December 1t is World Aids Day, an international day of reflection, when we celebrate those who are living positively with HIV, salute those working to end the epidemic and remember those who have died. It was not long ago that having HIV was a death sentence, but that is no longer the case.
The U.S. Government is proud to partner with the Government of Malawi to combat HIV through the U.S. President’s Emergency Plan for Aids Relief (Pepfar), the largest commitment by any nation in history to combat a single disease.
On World Aids Day 2014, nearly 35 years into the global Aids epidemic, it is important to reflect on how far we have come in Malawi. Since 2004, with the generous support of the American people, through Pepfar, the U.S. government has committed more than K 252 billion ( $506 million) to support Malawi’s HIV and Aids response. HIV prevalence has been reduced from 14 percent in 2004 to 10.6 percent. The National Aids Commission (NAC) reports 1.1 million Malawians are currently living with HIV, with annual HIV-related deaths around 46 000. While this number is still too high, it is a significant decrease from 2004 when there were 94 000 deaths recorded. Malawi is well known in the region for its leadership and innovations in streamlining ‘the public health approach’ to service delivery, which has contributed to the remarkable success of expanded antiretroviral therapy (ART). In 2011, Malawi switched to Option B+, which places all HIV-positive pregnant and breastfeeding women on ART for life. The Option B+ decision resulted in a dramatic increase in the number of health clinics providing ART from just over 350 in 2011 to more than 680 today. In fact, following Malawi’s impressive example, WHO recommended Option B+ as an approach for all countries to follow.
I find it inspiring that Malawi passed an important milestone in June 2014: over half a million patients are now alive on treatment! This is equivalent to 50 percent of the total HIV positive population and it means that close to 1 out of every 20 Malawian adults is now living on ART. This achievement seemed purely aspirational only a few years ago. In large part due to this rapid growth of HIV treatment and Malawians taking control of how to prevent HIV, life expectancy has increased dramatically while the number of Malawians becoming infected with HIV has decreased.
Working in partnership, we have come a long way, but we have more work to do to finish the job. To achieve an Aids-free generation, there are three things we must do together: Focus, Partner, and Achieve.
Focus: We must deliver the right support, at the right place, at the right time. This means focusing on the highest impact interventions, bringing them to scale in key locations and among the most vulnerable populations, all while maintaining a sense of urgency to get ahead of the epidemic.
Partner: No one entity alone can create an Aids-free generation. It will take all of us, working together to get there. This means strengthening our partnerships between donors and Malawi, the Global Fund, the UN family, the private sector, the faith community, and civil society.
Achieve: At the end of the day, it is about results – lives saved and new infections averted. Our collective success will be measured by how well we work together to target and tailor our efforts toward controlling the epidemic in Malawi. That means stronger collaboration and coordination than ever before to ensure that our respective investments are used efficiently and effectively, and with maximal impact.
This disease can only be defeated when everyone takes responsibility. So, what can you do? Get tested and know your status. Encourage your family members and friends to also get tested and know their status. If you are HIV negative – stay that way by protecting yourself. Use condoms every time you have sex and make wise choices regarding your sexual activities. If you are HIV positive, take advantage of the free care and treatment services that the Government of Malawi provides at clinics and hospitals in your community. Understand how infection happens and take every action to prevent spreading the virus. If you are on treatment, stay on treatment, so that you can live a long and productive life living positively with the virus.
We know that sustained collaborative work can improve the lives of countless individuals, families, and communities. We have clearly turned the corner of this unprecedented epidemic, and we are part of a larger community intent on maintaining the spotlight on the same goal.
—The author is the U.S. Embassy Chargé d’Affaires