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Adapting to the Changing Landscape of the Global HIV Response: A Call to Action

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Anthony Raphael
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Adapting to the Changing Landscape of the Global HIV Response: A Call to Action

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The Shifting Focus in HIV Response

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Over the years, the global HIV response has seen significant advancements, marking a considerable shift in the landscape of HIV epidemiology, prevention, treatment, and public health strategies. In the initial stages, the primary focus was on saving lives through antiretroviral treatment (ART). However, in the last 15 years, the focus has evolved towards virologic control. The approach now concentrates on the numbers of people who are tested, commence treatment, and achieve viral suppression. Previously, CD4 testing was considered essential, but its importance has dwindled, leading to a reduced capacity to diagnose advanced HIV. There are now fewer tools available for preventing and treating opportunistic infections resulting from advanced HIV, highlighting the neglect in terms of prevention, screening, diagnosis, and treatment of advanced HIV.

The Neglected Research on Advanced HIV

According to the World Health Organization (WHO), there is a concerning lack of research and development concerning advanced HIV. A survey conducted by WHO on the research pipeline for advanced HIV found it to be lacking, indicating a clear disregard for advanced HIV in the realms of prevention, screening, diagnosis, and treatment. This deficiency calls for an urgent need to refocus our efforts and resources towards addressing this pressing issue.

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Human Rights and the HIV Epidemic

An important aspect of the global HIV response is the protection of human rights, particularly those of women, girls, and the LGBTQ community. These groups have been at the forefront of the AIDS movement in recent years, driving significant gains. However, human rights violations continue to fuel the HIV epidemic. In 2022 alone, 4000 adolescent girls and young women were infected with HIV every week globally. Research by UNAIDS shows that decriminalizing same-sex relationships is a vital step towards ending the AIDS pandemic. Yet, the recent backlash against women's rights, LGBTQ rights, sexual and reproductive health, democracy, and civic space is a threat to everyone's health. Therefore, it is critical to support frontline human rights defenders and advocate for laws, policies, and practices that uphold human rights to ensure public health.

Ensuring the Sustainability of the HIV Response

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UNAIDS has taken steps to ensure that the impact of the HIV response remains durable. They have released the HIV Response Sustainability Primer to trigger national conversations about the future of a sustained HIV response. This initiative seeks to secure international support for marginalized communities, particularly women and girls, to protect human rights and accomplish the Sustainable Development Goals.

Case Study: Zimbabwe's HIV Drug Resistance Surveillance

One of the countries that have made commendable progress in the HIV response is Zimbabwe, a country that has achieved the UNAIDS 95-95-95 target among adults. The country has demonstrated a significant commitment to strengthening national antiretroviral drug resistance surveillance. This focus on HIV drug resistance, surveillance, and antiretroviral therapy is an excellent example of the need to adapt and evolve strategies in the face of changing needs in the global HIV response.

Conclusion: Adapting to the Changing Landscape

The global HIV response has indeed come a long way, but as the landscape changes, so must our approaches. As we enter a new phase of the HIV response, filled with additional challenges, it becomes imperative to monitor these developments and adapt accordingly. This includes refocusing our attention on the prevention, screening, diagnosis, and treatment of advanced HIV, upholding human rights, and ensuring the sustainability of the HIV response. Together, we can continue to make strides in the fight against HIV.

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