Prevention, testing and treatment services for HIV, viral hepatitis and sexually transmitted infections (IST) have led to unprecedented progress in improving the health of populations in the past two decades, with millions of HIV infections and AIDS deaths.
Investments in foreign aid in the world’s world response, such as the United States President’s Emergency Plan for AIDS relief (PEPFAR) and the World AIDS, Tuberculosis and Malaria Fund, were essential to this success, also significantly contributing to the progression of the elimination of hepatitis B and C, and STI control. However, steep disruptions of foreign aid and the provision of services threaten these gains, putting millions of people in danger – especially people living with HIV and key and vulnerable populations.
Many prevention interventions based on essential evidence, including pre-exposure to HIV (PREP) prophylaxis, harm reduction services for people who inject drugs and community-led programs have been permanently interrupted.
The first reports shared with which indicate that the prevention and treatment services for key populations are the most affected. The reports include the closure of health centers offering prevention, testing and processing interventions for key populations previously supported by American funding. These disruptions lead to staff shortages, interruptions of the supply chain and an increase in obstacles to access, leaving key populations – including gay men and other men who have sex with men, sex workers, people who inject drugs, prisons and trans and sexual people – vulnerable to infection and death, as well as stigma, and discrimination.
These developments compromise the capacity of service providers to deliver basic WHO recommendations which:
- All people living with HIV should receive antiretroviral treatment the same day (art) both to improve their health and prevent additional transmission by carrying out a sustained suppression of the viral load;
- There should be uninterrupted access to art for all populations, including key populations living with HIV, during service disturbances; And
- Person -centered approaches must be implemented and non -judged and without discrimination environments created to promote confidence, encourage coherent commitment to care and support the re -engagement of those who may have abandoned treatment.
Essential prevention services must remain a priority
Ensure that key populations can access prevention services that are free of discrimination are at the heart of HIV, hepatitis and STI responses. Community services have always been effective in increasing access and acceptability of programs, buffer the effects of stigma and discrimination. These programs facilitate the delivery of interventions which have proven to be effective thanks to rigorous scientific research, and which are recommended by who protect people from new infections and damage.
The essential prevention services recommended by the WHO are condoms and lubricants; Test for HIV, hepatitis B and C and other STIs; Prophylaxis post-exposure to HIV and pre-exhibition prophylaxis; And harm reduction activities, including the distribution of needles and syringes, naloxone to prevent the death of overdose and the treatment programs for the opioid agonist.
Commitment in sustainable financing and integrated health systems
While the countries and ministries of health are trying to mitigate the impact of the disturbances of the services, they must pursue long -term solutions, including sustainable domestic financing to protect these vital health services. This is essential to maintain the downward trend in the impact and mortality of HIV, and to progress towards the elimination of hepatitis and the control of STIs.
Who also highlights the value of an integrated HIV approach, bringing together stigmatization and services without discrimination for tuberculosis, viral hepatitis, sexual and reproductive health and non -transmitted diseases under the umbrella of strong primary health care. The integration of HIV leads to the optimization of resources and to improve the overall health of the population.
Who remains determined to support national governments, partners and donors to adapt to the change of support of donors to protect the health and well-being of the most vulnerable to HIV, viral hepatitis and STIs.