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Scoop
13 hours ago
- Health
- Scoop
Pacific Security And Health Leaders Pledge Cooperation
A conference of Pacific security and health leaders concluded in Suva last week with the promise to "collaborate more" on a drug crisis spiralling out of control. But public health experts say that law enforcement are undermining efforts to combat the drug-driven spread of HIV in Fiji, putting the wider region at risk. This comes at a time when transmission of the disease has risen to levels only surpassed by the Philippines within the Asia-Pacific region, according to UNAIDS. National HIV Response Taskforce chair Dr Jason Mitchell believes Fiji is still far behind where they need to be in terms of detection and prevention measures. "I think a lot of times when we are trying to introduce strong public health interventions, there's opposition, oftentimes from our law enforcement agencies." Dr Mitchell told RNZ Pacific that progressive prevention measures, such as needle and syringe programmes, are often opposed at all levels of Pacific governments. "There may be legislation that they are often expected to uphold. They could also be responding to the public or political sentiments around drugs and drug users." Speaking at the recent Pacific Regional and National Security Conference 2025, held in Suva, Dr Mitchell said that the growing drug trade in the Pacific is driving the spread of HIV. "About 50 percent of people who were infected with HIV last year were as a result of intravenous drug use" UN: 'Of course' police don't help According to a new UNAIDS report, "Aids, Crisis and the Power to Transform" Fiji stands out in all the worst ways. "Since 2014, number of new HIV infections in Fiji has risen by an alarming 10-fold. UNAIDS estimates that in 2014, there were fewer than 500 people living with HIV in Fiji. Just 10 years later, that number was 5900." That rate, according to the report puts Fiji above Papua New Guinea, the previous regional leaders, to the second fastest transmission rate in the Asia-Pacific, behind only the Philippines. The report further acknowledges that given people struggle to access support services where their case would be recorded, these estimates could fall short. "In 2024, only 36 percent of people living with HIV in Fiji were aware of their HIV status, and only 24 percent were receiving treatment." When asked whether law enforcement in Fiji hinders public health efforts, UNAIDS head Renata Ram said yes. "In the Pacific, law enforcement policies can sometimes create significant barriers to effective HIV prevention, particularly for key populations such as sex workers, men who have sex with men, and people who use drugs." "The criminalisation of these populations in many Pacific Island countries contributes to increased stigma and discrimination, driving them further away from essential health and HIV services." Ram said that colonial-era laws that continue to criminalise same-sex relations, sex work and drug possession are causing HIV-infected persons to avoid seeking help. "Punitive drug laws and the lack of protective legal environments for vulnerable populations hinder the implementation and scale-up of high-impact interventions, such as needle-syringe programmes and pre-exposure prophylaxis (PrEP)." Collaboration needed on all fronts Fiji Police Commissioner Rusiate Tudravu said at the conference that he and Dr Mitchell are finding time to sit down and have a chat. "It's more befitting for us to have more conference in regards to this, so that we can know what's happening in other countries, share information, look into the success stories of other countries, and how can we ourselves learn from what other countries are doing well." Tudravu said they have to fight a war on two fronts: trying to hold back the spread of drugs internally, while stopping the flow of drugs into the country from the wider Pacific. "We share information, we share resources, and we help each other... but having said that Pacific islands are limited to the resources that we have, so we need the partners that are out there, our bigger brothers, to come on board, because what we are doing in the Pacific also affects them." Global Initiative Against Transnational Organised Crime's head of the Pacific programme Virginia Comolli told RNZ Pacific that a transnational operation, with shared resources and the help of Australia and New Zealand, would give police the space to make changes internally. "This is certainly a law enforcement issue that requires involvement of the police and customs, etc, but it also requires these security actors to cooperate closely with doctors, with public health practitioners, with mental health specialists." Comolli said she was impressed with how open and frank the police leaders were. "They are the first ones to say they cannot fight this challenge alone... who would admit that capabilities within law enforcement aren't always up to scratch." "They also highlighted how legislation needs to be to be updated in order to be on par with these emerging challenges in the introduction of new illicit substances. So I think there was lots of honesty there."
RNZ News
a day ago
- Health
- RNZ News
Pacific security and health leaders pledge cooperation
The use of illegal drugs is harming communities in the Pacific, and it's an issue that must be addressed holistically. This was the takeaway from a Pacific Regional and National Security Conference panel on transnational crime and national security. 15 July 2025 Photo: Facebook / Pacific Security College A conference of Pacific security and health leaders concluded in Suva last week with the promise to "collaborate more" on a drug crisis spiralling out of control. But public health experts say that law enforcement are undermining efforts to combat the drug-driven spread of HIV in Fiji, putting the wider region at risk. This comes at a time when transmission of the disease has risen to levels only surpassed by the Philippines within the Asia-Pacific region, according to UNAIDS. National HIV Response Taskforce chair Dr Jason Mitchell believes Fiji is still far behind where they need to be in terms of detection and prevention measures. "I think a lot of times when we are trying to introduce strong public health interventions, there's opposition, oftentimes from our law enforcement agencies." Dr Mitchell told RNZ Pacific that progressive prevention measures, such as needle and syringe programmes, are often opposed at all levels of Pacific governments. "There may be legislation that they are often expected to uphold. They could also be responding to the public or political sentiments around drugs and drug users." Speaking at the recent Pacific Regional and National Security Conference 2025, held in Suva, Dr Mitchell said that the growing drug trade in the Pacific is driving the spread of HIV. "About 50 percent of people who were infected with HIV last year were as a result of intravenous drug use" According to a new UNAIDS report, "Aids, Crisis and the Power to Transform" Fiji stands out in all the worst ways. "Since 2014, number of new HIV infections in Fiji has risen by an alarming 10-fold. UNAIDS estimates that in 2014, there were fewer than 500 people living with HIV in Fiji. Just 10 years later, that number was 5900." That rate, according to the report puts Fiji above Papua New Guinea, the previous regional leaders, to the second fastest transmission rate in the Asia-Pacific, behind only the Philippines. The report further acknowledges that given people struggle to access support services where their case would be recorded, these estimates could fall short. "In 2024, only 36 percent of people living with HIV in Fiji were aware of their HIV status, and only 24 percent were receiving treatment." When asked whether law enforcement in Fiji hinders public health efforts, UNAIDS head Renata Ram said yes. "In the Pacific, law enforcement policies can sometimes create significant barriers to effective HIV prevention, particularly for key populations such as sex workers, men who have sex with men, and people who use drugs." "The criminalisation of these populations in many Pacific Island countries contributes to increased stigma and discrimination, driving them further away from essential health and HIV services." Ram said that colonial-era laws that continue to criminalise same-sex relations, sex work and drug possession are causing HIV-infected persons to avoid seeking help. "Punitive drug laws and the lack of protective legal environments for vulnerable populations hinder the implementation and scale-up of high-impact interventions, such as needle-syringe programmes and pre-exposure prophylaxis (PrEP)." Fiji Police Commissioner Rusiate Tudravu Photo: Fiji Police Force Fiji Police Commissioner Rusiate Tudravu said at the conference that he and Dr Mitchell are finding time to sit down and have a chat. "It's more befitting for us to have more conference in regards to this, so that we can know what's happening in other countries, share information, look into the success stories of other countries, and how can we ourselves learn from what other countries are doing well." Tudravu said they have to fight a war on two fronts: trying to hold back the spread of drugs internally, while stopping the flow of drugs into the country from the wider Pacific. "We share information, we share resources, and we help each other... but having said that Pacific islands are limited to the resources that we have, so we need the partners that are out there, our bigger brothers, to come on board, because what we are doing in the Pacific also affects them." Global Initiative Against Transnational Organised Crime's head of the Pacific programme Virginia Comolli told RNZ Pacific that a transnational operation, with shared resources and the help of Australia and New Zealand, would give police the space to make changes internally. "This is certainly a law enforcement issue that requires involvement of the police and customs, etc, but it also requires these security actors to cooperate closely with doctors, with public health practitioners, with mental health specialists." Comolli said she was impressed with how open and frank the police leaders were. "They are the first ones to say they cannot fight this challenge alone... who would admit that capabilities within law enforcement aren't always up to scratch." "They also highlighted how legislation needs to be to be updated in order to be on par with these emerging challenges in the introduction of new illicit substances. So I think there was lots of honesty there."
Scoop
3 days 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)
Medical News Today
5 days ago
- Health
- Medical News Today
WHO recommends lenacapavir as twice yearly injection to help prevent HIV
The human immunodeficiency virus (HIV), which can lead to acquired immunodeficiency syndrome (AIDS) if not treated, is currently treated by taking antiretroviral there is currently no approved vaccine for HIV. The World Health Organization (WHO) recently issued new guidelines recommending the use of injectable lenacapavir to help prevent HIV. According to UNAIDS, in 2024, about 40.8 million people around the world were living with the human immunodeficiency virus (HIV) — a virus that can lead to acquired immunodeficiency syndrome (AIDS) if not treated. The World Health Organization (WHO) reports that in the same year about 1.3 million people received a new diagnosis of HIV, and about 630,000 died from HIV-related causes. While there is currently no approved vaccine for HIV, the WHO has recently issued new guidelines at the 13th International AIDS Society Conference (IAS 2025) on HIV Science recommending the use of injectable lenacapavir to help prevent infection. What is lenacapavir and how does it work? Lenacapavir is a medication originally designed to treat HIV infection. It is currently sold under the brand names Sunlenca for HIV treatment, and Yeztugo for HIV prevention. According to Carolyn Chu, MD, MSc, FAAFP, AAHIVS, chief medical officer of the American Academy of HIV Medicine, lenacapavir is a novel antiviral medication — belonging to the 'HIV capsid inhibitor' class — which was initially developed for use as part of a combination treatment regimen for people with HIV. 'The initial product (brand name Sunlenca) was approved for treatment in late 2022 based on the CAPELLA Study that examined its safety and efficacy among study participants with HIV who were heavily treatment-experienced and had multidrug-resistant infection,' Chu explained to Medical News Today.'Because of its unique molecular properties, scientists were very interested in determining whether lenacapavir could also be developed for use as an HIV prevention intervention,' she added.'[Lenacapavir] disrupts multiple stages of the HIV life cycle, which makes it an attractive drug to study further — it is also very potent (with effective concentrations at pico-molar ranges) and is active against viruses which may be resistant to HIV medications that have been commonly used over the last decade.'— Carolyn Chu, MDChu said that when lenacapavir was studied as a long-acting pre-exposure prophylaxis (PrEP) HIV preventive option in the PURPOSE clinical trials, investigators found an almost 100% reduction in new HIV infections among participants who received it as a twice-yearly injectable. 'These findings led to its recent approval under a new indication, i.e., used as a prevention medication, brand name Yeztugo,' she added. What are the new WHO lenacapavir guidelines? Through its new guidelines, the WHO recommends the use of injectable lenacapavir twice a year as an additional PrEP option to help prevent HIV. Examples of currently used PrEP options include the oral medications Truvada (emtricitabine/tenofovir disoproxil fumarate) and Descovy (emtricitabine/tenofovir alafenamide), and the injectable drug Apretude (cabotegravir).The WHO also recommended the dapivirine vaginal ring (DVR) in 2021 as an additional PrEP choice for cisgender women. The guidelines are based on safety and efficacy findings for lenacapavir from various studies and clinical trials, most notably PURPOSE 1 and PURPOSE 3 of the PURPOSE 1 trial in cisgender women resulted in no cases of HIV infection among study participants given lenacapavir. Further, the PURPOSE 2 trial found 99.9% of cisgender men and gender-diverse people did not become infected with HIV after receiving the drug. In addition to the lenacapavir recommendation, the WHO also recommends a public health approach to HIV testing through the use of HIV rapid tests. Lenacapavir for people concerned about HIV infectionAccording to the WHO's new guidelines, offering injectable lenacapavir twice a year may help overcome potential barriers to current PrEP options, such as unwillingness to take a regular oral pill and a wish for lower amounts of clinic visits. 'Lenacapavir represents a major scientific advance — it's the first long-acting injectable HIV prevention strategy that requires dosing just twice a year,' Chu told MNT.'For some individuals, especially those who have difficulty adhering to daily or even bimonthly prevention strategies like oral PrEP or cabotegravir, this would be especially welcome,' she Liu, MD, MPH, FACP, FIDSA, chief of infectious diseases at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, explained to MNT that:'Across the world HIV remains a serious disease and preventing new infection is critical. Lenacapavir is an injectable antiviral that lasts 6 months, protecting people for long periods of time. Oral antivirals that are approved for preventing HIV require daily dosing to be effective.' 'People don't like storing oral HIV antivirals at home, where there is stigma attached to those medications, and people forget to take medications or use condoms,' Liu continued. 'Large-scale treatment of people with lenacapavir will be the most efficient way yet to prevent HIV infection until an effective vaccine is produced.'The critical need for HIV prevention HIV and AIDS continue to be a global problem. According to UNAIDS, although the number of new global HIV infections has decreased by about 39% since 2010, there are still areas around the world where numbers are increasing, making the need for HIV prevention critical. 'Prevention of HIV is much less expensive than treating people with HIV infection with expensive antivirals for the rest of their lives,' commented Paul E. Sax, MD, clinical director of the Division of Infectious Diseases at the Brigham and Women's Hospital, and professor of medicine at Harvard Medical is another reason why prevention is important. 'Treatment with antivirals is very difficult to sustain, particularly in poorer countries,' said Sax.'The ideal situation is to have multiple options for preventing HIV among those at risk — this includes not only available PrEP strategies, but also other novel PrEP approaches such as an investigational once-monthly pill for those who don't like or want injections,' he explained.'Of course, we still hope that the HIV vaccine research will advance to the point of giving us an effective vaccine, but the scientific hurdles have proven very high, so we are not anticipating any major breakthroughs in this area in the near future,' Sax added, on a cautionary note. Finally, Chu noted that:'Right now, a lot of conversations are centered on ensuring that everyone who is interested in (lenacapavir) will have access to it. Multiple studies have confirmed that interest in this new option is high, and so our systems and policymakers need to be forward-thinking and work in close collaboration with community members and other stakeholders to ensure that all the necessary pieces to initiate and continue this new PrEP option (e.g., HIV screening/testing, obtaining the medication from pharmacies, training people on how to administer the doses, relaying medication/appointment reminders, etc.) are identified soon and can be rolled out equitably.'
The Australian
6 days ago
- Health
- The Australian
US funding cuts could reverse decades of gains in AIDS fight: UN
The halt to US foreign aid is a "ticking time bomb" that could reverse decades of hard-fought gains in the fight against AIDS, the United Nations warned Thursday. Around 31.6 million people were on antiretroviral drugs in 2024 and deaths from AIDS-related illnesses had more than halved since 2010 to 630,000 that year, the UNAIDS agency said in a new report. Now however, infections were likely to shoot up as funding cuts have shuttered prevention and treatment programmes, it said. The United States was the world's biggest donor of humanitarian assistance until President Donald Trump's abrupt slashing of international aid in February. That left the global humanitarian community scrambling to keep life-saving operations afloat. "We are proud of the achievements, but worried about this sudden disruption reversing the gains we have made," UNAIDS executive director Winnie Byanyima told AFP ahead of the report's launch in Johannesburg. The agency in April warned that a permanent discontinuation of PEPFAR, the massive US effort to fight HIV/AIDS, would lead to more than six million new infections and an additional 4.2 million AIDS-related deaths in the next four years. This would bring the pandemic back to levels not seen since the early 2000s. - A 'ticking time bomb' - "This is not just a funding gap," Byanyima said in a press release. "It's a ticking time bomb" whose effects are already felt worldwide. Over 60 percent of all women-led HIV organisations surveyed by UNAIDS had lost funding or had to suspend services, the report said. In a striking example, the number of people receiving pre-exposure prophylaxis (PrEP) drugs to prevent transmission in Nigeria fell by over 85 percent in the first few months of 2025. The "story of how the world has come together" to fight HIV/AIDS is "one of the most important stories of progress in global health", Byanyima told AFP. "But that great story has been disrupted massively" by Trump's "unprecedented" and "cruel" move, she said. "Priorities can shift, but you do not take away life-saving support from people just like that," she said. - Key research hit - Crucial medical research on prevention and treatment have also shut down, including many in South Africa which has one of the highest HIV rates in the world and has become a leader in global research. "Developing countries themselves contribute very much towards the research on HIV and AIDS, and that research serves the whole world," Byanyima said. In 25 out of 60 low- and middle-income countries surveyed by UNAIDS, governments had found ways to compensate part of the funding shortfall with domestic resources. "We have to move towards nationally owned and financed responses," Byaniyma said. She called for debt relief and the reform of international financial institutions to "free up the fiscal space for developing countries to pay for their own response". "It is the responsibility of every government to provide for its people," South Africa's health minister Aaron Motsoaledi said at the report's launch, calling the US pullout a "wake-up call". The global HIV response built from grassroots activism was "resilient by its very nature", Byanyima told AFP. "We moved from people dying every single day to now a point where it is really like a chronic illness," she said. "There is no question that the investment has been worth it, and continues to be worth it. It saves lives." jcb/ho/jj
