Alarming Aids-related deaths in sub-Saharan Africa ……in the era of anti-retrovirals

By Sharon Kavhu

Paris – At least 30 to 40 percent of people who are HIV positive in sub-Saharan Africa are dying due to late diagnosis and treatment failure, Medecins Sans Frontiers has said.

MSF, an international medical humanitarian organisation, said one third of the estimated 30 to 40 percent deaths occurred within 48 hours after hospital admission and the rate was alarming.

The statistics, which were based on a survey conducted in Malawi, Kenya, Democratic Republic of Congo (DRC), South Africa and Guinea by MSF was presented during the recently held International Aids Society (IAS) HIV Science Conference in Paris, France.

“At MSF-run and MSF-supported hospitals in DRC, Guinea, Kenya and Malawi people arrive with such severe immune failure that overal mortality for the patients presenting with Aids is between 30 to 40 percent.  Almost one third of those deaths occur within 48 hours,” said HIV and tuberculosis policy advisor of MSF Access Campaign, Sharonann Lynch.

“The main causes of illness and death are due to treatment failure or interruption and late diagnosis.”

She said the situation was being worsened by the fact that many people living with HIV within the areas of survey were not keen to know their HIV status.

“At community level, MSF population surveys also show that a proportion of people living with Aids in communities in southern and eastern Africa remain untested and untreated.  Around 10 percent of the people living with HIV in the districts of Malawi, Kenya and South Africa had Aids, of which 47 percent had never received testing or treatment.”

While the mentioned countries have people living with HIV and yet ignorant of their status, Kenya’s population has Aids infected people being hospitalised due to treatment failure.

David Maman, MSF epicentre epidemiologist, said: “Despite extensive access to anti-retrovirals, there has not been the expected drop in late-stage presentations of HIV in developing countries.

“What is different is that among people admitted in hospitals, the majority are already diagnosed and many have been on treatment for several years.

In Hama-Bay Kenya, where antiretrovirals have been available for years, half of the patients hospitalised in Aids cases show signs of treatment failure.  We are pushing to switch these patients to second line anti-retroviral treatment more rapidly.”

MSF acknowledged that there was a need for key interventions in sub-Saharan Africa to prevent and treat Aids.

Among the interventions include the rapid rollout of “test and start”, CD4 baseline testing at ART initiation, routine viral load testing, point of care diagnosis for tuberculosis, improved treatment for cryptococcal menigits, rapid switch to second line ART for failing and advanced patients, and effective and accessible treatment for opportunistic infections.

MSF is also calling for models of care geared towards prevention, treatment and support for patients living with HIV/Aids, and free specialised hospital-based care free of charge for patients in sub-Saharan Africa.

The sub-Saharan Africa’s high Aids deaths were evident that the region is lagging behind in the global HIV response.  According to UNAIDS July 2017 HIV global statistics, Aids related deaths have fallen by 48 percent since the peak in 2005.

“In 2016, one million people died from Aids-related illnesses worldwide, compared to 1.9 million in 2005 and 1.5 million in 2010,” highlighted part of the UNAIDS HIV global report.

“In the eastern and southern African region, there were 19.4 million people living with HIV in 2016. There were 420 000 Aids-related deaths recorded and the figure has declined by 42 percent since 2010,” said the report.

July 2017
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