National Emergency Response Council on HIV/AIDS

ESWATINI LAUDED BY MEDICINES FOR AFRICA FOR MEETING GLOBAL 95-95-95 HIV TARGETS

8 June 2021

With the multitude of accolades the country has been receiving due to the 95-95-95 milestones, the Kingdom of Eswatini has further been recognized and applauded by Medicines for Africa for meeting the global 95-95-95 Ending AIDS targets, and is the first country in Africa to be congratulated for this phenomenal milestone. Medicines for Africa is an organization that provides data-driven strategic sourcing of quality medicines from reputable manufacturers, to serve the treatment needs of entire national populations. Medicines for Africa consolidates demand to create economies of scale and coordinate joint purchasing in order to reduce the cost of quality medicines.

The global 95-95-95 ENDING AIDS target means that 95% of people living with HIV in Eswatini know their status, that 95% of those who know their HIV positive status are accessing treatment and that 95% of people on treatment have suppressed viral load. This means, an entire generation of children are likely to be born HIV free because of wide treatment coverage.  This shows how great progress is made when governments commit to investing in the health of their people. 

Eswatini has one of the highest HIV prevalence rates in the world: 27% of adults are HIV positive.  Even so, Eswatini, is among the first countries to achieve the ‘95-95-95’ global HIV target. For Eswatini, this success can be attributed to the robust investment in HIV prevention and treatment interventions targeting the hardest-to-reach and most vulnerable populations. These interventions  include girls and young women, who across East and southern Africa continue to be disproportionately affected by HIV. In Eswatini, 63% of people living with HIV are women.  Adolescent girls and young women take part in  safe sex training, facilitated by PACT, where they are taught about relationships, safe sex, HIV prevention, gender and strategies for those living with HIV

There is evidence that keeping adolescent girls in school reduces their vulnerability to HIV infection. Across Eswatini and other countries with a high burden of HIV among adolescent girls, the Global Fund invests in education, health and economic programs that focus on girls and young women to help reduce their vulnerability to the disease. This includes through “Girl Champ”, a program by Project Last Mile in Eswatini that informs and empowers adolescent girls to protect their health by setting up safe, girls-only spaces for youth-centered dialogue on vital health issues including HIV prevention.

Now as we are on the last mile of Ending AIDS as a public health threat, there are different ways to define the end of an HIV epidemic, and all of them involve drastic declines in new infections in key populations. Here are a few terms you might need to know in order to understand common objectives and targets in the ending AIDS agenda:

Prevalence

HIV prevalence refers to the number of people living with HIV at a specific point in time. Ever since effective treatment for HIV was developed, this number has continued to rise due to decreased mortality and ongoing new infections. The central objective is to decrease prevalence while continuing to improve health outcomes for people living with HIV. “Bending the curve” on prevalence would effectively mean an end to epidemic levels of new HIV and AIDS cases. We do this by dramatically reducing incidence.

Incidence

HIV incidence is the number of new HIV infections in a population during a certain time period. In order to reach our goal of reducing prevalence for the first time since effective treatment became available, we need to dramatically reduce incidence.

New Diagnoses

The number of people who have received a confirmed HIV positive diagnosis in a given period. This is NOT the same as incidence; new diagnoses may be higher, lower, or equal to incidence depending on testing rates in key populations. Determining targets for new diagnoses is tricky; incidence estimates are a better option whenever they are available. When new diagnoses are being used, they should be tied to testing rates; a decline in new diagnoses could mean new infections are going down, or it could mean that we’re not doing enough testing of key populations.

Morbidity

Refers to having a disease or a symptom of disease, or to the amount of disease within a population. The ending AIDS agenda seeks to ensure that HIV-related morbidity, notably opportunistic infections and cancers associated with AIDS are drastically reduced.

Mortality

Death. The ending AIDS agenda also seeks to ensure that people living with HIV do not have higher mortality rates than the general population.