Doctors Without Borders Warns: “No Time to Lose” in Fighting AIDS

Doctors Without Borders Warns: “No Time to Lose” in Fighting AIDS

In a report released on December 2, 2019, the international medical humanitarian organization Doctors Without Borders/Medecins Sans Frontieres (MSF) has issued a call to affected countries “to urgently deploy and fund recommended approaches to prevent, detect, and treat advanced HIV and AIDS at community level.”

The report, No Time to Lose, analyzed fifteen countries in Africa and Asia to assess the current state of funding and implementation of up-to-date strategies to combat HIV/AIDS in those countries. They lament that “[d]espite the existence of World Health Organization (WHO) guidelines since 2017 on advanced HIV, governments have been slow to align their national guidelines with them.” Such delays, the report goes on, hinder recent progress in the number of reducing the number of people exposed to and dying from HIV/AIDS.

“There is no way the world will reach the UNAIDS target of less than 500,000 deaths from AIDS in 2020,” said Dr. Gille Van Cutsem, senior advisor to MSF on HIV, “without decisive action on dealing with retention to care, treatment interruptions, and resulting mortality.”

The report singles out the use of easy-to-use rapid tests to assess the condition of people’s immune systems (including CD4 count), and to diagnose the most common and deadly opportunistic infections. These rapid tests deliver results in a matter of hours, which helps physicians get people on the appropriate treatment more quickly. The report highlights conditions in Malawi, where two-thirds of patients who were admitted to the MSF-supported hospital in Nsanie arrived at hospital already in an advanced stage of the disease. At MSF’s Kinshasa hospital in the Democratic Republic of the Congo, that number is 71%. If these patients had been tested earlier, their deaths might have been prevented.

Despite the WHO’s guidelines, the report states that such rapid tests are almost never available at the community level, even though early detection can mean the difference between life and death for many. MSF found that only eight of the fifteen countries surveyed use rapid TB-LAM to test advanced HIV patients, and those are available only in MSF-supported health centers in all the countries covered in the report. The lack of these tests makes the global UNAIDS 90-90-90 targets harder to attain.

Florence Anam, MSF’s HIV/TB advocacy coordinator and lead author of the report, said in a press release “We all need to accept that the job is not over once people are on treatment and doing well. We have to be there for people for the whole treatment journey, which means people’s entire lives. We will not end the ravages of HIV by digging more graves, but by doing all we can to keep people healthy, no matter where they live and what their life circumstances are. They must be supported mentally and medically as close as possible to where they live.”

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—Reporting by Hank Trout

Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick. Follow him on Twitter @HankTroutWriter.