By: Dr Aimee Rurangwa
PEPFAR Ethiopia Country Coordinator
On World AIDS Day, commemorated on December 1 every year, we pay tribute to the millions who are infected and affected by HIV/AIDS worldwide. We continue to spread the word that despite much success, too many lives are still being devastated by this deadly disease. Our task looms large, but our message is simple: Ending the HIV Epidemic, Equitable Access, and Everyone’s Voice.
This theme reflects the U.S. government’s strong bipartisan commitment to ending the HIV epidemic globally. It further highlights PEPFAR’s ongoing efforts to help countries in achieving sustained epidemic control of HIV by supporting equitable health services and solutions, enduring national health systems and capabilities, and lasting collaborations. It also conveys PEPFAR’s deep commitment to making sure that the diverse voices of all affected ages, genders, and population groups are heard and valued in the global AIDS response.
With nearly two decades of bipartisan support across presidential administrations and from the U.S. Congress, the United States has invested more than $3 billion to the AIDS response effort in Ethiopia through PEPFAR and as the leading donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). This is the largest commitment ever by one country to address a single disease.
Today, our efforts provide life-saving antiretroviral treatment (ART) for 425,653 men, women, and children which accounts for 98% of the treatment being offered nationally. Among the people living with HIV receiving treatment and tested for HIV viral load, 96% have achieved viral suppression which is an important achievement in breaking the HIV transmission cycle, PEPFAR has also provided HIV testing and counseling for more than 2.7 million people and ensured that over 438,000 orphans and vulnerable children, as well as their caregivers receive the care and support services they need. PEPFAR is closely working with the Government of Ethiopia and other key development partners to achieve the common goal of epidemic control by creating a sustainable lasting infrastructure of capacity building to confront current and future health challenges.
Ethiopia is positioned to reach HIV epidemic control despite challenges brought about by the COVID-19 pandemic, current political dynamics, and security challenges that affect PEPFAR program implementation, and are expected to impact our results for coming quarters, if not years.
In the past year, treatment continuity and viral suppression have strengthened in response to program innovations introduced by the Government of Ethiopia in concordance with PEPFAR guidance. However, these successes are now impacted by the widespread security challenges in Afar, Amhara, Tigray and parts of Benishangul-Gumuz, and Oromia regions. In response, PEPFAR and its implementing partners are continuing to innovate programs, adapt practices, and find creative solutions to accelerate performance while maintaining safety in the remainder of the year.
PEPFAR-supported programs have safely ensured access to HIV services, including core prevention services that were affected by early COVID-19 mitigation measures. Many of these HIV prevention programs have since expanded significantly, while keeping clients and staff safe from COVID-19.
Globally, PEPFAR has helped replace death and despair with vibrant life and hope, and tragedy with triumph. According to UNAIDS, AIDS-related deaths have been cut by 64 percent since their peak in 2004, and new HIV infections reduced by 52 percent since their peak in 1997.
PEPFAR supports the Ethiopian Government to ensure that people of all ages, genders, and population groups have equitable access to life-saving HIV prevention and treatment services. Equally important, PEPFAR also supports enabling policies and the systems and capabilities countries need to deliver effective, efficient, and sustainable health care, including for HIV, even in times of great public health adversity.
PEPFAR investments have supported programs at more than 1000 facility and community health clinics, including six state-of-the art regional laboratories. The continued technical support helped strengthen disease surveillance, supply chain, health and laboratory information systems; community capabilities; and routine and rapid analysis of data for decision making and program iteration.
PEPFAR supported countries have successfully leveraged these PEPFAR-supported public health, clinical, and laboratory platforms to prevent other deadly diseases from raging out of control and these platforms are significantly aiding the response to the COVID-19 pandemic while protecting and advancing HIV progress.
To sustainably control the HIV epidemic, PEPFAR collaborates with the Ethiopian Governments and communities to support enabling environments and to eliminate barriers to quality HIV service access, such as stigma and discrimination.
PEPFAR-supported public health, clinical care, and laboratory platforms have been and remain vital in the ongoing fight against COVID-19. Through the COVID-19 pandemic, PEPFAR has continued to save and improve lives through swift and decisive action driven by data, agility, and innovation. We have worked with countries, communities, and partners on two primary goals: Protecting and advancing global HIV gains, including for the most vulnerable and marginalized, and supporting the global COVID-19 response by leveraging the robust public health and clinical platforms in place after nearly two decades of PEPFAR investments.
As the global community continues efforts to control the COVID-19 pandemic, we must not forget the persistent challenge of the global HIV epidemic, now entering its fifth decade. Last year, 1.5 million people were infected with HIV and nearly 700,000 people died of AIDS-related illnesses worldwide. These figures have declined markedly from their historic peaks largely thanks to the U.S. government’s strong bipartisan global AIDS leadership and investment, but HIV continues to take a devastating toll on millions of people worldwide.
We are at a crossroads in the global AIDS response, and the choices we make now will have critical implications for years to come. After decades of progress, our work is not yet finished. If we falter, millions more people will be infected with HIV, and millions more people now living with HIV will die of AIDS. But if together, we confront the challenges before us with conviction and compassion, we can pave the path to end the HIV epidemic everywhere and secure a better future for everyone.
*PEPFAR- The U.S. President’s Emergency Plan for AIDS Relief