New approach needed


The Director of the Pan American Health Organization (PAHO) Dr Carissa F. Etienne says scientific innovation has made unprecedented progress against HIV/AIDS but urged countries to rethink the response to end the epidemic.

“Science has guided innovation towards unprecedented progress in the response to an infectious disease that, until recently, represented a threat to the lives of many people,” said the Dominican-born Dr Etienne, who is also the Regional Director for the Americas of the World Health Organization (WHO).

“The world is not on track to achieve the goal of eliminating AIDS as a threat to public health by 2030. The road to ending AIDS runs through providing access and universal health coverage,” she told delegates to the 10th IAS Conference on HIV Science (IAS 2019).

IAS 2019 is taking place in the Americas region for the fourth time since it began in Buenos Aires in 2001. It brings together more than 6,000 scientists, clinicians, public health experts and community leaders from around the world to examine the latest research developments in HIV and explore how to realistically implement that knowledge to address the epidemic.

The conference, organised by the International AIDS Society, ends on Wednesday and Dr Etienne acknowledged that the implementation of sound approaches based on public health, human rights and evidence has managed to reverse the course of the epidemic in many countries.

According to Dr Etienne, the sustainable development agenda and the revitalised global commitment to universal health coverage are an opportunity for the sustainability and financing of the HIV response as well as for the integration and expansion of the prevention, testing and treatment of the infection with other health services.

“It is time for antiretroviral prevention, testing and treatment services for HIV to be fully available along with the services of TB, STIs, viral hepatitis, sexual and reproductive health and non-communicable diseases in the first level of care, where the needs of affected communities can be better served,” she said.

Dr Etienne said in the Americas, PAHO has promoted this approach to the integration of services and achieved the dual elimination of mother-to-child transmission of HIV and syphilis in various countries of the region, through the provision of comprehensive health services, maternal and child health that are provided at the primary health care level.

The PAHO director said that more research is needed so that innovation can continue to improve the effectiveness of prevention methods, treatment regimes, the development of new laboratory tools, and the use of integrated platforms for diagnosis and monitoring.

She added that more data and evidence are needed for the provision of cost-effective and friendly services, to refine the fight against stigma and discrimination in health services and to continue exploring new financing mechanisms that promote sustainability.

Dr Etienne recognised the contributions of the LGBTI community, noting that the principle of HIV activism “leave no one behind” has now become a central axis of the global development agenda.

Figures show that detection and treatment programmes in several regions of the world are not on the right track, and the gaps tend to be greater among the populations most at risk of infection, young people and children.

There have been new cases of infections in Eastern Europe, Central Asia, Middle East, North Africa and in Latin America.

“Science and innovation must find solutions to new and long-standing challenges and new knowledge and guidance will only have an impact if there are national programmes and strong community systems in place to implement them,” Dr Etienne said.

She said that “science, evidence and innovation should continue to guide HIV policies, programmes and investments,” and called on all partners to intensify and accelerate action to end AIDS in 2030.


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