New U.S. funding to boost Zim adherence to new WHO guidelines

The United States Global AIDS coordinator, Ambassador Deborah Birx, says Zimbabwe is among countries that are receiving additional funding from the new US$150 million commitment by the President's Emergency Plan for AIDS Relief (PEPFAR) as the U.S. aligns resources to assist countries adhere to the new World Health Organization (WHO) AIDS treatment guidelines.

"We anticipated the (WHO) guideline release at this critical meeting," said Ambassador Birx during a press briefing on the sidelines of the 18th International Conference on HIV/ AIDS and STIs (ICASA) in Harare on Tuesday.

Ambassador Birx oversees implementation of PEPFAR, the largest commitment by any nation to combat a single disease in history, as well as all U.S. Government engagement with the Global Fund to Fight AIDS, Tuberculosis and Malaria.

"We sent notifications to countries just in the last month that there is another $150 million available immediately for countries to apply for that will adopt the "Test and Start" strategy for men in the DREAMS districts - and certainly Zimbabwe is one of those countries and so has received the additional money to prevent new infections in young women."

She added that Zimbabwe had also received additional funding to advance voluntary medical male circumcision to prevent infections in young men.

Zimbabwe received an additional $20 million to reduce new HIV infections in adolescent girls and young women with the ultimate goal being is to help girls develop into Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) women. PEPFAR will also provide an additional $13 million for voluntary male circumcision activities. This new funding brings the total U.S. commitment to HIV and AIDS in Zimbabwe in 2016 to $128 million to cover key treatment, prevention and testing initiatives to combat HIV and AIDS.

The WHO guidelines have removed all limitations on eligibility for antiretroviral therapy (ART) among people living with HIV using a lower daily dose of the antiretroviral medication, efavirenz. The guidelines were updated following a study, led by the Kirby Institute's Professor Sean Emery, which found that a reduced dose of the drug was strong enough to suppress HIV replication and resulted in fewer drug-related side effects.

Addressing concerns about the burden to African countries that will come with the increased number of individuals receiving treatment, Ambassador Birx said the United States government had increased availability of resources, as well as, partnered with private players for innovations that will contain the spread of HIV and work with local community-based innovative efforts to curb the epidemic.

A renowned medical expert in the field of HIV/AIDS, immunology, vaccine research, and global health, Ambassador Birx said the WHO guidelines are critical. "First, they clearly show that patients do much better and thrive if they are treated as soon as they are diagnosed; and so there is a personal health reason to go on treatment immediately," she said. "There is also the added benefit that individuals on treatment whose viral loads aren't detectable usually don't transmit the virus; so there is a health benefit for the individual and a prevention benefit for the community."

She said in addition to providing funding, she felt "there are incredible efficiencies achieved when you move to every six months for drugs and follow up and that cost savings from less appointments and prescriptions can be reinvested in treating more patients."

Commenting on progress made by African countries in providing resources for HIV and AIDS programs, she said the United States has been "very encouraged by what countries like South Africa, Namibia, and Botswana- are doing to invest in the pandemic."

Commented Ambassador Birx: "We think that more and more countries need to make that kind of investment because if we control and we believe its possible to control the HIV pandemic and if life expectancy starts increasing again resources will need to be available 10 to 20 years from now for other health issues that populations face," she said.

She said shared responsibility was key in achieving the 90-90-90 targets set by UNAIDS. "We have to do a better job at making the clear economic arguments; some ministers of finance see that this is a smart investment which we believe it is, we believe it impacts economic development and productivity;" she said. "The health and welfare of the citizenry is really critical for democracy and governance, so we believe all of the pieces are interrelated."

However, she cautioned about focusing only on the money. "We should also be doing the policy changes that will allow all of our dollars to go further and treat more individuals that is why we are calling for shared responsibility in adopting these new WHO guidelines."

She said investment in HIV/AIDS now and controlling the epidemic will free up those same resources for broader health care issues as the populations age.