AIDS, a fight still ongoing

Antoine Delers
18 July 2019
Since its discovery in the late 1970s, the AIDS virus has killed more than 35 million people and remains a major global public health problem.

What is HIV?

The human immunodeficiency virus (HIV) weakens the body's defence systems against infections and certain types of cancer. This deterioration in white blood cell function creates progressive immunodeficiency and increases the risks of infections, cancers and other diseases. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage of HIV infection.

The virus can be transmitted through contact with various body fluids (blood, breast milk, semen and vaginal secretions) from infected people. Risk behaviours include unprotected anal or vaginal penetration, needle sharing during drug injections, high-risk blood transfusions or tissue transplants, among others. The presence of other sexually transmitted infections (STIs) increases the risk of sexual transmission.

Symptoms may vary depending on the stage of infection. During the first few months after contracting the virus, people may develop flu-like symptoms (fever, headache, sore throat, etc.) or may not show any symptoms, which increases the risk of contamination. As the immune system becomes deficient, other signs may appear and, without treatment, serious diseases such as tuberculosis are likely to occur.

 

HIV in figures

 

At the end of 2017, an estimated 36,9 million people were living with HIV, including 1,8 million children. In that same year, 940 000 infected people died from one or more HIV-related causes.

  • Africa is the most affected region (with 25,7 million people living with HIV) and concentrates more than two thirds of the world's new infections.
  • Only an estimated 75 % of people who have contracted the virus are aware of their situation.
  • 21,7 million people were receiving antiretroviral treatment (ART) in 2017, including 80 % of pregnant and lactating infected mothers.
  • Between 2000 and 2017, the number of new infections decreased by 36 %, while the number of deaths fell by 38 %, representing 11,4 million lives saved through ART treatment.

Source: WHO

Testing

Testing allows to determine the presence of antibodies defending the organism against HIV. Most people produce them within 28 days of infection, but these antibodies may not be detected at an early stage of the disease. Therefore, it is better to wait for a while before taking the test after having taken a risk. A second test is usually performed on all people originally diagnosed as positive, in order to exclude any possibility of misdiagnosis. The HIV test must be voluntary and the right to refuse is also recognised.

Testing after risk-taking (unprotected sex, condom tearing, needle sharing, etc.) is important, but it is also essential to know your situation and reassure yourself. Diagnosing HIV as early as possible is crucial to ensure rapid treatment of the disease.

 

Prevention

At an individual level, the risk of infection can be reduced by limiting exposure to risk factors. According to the World Health Organisation (WHO), the main approaches to HIV/AIDS prevention are:

  • the use of male or female condoms;
  • HIV and STI testing and counselling;
  • the voluntary medical circumcision of men;
  • the use of antiretrovirals for prevention;
  • the elimination of mother-to-child transmission of HIV.
A health worker punctures blood from a boy's finger in Uganda.
© Shutterstock

Treatment

There is currently no cure for HIV infection, but a combination of three antiretroviral drugs (ARVs) can control the virus and help prevent its transmission. People living with HIV can thus enjoy a long and productive life. This antiretroviral treatment (ART) inhibits the replication of the virus in the body, but does not cure the infection. It also allows the immune system to gradually restore its capacity to fight infections.

 

The major challenges to be faced

The WHO highlights four main challenges that remain to be overcome in order to fight AIDS effectively:

  1. Prevent the transmission of the virus and adapt prevention programmes to people most at risk as well as facilitate access to effective methods to avoid contracting the disease.
  2. Extend access to ART treatment to anyone diagnosed positive and facilitate access to testing procedures. About 25% of people living with HIV are still unaware of their situation.
  3. Minimize ARV drug resistance, a growing phenomenon that is worrying scientists.
  4. Maintain global funding for a sustainable response to HIV.

 

Some of Belgium's actions against AIDS

 

Antwerp Institute of Tropical Medicine (ITM)

The importance of the ITM in AIDS research is undeniable since this institute has allowed to recognise AIDS as a disease that affects both heterosexual and homosexual persons and that first developed in the poor regions of the African continent. Many foundations for global AIDS research have been established in Antwerp. Moreover, for decades, ITM has been a supplier of medical services and a leader in the fight against the taboos faced by people infected with HIV in Belgium.

 

Enabel

Enabel, the Belgian Development Cooperation Agency, is active in the fight against AIDS in the field. For example, between 2011 and 2019, the organisation initiated a project in Burundi to support the National Health Information System of the Ministry of Public Health and the Fight against AIDS, with a budget of approximately 8 000 000 euros. Among other things, Enabel fights sexually transmitted infections in northern Mali and has a budget of approximately 355 600 euros for this purpose.

 

The Global Fund

The Global Fund to Fight AIDS, Tuberculosis and Malaria is a non-profit foundation that raises and invests resources to put an end to epidemics of HIV, tuberculosis and malaria, as part of the achievement of the United Nations' Sustainable Development Goals (SDGs). Belgium ranks 16th as a public donor to the Global Fund. Its contributions amount to a total of 241,9 million euros up to now.

 

UNAIDS

This is a United Nations programme that coordinates the work of the various UN specialised agencies to put an end to the AIDS pandemic as a threat to public health. In 2016, Belgium signed a new funding agreement that renews its contribution to UNAIDS with an annual contribution of 3 million euros from 2017 to 2020.

 

Sources: WHO, ITG, Enabel, Global Fund, UNAIDS

 

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