to improve data quality assurance and the national surveillance programme.
We are helping in the monitoring of progress across the 90-90-90 HIV cascade; Policy advice and innovative approaches to achieve HIV prevention, care and treatment.
For example, capacity building for identification and scale up of differentiated models of care.
UNAIDS is supporting the establishment of a National Coalition on HIV Prevention and the establishment of Champions to bring more attention to the urgency of HIV prevention and to meet prevention targets.
The Team has helped in the development of a Catch-Up Plan that would help address the critical gaps and bottlenecks that are impeding the achievement of treatment and prevention targets.
The team in Ghana has played a big role in Resource Mobilization: For example, technical support was provided to develop wining proposals to the Global Fund and PEPFAR. Over $63.2 million was secured from the Global Fund and US$23.7 million from the US Government.
Q:What is your advice to government on their HIV/AIDS reduction derive?
A:Ghana has all the right policies in place, a lot of the expertise and resources both domestic and external required to bring the AIDS epidemic to a complete end.
However, Ghana cannot achieve the desired results if these policies and plans are not implemented and scaled-up.
Ghana needs to move on an accelerated path to catch up by addressing gaps and bottlenecks in HIV service delivery and policy implementation and establishing strong oversight and accountability mechanisms.
The vision of “Ghana Beyond Aid” requires investment in the health of the nation and having close oversight on how the combined development partner funding and domestic resources are being utilised for solutions and results to address health challenges like HIV/AIDS.
It is only in this way that Ghana will able to wean off funding from development partners and ensure that vital domestic financial resources are no longer diverted to pay for the cost of mothers, children and young people sick or dying from AIDS-related illnesses. Investment in prevention and treatment will bring high returns.
However, Ghana cannot achieve the desired results if these policies and plans are not implemented and scaled-up.
Ghana needs to move on an accelerated path to catch up by addressing gaps and bottlenecks in HIV service delivery and policy implementation and establishing strong oversight and accountability mechanisms.
The vision of “Ghana Beyond Aid” requires investment in the health of the nation and having close oversight on how the combined development partner funding and domestic resources are being utilised for solutions and results to address health challenges like HIV/AIDS.
It is only in this way that Ghana will able to wean off funding from development partners and ensure that vital domestic financial resources are no longer diverted to pay for the cost of mothers, children and young people sick or dying from AIDS-related illnesses. Investment in prevention and treatment will bring high returns.
Q:Is there any other thing you would like to add?
A:Ghana has enjoyed a prestigious position as Chair of the UNAIDS Programme Coordination Board throughout 2017 and the Minister of Health did an excellent job.
His Excellency the President of Ghana, as the Co-Chair of the SG’s group of Eminent Advocates for the SDGs, is in an excellent position to champion the 90-90-90 targets, promote the catch-up approach and have the end of HIV/AIDS in Ghana, as one of his great achievements.
Ghana can be a shining example of how a country that exercised strong and persistent leadership to end the AIDS epidemic as a public health threat.
His Excellency the President of Ghana, as the Co-Chair of the SG’s group of Eminent Advocates for the SDGs, is in an excellent position to champion the 90-90-90 targets, promote the catch-up approach and have the end of HIV/AIDS in Ghana, as one of his great achievements.
Ghana can be a shining example of how a country that exercised strong and persistent leadership to end the AIDS epidemic as a public health threat.
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