Latest news with #EamonnMurphy
Scoop
9 hours ago
- General
- Scoop
Will We-the-Quails Unite To Lift The Net Or Wither Away The Gains Made In AIDS Response?
Let us refresh the old gold Buddhist tale of The Quail and the Net: 'Long ago a flock of quails lived in a forest. Everyday a hunter would cast a net and trap many of them. But eventually, a wise quail told the rest that if they worked together, they could lift the net collectively at the same moment and escape as one. Next time the hunter tried to capture them, quails moved in unison, raising the net and flying off together. Unity is strength,' said Eamonn Murphy, Director of UNAIDS for Asia Pacific and Central Asia and Eastern Europe regions around the world's largest conference on HIV science (13th International AIDS Society Conference on HIV Science). He continued narrating this tale of deep wisdom: 'For several days thereafter, quails were able to drop the net far from the catcher's reach. But soon some of them became annoyed – small quarrels started – one quail felt 'I am doing most of the work' the other felt 'I want to go in the opposite direction' - eventually they stopped working together. Next time the net fell, instead of flying, they argued. Then the hunter caught them all. This tale teaches us that the discord and breaking focus can lead to ruin.' AIDS response faces the ruin but would we – the quails – fight or unite? 'I would be blunt. Today, it is the AIDS response that faces ruin. We are all the quails – from advocates to academics, countries to communities, doctors to development partners - we worked together to lift the net of the disease that once threatened to devastate us. We even came up with a plan to cast it off for good. Some of us have grown tired, others are doing part of the work but not all they should – many are not pulling their weight – and now we risk being tracked by a disease we should be condemning to history,' said Eamonn Murphy of UNAIDS. 'Recent global funding cuts could send the world back to levels of HIV infections and AIDS-related deaths not seen since the early 2000s,' said Murphy while showing a 5-years projection of how new HIV infections and AIDS-related deaths globally can dangerously rise if the lost funding both this year and in recent years does not return. 'Many countries have reduced their investments and domestic funding is often inadequate to fully fund the AIDS response – which has been relying on external support.' Agrees Dr Jakkrapatara Boonruang, research physician at the Institute of HIV Research and Innovation (IHRI) and a Mark Wainberg Fellowship Awardee: 'There is more work which needs to be done for ending AIDS by 2030. The latest UNAIDS global AIDS update 2025 launched before IAS 2025 shows that along with US funding cuts, other international financing for HIV is also waning. The impact is more severe where HIV programmes were majorly funded by international donors.' 'Even though in Thailand where most of the HIV-related services have been included in universal health coverage of the government, there are some aspects like reimbursements that have not been covered. Salaries of service providers and utility courses are yet to be covered by the universal health coverage for instance,' added Dr Boonruang. 'While services are fully covered by tax payers money, service providers are losing jobs or facing salary reductions. For example, we at IHRI have lost 20% of our colleagues following the suspension of US funding.' Rising new infections, low treatment coverage and funding cuts in Asia Pacific 'Nine countries in Asia and the Pacific region have rising new HIV infection rates. 9 countries in the region have too low coverage of lifesaving antiretroviral treatments. Moreover, the region has been hit with funding crisis – and – overall HIV prevention crisis too,' said Cedriann Martin, UNAIDS Communications Advisor. Between 2010 to 2024, there were 9 countries in Asia Pacific which reported an increase in newly diagnosed people with HIV. Fiji has the world's fastest growing epidemic, new HIV infections increased by over 3091% in Fiji. Along with Fiji, other countries in Asia Pacific where there was an upswing in the number of people newly diagnosed with HIV between 2010-2024 are: * 942% rise in Philippines * 187% rise in Afghanistan * 84% rise in Papua New Guinea * 67% rise in Bhutan * 48% rise in Sri Lanka * 42% rise in Timor-Leste * 33% rise in Bangladesh * 16% rise in Lao PDR Between 2010-2024, there were 9 countries in Asia Pacific which are also treating less than half of the people living with HIV, such as Afghanistan (11%), Pakistan (16%), Fiji (24%), Philippines (40%), Bangladesh (41%), Indonesia (41%), Mongolia (41%), PNG (46%), and Maldives (48%). Cambodia treats most people with HIV (92%) in the region. Prevention crisis in Asia Pacific Compared to the decline in the number of people newly diagnosed with HIV between 2010-2024 worldwide (40%), the decline in Asia Pacific is far behind (17%). 'Asia Pacific has a prevention crisis. The reduction of new infections has flatlined. Every 2 minutes a new person contracts HIV in our region today. Every hour we have 35 new HIV infections including 9 among young people. Every single day, we have over 300 men who have sex with men, over 80 persons who inject drugs, over 50 sex workers, and over 15 transgender persons, newly infected with HIV in the region,' said Eamonn. 'It is like we are trying to empty the bowl but have not turned off the tap.' What is worrying for CNS (Citizen News Service) is that as per the Global AIDS Update 2024 (last year), these numbers were also almost the same. So, there is hardly any significant change when it comes to prevention, testing and treatment targets in the region. Rather on the contrary, challenges have gone up manifold this year. 79% of new HIV infections were among key populations and their partners: 43% among men who have sex with men, 7% among sex workers, 12% among persons who inject drugs, 2% among transgender peoples, among others. 'Criminalisation and marginalisation deepen their vulnerability making it harder for HIV key populations to access services – and less likely to engage with the services available,' remarked Eamonn Murphy of UNAIDS. Weak HIV response in Asia Pacific region in recent years: Why? Not just HIV prevention is flatlined in the region but also HIV testing and treatment have only increased marginally since 2023. 'This region is not speeding towards the finish line. At best, it is (too) slowly inching forwards,' said Eamonn Murphy of UNAIDS. '1 in every 5 people living with HIV still do not know their HIV status; 1 in 4 people are not on lifesaving antiretroviral treatment, 1 in 3 have not achieved a suppressed viral load,' said Murphy. Scientific research and WHO guidelines show that if a person living with HIV is on lifesaving antiretroviral therapy and viral load remains undetectable, then not only the person lives normal healthy lifespans but also there is zero risk of any further HIV transmission. So, treatment works as prevention too. Undetectable equals Untransmittbale or #UequalsU. That is why 2025 HIV targets call upon countries to ensure that at least 95% of people know their status, 95% are on treatment and 95% are virally suppressed. 'In Asia Pacific by end of 2024, 79% know their status, 69% of them are on treatment, and 66% of them have suppressed viral load,' said Eamonn. 'By the time we reach the end of 2025, we may have to diagnose an additional 1.1 million people with HIV and treat 1.5 million people with HIV in this region. So, realistically we are going to miss 2025 targets in Asia Pacific.' The latest Global AIDS Update 2025 of UNAIDS shows that when it comes to HIV targets for 2025, progress among children with HIV in the region is the worst. 70% of children (or their caregivers) know their status, 67% are on treatment, and 57% are virally suppressed. Among women with HIV in Asia Pacific, 83% know their status, 72% are on treatment and 71% are virally suppressed. Among men with HIV in the region, 77% know their status, 67% are on treatment and 65% are virally suppressed. 'By the time we should be realising the dream of AIDS-free generations we are dropping the ball for our future generations. Care for children begins with support for their families. Prevention of mother to child transmission of HIV services, are a critical starting point of early infant diagnosis and ongoing care. For many in our region they do not have access to early HIV screening and treatment and psychosocial support they need,' said Eamonn Murphy. He added: 'We should respond to gender dynamics for both men and women in this region. We have to work with partners to increase health seeking behaviour among men and to lower intimate partner violence for relevant countries and communities. Better HIV service results require a collective intersectional action. Let us learn the lessons from the Quail and the Net 'The world still has not learnt the lessons of the quails- we need to work together. We have a small window of opportunity to get it right. We know what central components of AIDS response are, we have the science, knowledge, evidence, and partnerships, yet we are continuing to rely too heavily on treatment approach. In Asia Pacific region, we need a HIV prevention revolution that is anchored in human rights,' said Eamonn Murphy of UNAIDS. 'If we are together focussed and unified, we can fly towards the end of this epidemic as a public health threat – we can end AIDS now. If not, we will all fail.' Shobha Shukla, Bobby Ramakant – CNS (Citizen News Service) (Shobha Shukla and Bobby Ramakant co-lead the editorial at CNS (Citizen News Service) and Shobha was the Lead Discussant on SDG-3 at UN High Level Political Forum 2025. Follow them on Twitter/X: @Shobha1Shukla, @BobbyRamakant)
Scoop
12-07-2025
- Health
- Scoop
Global HIV Funding Crisis Risks Rising Deaths
BANGKOK/GENEVA, 11 July 2025 —UNAIDS has launched its 2025 Global AIDS Update, 'AIDS, Crisis and the Power to Transform'. It shows that a historic funding crisis is threatening to unravel decades of HIV response progress unless countries make radical programming and funding shifts. The report highlights the impact of recent large-scale cuts from international donors. Despite marked progress in the HIV response in 2024, abrupt funding shortfalls this year have halted HIV prevention programmes and jeopardized treatment services. 'This is not just a funding gap—it's a ticking time bomb,' said UNAIDS Executive Director Winnie Byanyima. 'We have seen services vanish overnight. Health workers have been sent home. And people—especially children and key populations—are being pushed out of care.' Key populations are groups at higher risk of contracting HIV including men who have sex with men, people who inject drugs, people in prisons and other forms of detention, sex workers and transgender people. Although several countries are increasing national budget allocations, the global HIV response cannot rely on domestic funding alone. The report calls on the international community to urgently come together to secure the required funding, support countries to close the remaining prevention and treatment service gaps, remove legal and social barriers, and empower communities. Asia-Pacific risks a ballooning HIV epidemic In 2024 there were an estimated 6.9 million people living with HIV in Asia and the Pacific. Next to Eastern and southern Africa, this is the world's largest epidemic. AIDS-related deaths have declined by half (53%) since 2010 with 150 000 lives lost in the region last year. One of four new infections globally are in Asia-Pacific. In 2024, 300 000 people were newly infected in the region. Since 2010, new HIV infections reduced by just 17 per cent. This region accounts for nine of the 32 countries where new HIV infections have risen since 2010. These are Fiji (3091%), the Philippines (562%), Afghanistan (187%), Papua New Guinea (84%), Bhutan (67%), Sri Lanka (48%), Timor-Leste (42%), Bangladesh (33%) and Lao PDR (16%). In 2024 less than quarter million people in the region took PrEP, a medication that prevents HIV infection. This is dismally short of the 8 million target. Not enough people are benefitting from tailored prevention services. About half of sex workers, one-third of men who have sex with men and transgender people and one-fifth of people who inject drugs had access to prevention services last year. Young people from key population communities remain highly vulnerable. 'Our hope to end the AIDS pandemic as a public health threat by 2030 in Asia-Pacific is now hanging by a thread! The region's incredible strides are set back when a new person is infected every two minutes!' said Eamonn Murphy, Regional Director of UNAIDS Asia Pacific and Eastern Europe Central Asia. He called on governments and the international community to urgently and adequately fund effective prevention approaches including community systems, HIV treatment, PrEP and emerging long-acting technologies. In 2024, the number of people newly diagnosed with HIV in Fiji tripled from 2023 levels, with preliminary data indicating that half of people on antiretroviral therapy likely contracted HIV through injecting drug use. The report includes a case study highlighting the urgent need for harm reduction services for people who inject drugs in Fiji. Another case study in the report notes that in the context of US funding cuts, the Philippines urgently needs prevention investments and programming targeting young key populations, particularly young men who have sex with men. Despite some commendable progress, more work needed around HIV testing and treatment In 2024, 79% of people living with HIV in this region were aware of their HIV status. Just two-thirds of all people living with HIV were on treatment (69%) and achieved a suppressed viral load (66%). Globally, quarter of the people living with HIV who are not yet accessing HIV treatment are in Asia-Pacific. In 2024 less than half of people living with HIV in Afghanistan, Bangladesh, Fiji, Indonesia, Mongolia, Pakistan, Papua New Guinea and the Philippines were on antiretroviral therapy. 'For those who either don't have HIV services available or are too afraid to access them, there is also a crisis!' said Harry Prabowo, Coordinator of the Asia Pacific Network of People living with HIV (APN+). 'Our region's assignment to expand access to care and community support to reach those being left behind is now overdue.' Notwithstanding these challenges, the report singles out several countries in the region for commendable progress in various areas. Nepal is among just five countries worldwide that have reduced new HIV infections by more than 75% since 2010. Cambodia successfully treats almost all diagnosed people with >98% of those on treatment achieving viral suppression in 2024. Australia is within reach of the 95-95-95 testing, treatment and viral suppression targets. Thailand is among the countries with robust domestic investments, funding more than 90% of its response. Bhutan, Pakistan, Timor-Leste and Thailand plan to increase domestic allocations for the HIV response in 2026. Indonesia increased domestic HIV spending more than fourfold between 2010 and 2022. For the region as a whole, just half of the required HIV response resources are now available.
Scoop
16-06-2025
- Health
- Scoop
Will We Rise To #endAIDS Challenge Or Stumble Withering Away The Gains In HIV Response?
Press Release – CNS The recent funding cuts by the US have further exacerbated the problems. UNAIDS projects that there would be an additional 6.6 million new HIV infections and 4.2 million deaths by 2029 just because of the shortfall created by US funding cuts. June 13, 2025 We have all the scientifically proven tools to end AIDS. It is about ensuring that these tools reach people who need them the most, through a sustainable HIV response, so said Dr Adeeba Kamarulzaman, the well known infectious diseases expert form Malaysia and a former President of International AIDS Society (IAS). She was speaking at the plenary of the 10th Asia Pacific AIDS and Co-infections Conference (APACC 2025) in Tokyo, Japan. The world is indeed at the crossroads, in terms of the global response to HIV today. The Asia Pacific region has 3/4 of the world's population and 6.7 million people living with HIV. The region accounts for almost a quarter of the annual new HIV infections globally (23%), making it the world's second-largest HIV epidemic after Eastern and Southern Africa. The recent funding cuts by the US have further exacerbated the problems. UNAIDS projects that there would be an additional 6.6 million new HIV infections and 4.2 million deaths by 2029 just because of the shortfall created by US funding cuts. Impact of an international HIV funding crisis on HIV infections and mortality in low-income and middle-income countries is so unacceptable if we take into account the promise of SDGs by all governments worldwide. 'So, will the world rise to the challenge, to make the future response affordable, or will we stumble, throwing away the progress of the last two decades and creating a drain on future resources of countries?' wondered Eamonn Murphy, Regional Director, UNAIDS for the Asia Pacific and Eastern Europe and Central Asia. Speaking at APACC 2025, Murphy called for prioritising four other dimensions of sustainability- political leadership, enabling laws and policies, element of services and solutions and having proper systems in place, apart from financial stability. HIV prevention as cornerstone of sustainable HIV response UNAIDS leader Eamonn Murphy also stressed upon making prevention as the cornerstone of a sustainable HIV response. 'To end AIDS as a public health emergency we need a far stronger focus on prevention, and not just on keeping people living with HIV alive and well. New infections are like a leaking tap – 'every drop in the bucket' is another individual requiring a life on treatment. The only way to ensure a sustainable response is to stop this flow.' As per latest UNAIDS data, globally between 2010 and 2023, there was a 39% decline in new HIV infections. However, the rate of decline in Asia Pacific was three times slower than this by 13% during the same period. There were 300,000 new infections – one every two minutes -in 2023 in this region. Also, since 2010, the new HIV infections amongst gay men and other men who have sex with men across the region, have increased by 33%. Build more effective and efficient HIV programmes Eamonn laments that countries are investing too little in scaling up HIV prevention. 'While there is a high political commitment to fund treatment, there is limited will to invest in prevention.' 'Four out of every five new HIV infections occur among key populations. However, only one third of these communities have access to HIV prevention services. Key population led HIV prevention services are severely underfunded with less than 15% of HIV resources going into interventions for key populations,' he said. This is despite the proven evidence that key population led HIV service delivery model has been critical to bridge the gap between the public health services and those unreached. For example, 80% of PrEP (Pre-Exposure Prophylaxis for HIV prevention) is delivered by clinics run by key populations in Thailand. Thai PrEP rollout is the largest rollout in Asia Pacific region. Key populations or communities remain the largest provider and carer for those on PrEP even today in the land of smiles. Eamonn Murphy of UNAIDS added: 'PrEP related HIV prevention services largely remain donor dependent. PrEP, social contracting and other differentiated or innovative services mostly remain as pilot projects, and not continued at a scale to have impact on national or regional epidemics. For example, there is a 98% gap to the region's PrEP target of reaching 8.2 million people by 2025.' PrEP – Pre-Exposure Prophylaxis for HIV, refers to medicines used to reduce the risk of HIV acquisition for HIV-negative people. They were first approved by US FDA in 2012. Long walk to integrated health responses Even though financial sustainability is important there is need for improvements in the system integration, in legal and social environments, and in community engagement and leaderships, says Dr Adeeba. 'Addressing the legal and social environment, which the key populations find themselves in terms of coming forward for prevention, as well as treatment, is one area that requires much attention.' With legal barriers to HIV response existing in 39 countries of Asia Pacific, key populations are criminalised in many countries. These barriers include criminalising sex work or same-sex relations, or criminalising drug use, criminalising transmission of, or non-disclosure of HIV transmission, and restricting entry and stay of people living with HIV in the country. All these legal and social impediments have resulted in poor outcomes of HIV response in those countries. Dr Adeeba also advocates for community engagement and leadership by involving communities not only in the designing of programmes, but also community based monitoring through peer led interventions- like in Thailand, which has great examples of key population led clinics and anti retroviral treatment. Role of academia As researchers and scientists, we must continue to advocate and stand firm in terms of the importance of science. Otherwise how else are we going to get the breakthroughs, like the importance of lifesaving antiretroviral therapies for treatment as prevention. HIV treatment works as prevention because science has proven that there is zero risk of any further HIV transmission from those people with HIV who are receiving the treatment, remain virally suppressed and have undetectable equals untransmittable to be true in their lives. But the role of researchers does not end here. We then need to scale it up and the best way is through implementation research, says Dr Adeeba. PopART Dr Adeeba cited the example of one of the largest HIV implementation research studies- the HPTN 071 or PopART- a community-based, randomised study that was conducted during 2013-2018 across 21 high HIV burden, resource-limited urban settings in South Africa and Zambia, with a total estimated population of 1 million. The name PopART, stands for Population Effects of Antiretroviral Therapy to reduce HIV Transmission, because the study focused on evaluating the impact of a combination HIV prevention package, including universal test and treat, on community-level HIV incidence. The study aimed to determine how a community-wide approach to HIV prevention, including the use of antiretroviral therapy, could reduce the spread of the virus at a population level. This PopART intervention with lifesaving antiretroviral therapy reduced HIV incidence by 30%, achieved 90% testing coverage, and increased viral suppression at population level even in remote parts of Africa. It demonstrated feasibility of scaling community based universal test and treat and influenced WHO guidelines on test and treat. Dr Adeeba rightly insists that 'Another very important role of researchers and academicians is to not just advocate with political leaders but also with pharmaceutical companies in making all the new advances accessible to countries that need them most. For example, the price of Human Papilloma Virus (HPV) vaccine, which has been around for a long time, is still extremely high, and inaccessible to many parts of the world. So, this is another important role that we as scientists and researchers must play- advocate to ensure sustainability of the HIV response, particularly in this day and age where financial resources are limited'. Women with HIV are up to 6 times higher risk of HPV related cervical cancer. What next? With a decline in international donor support, it becomes all the more necessary for countries to transition to more sustainable domestic driven HIV financing. UNAIDS leader Eamonn cites some good practice examples from the Asia Pacific region to see what sustainable responses could look like. 'Thailand has shown the model of integrating HIV services, introducing universal health coverage, and scaling up social contracting to reach the community organisations. and we need to pick up on that to share with other countries. Thailand already covers 90% funding of their responses and is developing a sustainability roadmap for the remainder. India is another example of progressive public policy to uphold the human rights of people in the HIV key populations, and they fund over 95% of their funding. In Malaysia, we find an example of diversified domestic resource mobilisation that targets the private sector. We can learn from these and other examples that make the right mix in different countries. We know what to do, the time of cherry picking in sustainability strategies is over. We must act now to enforce all relevant best practices and to keep the hope of ending AIDS alive.' Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here
Scoop
15-06-2025
- Health
- Scoop
Will We Rise To #endAIDS Challenge Or Stumble Withering Away The Gains In HIV Response?
June 13, 2025 We have all the scientifically proven tools to end AIDS. It is about ensuring that these tools reach people who need them the most, through a sustainable HIV response, so said Dr Adeeba Kamarulzaman, the well known infectious diseases expert form Malaysia and a former President of International AIDS Society (IAS). She was speaking at the plenary of the 10th Asia Pacific AIDS and Co-infections Conference (APACC 2025) in Tokyo, Japan. The world is indeed at the crossroads, in terms of the global response to HIV today. The Asia Pacific region has 3/4 of the world's population and 6.7 million people living with HIV. The region accounts for almost a quarter of the annual new HIV infections globally (23%), making it the world's second-largest HIV epidemic after Eastern and Southern Africa. The recent funding cuts by the US have further exacerbated the problems. UNAIDS projects that there would be an additional 6.6 million new HIV infections and 4.2 million deaths by 2029 just because of the shortfall created by US funding cuts. Impact of an international HIV funding crisis on HIV infections and mortality in low-income and middle-income countries is so unacceptable if we take into account the promise of SDGs by all governments worldwide. 'So, will the world rise to the challenge, to make the future response affordable, or will we stumble, throwing away the progress of the last two decades and creating a drain on future resources of countries?' wondered Eamonn Murphy, Regional Director, UNAIDS for the Asia Pacific and Eastern Europe and Central Asia. Speaking at APACC 2025, Murphy called for prioritising four other dimensions of sustainability- political leadership, enabling laws and policies, element of services and solutions and having proper systems in place, apart from financial stability. HIV prevention as cornerstone of sustainable HIV response UNAIDS leader Eamonn Murphy also stressed upon making prevention as the cornerstone of a sustainable HIV response. "To end AIDS as a public health emergency we need a far stronger focus on prevention, and not just on keeping people living with HIV alive and well. New infections are like a leaking tap - "every drop in the bucket" is another individual requiring a life on treatment. The only way to ensure a sustainable response is to stop this flow." As per latest UNAIDS data, globally between 2010 and 2023, there was a 39% decline in new HIV infections. However, the rate of decline in Asia Pacific was three times slower than this by 13% during the same period. There were 300,000 new infections - one every two minutes -in 2023 in this region. Also, since 2010, the new HIV infections amongst gay men and other men who have sex with men across the region, have increased by 33%. Build more effective and efficient HIV programmes Eamonn laments that countries are investing too little in scaling up HIV prevention. 'While there is a high political commitment to fund treatment, there is limited will to invest in prevention." "Four out of every five new HIV infections occur among key populations. However, only one third of these communities have access to HIV prevention services. Key population led HIV prevention services are severely underfunded with less than 15% of HIV resources going into interventions for key populations," he said. This is despite the proven evidence that key population led HIV service delivery model has been critical to bridge the gap between the public health services and those unreached. For example, 80% of PrEP (Pre-Exposure Prophylaxis for HIV prevention) is delivered by clinics run by key populations in Thailand. Thai PrEP rollout is the largest rollout in Asia Pacific region. Key populations or communities remain the largest provider and carer for those on PrEP even today in the land of smiles. Eamonn Murphy of UNAIDS added: "PrEP related HIV prevention services largely remain donor dependent. PrEP, social contracting and other differentiated or innovative services mostly remain as pilot projects, and not continued at a scale to have impact on national or regional epidemics. For example, there is a 98% gap to the region's PrEP target of reaching 8.2 million people by 2025." PrEP - Pre-Exposure Prophylaxis for HIV, refers to medicines used to reduce the risk of HIV acquisition for HIV-negative people. They were first approved by US FDA in 2012. Long walk to integrated health responses Even though financial sustainability is important there is need for improvements in the system integration, in legal and social environments, and in community engagement and leaderships, says Dr Adeeba. "Addressing the legal and social environment, which the key populations find themselves in terms of coming forward for prevention, as well as treatment, is one area that requires much attention." With legal barriers to HIV response existing in 39 countries of Asia Pacific, key populations are criminalised in many countries. These barriers include criminalising sex work or same-sex relations, or criminalising drug use, criminalising transmission of, or non-disclosure of HIV transmission, and restricting entry and stay of people living with HIV in the country. All these legal and social impediments have resulted in poor outcomes of HIV response in those countries. Dr Adeeba also advocates for community engagement and leadership by involving communities not only in the designing of programmes, but also community based monitoring through peer led interventions- like in Thailand, which has great examples of key population led clinics and anti retroviral treatment. Role of academia As researchers and scientists, we must continue to advocate and stand firm in terms of the importance of science. Otherwise how else are we going to get the breakthroughs, like the importance of lifesaving antiretroviral therapies for treatment as prevention. HIV treatment works as prevention because science has proven that there is zero risk of any further HIV transmission from those people with HIV who are receiving the treatment, remain virally suppressed and have undetectable equals untransmittable to be true in their lives. But the role of researchers does not end here. We then need to scale it up and the best way is through implementation research, says Dr Adeeba. PopART Dr Adeeba cited the example of one of the largest HIV implementation research studies- the HPTN 071 or PopART- a community-based, randomised study that was conducted during 2013-2018 across 21 high HIV burden, resource-limited urban settings in South Africa and Zambia, with a total estimated population of 1 million. The name PopART, stands for Population Effects of Antiretroviral Therapy to reduce HIV Transmission, because the study focused on evaluating the impact of a combination HIV prevention package, including universal test and treat, on community-level HIV incidence. The study aimed to determine how a community-wide approach to HIV prevention, including the use of antiretroviral therapy, could reduce the spread of the virus at a population level. This PopART intervention with lifesaving antiretroviral therapy reduced HIV incidence by 30%, achieved 90% testing coverage, and increased viral suppression at population level even in remote parts of Africa. It demonstrated feasibility of scaling community based universal test and treat and influenced WHO guidelines on test and treat. Dr Adeeba rightly insists that "Another very important role of researchers and academicians is to not just advocate with political leaders but also with pharmaceutical companies in making all the new advances accessible to countries that need them most. For example, the price of Human Papilloma Virus (HPV) vaccine, which has been around for a long time, is still extremely high, and inaccessible to many parts of the world. So, this is another important role that we as scientists and researchers must play- advocate to ensure sustainability of the HIV response, particularly in this day and age where financial resources are limited'. Women with HIV are up to 6 times higher risk of HPV related cervical cancer. What next? With a decline in international donor support, it becomes all the more necessary for countries to transition to more sustainable domestic driven HIV financing. UNAIDS leader Eamonn cites some good practice examples from the Asia Pacific region to see what sustainable responses could look like. 'Thailand has shown the model of integrating HIV services, introducing universal health coverage, and scaling up social contracting to reach the community organisations. and we need to pick up on that to share with other countries. Thailand already covers 90% funding of their responses and is developing a sustainability roadmap for the remainder. India is another example of progressive public policy to uphold the human rights of people in the HIV key populations, and they fund over 95% of their funding. In Malaysia, we find an example of diversified domestic resource mobilisation that targets the private sector. We can learn from these and other examples that make the right mix in different countries. We know what to do, the time of cherry picking in sustainability strategies is over. We must act now to enforce all relevant best practices and to keep the hope of ending AIDS alive." Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here
