Multi-sectoral approach needed in HIV treatment - Prof. Torpey
The Dean of School of Public Health, University of Ghana, Professor Kwasi Torpey, has called for collaboration between the government, communities and the private sector to reduce new HIV infections.
He said the reduction in infections from about 23,000 in 2018 to 17,000 in 2021 was not adequate for the country to attain epidemic control in the next decade.
“There is therefore the need for all to work towards accelerated reduction of new infections collectively and rapidly through the expansion of prevention services for general and key populations, “ he said.
Prof. Torpey said this at a public lecture organised by the Ghana AIDS Commission (GAC) to mark its 20 anniversary. It was also part of activities heralding the 2022 World AIDS Day which falls on December 1.
The lecture, on the theme: “20 years of a multi-sectoral HIV Response: Accelerating Progress to end AIDS” was attended by health professionals, students and other members of the public.
According to Prof. Torpey, after 40 years of HIV, it was obvious that successful prevention, care and treatment required partnerships, alliances and collaborations to reduce new infections.
Prof. Torpey said a multi-sectoral partnership approach would result in better access to a wider community of people, information, resources and facilitate rapid programme implementation.
He added that through multi-sectoral partnerships, creative approaches were promptly translated from research into policy and practice, adding that multisectorality brought “us all together in advancing our shared objectives”.
Giving evidence of how multi-sectoral partnership has helped in the past, he said the full force of multisectorality of the country’s HIV response was unleashed with the introduction of $25 million Ghana AIDS Response Fund (GARFUND) which was supported by the World Bank about two decades ago.
That, he said, galvanised the national response with the involvement of civil society as well as government agencies, adding that the multisectoral HIV/AIDS project (MSHAP) followed in a bid to reduce new infections and mitigate the impact of HIV.
“It is no more a choice of treatment against prevention but deploying effective interventions within the prevention-treatment continuum. These include HIV risk reduction strategies, condom use, social and behavioural change communication as well as pre-exposure prophylaxis,” he stated.
On HIV testing, Prof. Torpey said the world had come a long way with various transitions in HIV testing, emphasising that the first-generation test available in the 1980’s could detect HIV infections after eight to 10 weeks.
“This long window period created challenges for HIV diagnosis but fortunately, the current fourth to fifth generation tests can detect HIV infection within one to two weeks, which offers an opportunity for early diagnosis and reduced risk of transmission,” he said.
According to him, HIV testing was the gateway to identification of infection and a critical component in ending the AIDS fight.
Prevention of Mother to Child Transmission
On prevention of Mother to Child Transmission, Prof. Torpey said HIV in children was a blot on the conscience of the country and the West Africa region at large, explaining, “this is because we have the knowledge and the strategies to eliminate paediatric HIV.”
He said the country recorded roughly a million pregnancies a year and about 98 per cent of pregnant women attended antenatal clinic at least once.
The university don added that 92 per cent of pregnant women who attended antenatal clinic and tested HIV positive were on treatment, adding that the number included new and already diagnosed cases.
That, he said, showed rapid progress from 2016 where only 50 per cent of HIV positive pregnant women received treatment compared to the current 92 per cent.
Despite the strong results, he quizzed,“Why are our mother to child transmission rates still above the elimination target?”
Prof. Torpey said only five of the 16 regions provided antiretrovirals to 95 per cent of pregnant women diagnosed positive, a situation he described as “a missed opportunity. “
The Dean said HIV treatment globally and in the country in particular had undergone significant changes in the last 20 years.
“We have come from a period where patients had to take five to 10 tablets daily to once daily treatment. The current drugs are very potent and have favourable side effects,” he stated.
Stigma and discrimination
On stigma and discrimination, he said they undermined efforts to end HIV/AIDS.
“Every person regardless of their gender, age, religion, tribe, orientation and profession must have access to HIV prevention, care and treatment services. From the public health perspective, elimination of stigma and discrimination in all shapes and forms is a critical step in ending AIDS.
“The future of HIV prevention and treatment is very bright with new prevention technologies, long acting treatment, evidence-based strategies to prevent mother to child transmission, expansion of HIV testing, reducing stigma and discrimination in our communities and facilities and a programme that is inclusive for general, key and priority populations, “ he said.