Editorial Comment: Aids Day reminds us how we win victories

02 Dec, 2022 - 00:12 0 Views
Editorial Comment: Aids Day reminds us how we win victories

The Herald

Once again all countries yesterday commemorated World Aids Day, once again reminding ourselves that HIV still exists, that people are still dying, but also reminding ourselves of the decades-long battle that has scored so many victories, and giving ourselves the opportunity to rededicate ourselves to pushing onwards to the final victory.

President Mnangagwa in his own message struck the right note. He spoke of the Zimbabwean successes, he spoke of the special effort his own administration has made to accelerate the progress and entrench the progress, and he spoke about what still has to be done, since we are not yet where we need to be, with no new infections and with all those who are infected on treatment and able to live their normal life.

The successes are mounting. Our numbers of new infections fell sharply from 31 600 in 2018 to 22 800 last year and are still falling. 

The number of people dying from the suppression of their immune system, the final stage of an untreated HIV infection, fell from 25 200 to 20 200 in the same four years, while the number of those who know about their infection and who are on treatment rose to 98 percent.

All this means that this year we must be recording fewer than 20 000 new infections and fewer than 20 000 deaths, and those figures show the years it can take from infection to death without treatment. 

So the deaths are from the far larger numbers being infected a decade or more ago and who never came forward for testing and medication.

Zimbabwe has done well in the battle, despite some difficult conditions. When the first cases of Aids emerged in the 1980s, there was a lot of denial among those at risk, a lot of ill-informed and loose talk, a lot of people refusing to take matters seriously and a need for major cultural as well as medical changes.

And yet as a nation we were able to produce people who could make a difference, and a big difference. Major campaigns were launched to tell people exactly how HIV was spread, and just as importantly how it could not be spread. 

So much of the frightening nonsense circulating in those days was swamped by straight-forward science-based information.

Then we told people exactly how they could minimise or eliminate the risk of infection, and as we were talking about something as personal as sexuality there was a temptation to lose the point in a pure debate on morality. 

Instead the thrust of the campaign, and the teaching that went with it, was non-judgemental. People were told what their options were if they wished to survive, and while there were moral choices to be made there were also discussions on the sheer mechanics of avoiding infection.

In many ways these early campaigns were a cultural revolution. Things that were seemingly never discussed in families and with teenagers became topics of discussion, driven by the need to ensure survival. 

The death toll kept rising, with those years, up to a decade in many cases, from infection to death creating the gap between the spreading of knowledge and the inevitable progress of the infection. 

Then came hope, the advent of the anti-retroviral treatment, and for once a major global effort to make this treatment affordable rather than something that major pharmaceutical companies could use to make mega-profits from their patents. Zimbabwe moved fast. We had already agreed in our Parliament to imposing a modest levy on our income taxes, and so we know had a flow of extra funds.

With the advent of ARTs we could afford to buy these for the majority of those who needed them and who could not afford. 

That special national effort was not enough, but the fact it was being made impressed enough people elsewhere to help. It is always easier to find partners to top up when you make your own efforts.

We had to overcome major resistance to testing. Many people who were potentially at risk simply did not want to know, and in fact they used to say they would live longer if they were infected and did not know. 

That was always a dubious proposition, and pure wishful thinking, as some very brace people showed when they went public with their positive diagnosis and started pointing out that taking a lot more care with their health would extend their life, and in any case there was hope that some effective treatment would be found if they lived longer.

ARTs came through in time to save a lot of those brave people, and to make it crucial for others who were at risk to get tested. 

Some did, some did not, which is one reason we still have Aids deaths, but over the next two decades we have seen well over 90 percent of those infected know their status and 98 percent of those who know they are infected are now on treatment. 

And Zimbabwe is still joining world leaders in the treatment and in the campaigning, as the President pointed out.

Despite the suffering and the deaths we can learn from our victories, and learn from the impending final victory in less than a decade. 

The main lessons are that if everyone has proper information, if we base our medical decisions on the best science, if we do not try and fool ourselves or spread lies, and if we mobilise and work together, then we can defeat even HIV and Aids. 

Sometimes we need to be reminded, as the reluctance by some to come forward for Covid-19 vaccinations shows, and the lies told about vaccines, or the reluctance to have children vaccinated, as we have seen. 

People are not always logical, but when we do, collectively, the right things then we win battles and win wars, and in so many medical emergencies and campaigns we need to work collectively to win.

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