Zero by 20130: Rabies vaccination campaign targets 300,000 dogs and cats - Mozambique
Notícias (File photo) / Francisco Mbofana
One of the main challenges in the fight against HIV/Aids in Mozambique is diagnosing and treating men to prevent HIV from spreading, the executive secretary of the National Council for AIDS says.
“They are more afraid of being stigmatised and discriminated against than women,” Francisco Mbofana, executive secretary of the National Council for HIV and AIDS, told Lusa.
Also, women resort to health services more often, especially around childbirth, while men still shy away from diagnosis and treatment.
This situation is holding Mozambique back even as it faces missing the “90-90-90 strategy”: an international target to have 90 percent of the population know its status, and 90 percent of the infections under antiretroviral treatment achieving 90 percent viral suppression by 2020.
Mozambique is far from reaching any of these targets. Mbofana estimates that 50 to 56 percent of the population now know their status, that 60 percent of the infected people are being treated and that less than 40 percent of these have achieved viral suppression.
Mozambique however has made progress: it registered 120,000 new infections in 2010 and set a target of a 75 percent reduction by 2020, less than 30,000 new infections per year.
However, within about three years of the target, the number is around 83,000 annual infections and the country remains the second-highest in Southern and Eastern Africa for new infections per year, after South Africa, according to 2016 UNAIDS data.
“It is not an enviable reduction rate,” Mbofana said, reiterating the need for secondary prevention through full diagnosis and compliance with antiretroviral treatment in order to achieve viral suppression.
“Those who follow the treatment rigorously achieve viral suppression, that is, their transmission capacity is reduced by 96 percent,” he said.
On the other hand, he said the system available to attend to everyone was weak, so investing in prevention was a smart choice to reduce the number of people needing treatment and give the best treatment to those already infected.
In the face of the 90-90-90 strategy, Mozambique intends to take the “test-start” approach across the whole country, where, if diagnosis is positive, antiretroviral treatment is immediately initiated. It will do this in the provincial capitals.
The treatment should start “up to a month after diagnosis”, which is “complicated” because these are often apparently healthy people and more resistant to being medicated, but in whom antiretrovirals can be more efficient because the viral load is not very high.
Post-diagnosis, the challenge is adherence and retention, with three out of ten people entering treatment leaving within 12 months, and men more at fault than women.
At least during pregnancy, “the woman follows the antiretroviral treatment, because she understands that it is important not to pass the infection to the child. She continues for a few more months during breastfeeding, but after that she no longer sees the need and almost always gives up treatment”. This makes it difficult to have 90 percent of those infected under treatment.
“Treatment cannot fail” for viral suppression, and here “challenges go beyond the individual, and have to do with family and community, which can help [address] stigma issues”.
“People who are afraid of discrimination end up not taking medication” for fear of being identified and targeted.
The CNCS has “ongoing interventions in health units, but also at the level of communities and families, with whom individuals spend most of their time”, in order to raise awareness of the disease and ensure diagnosis does not lead to discrimination.
The initiatives involve non-governmental organisations (NGOs), traditional authorities, neighbourhood structures and religious leaders.
At the NGO level alone, Francisco Mbofana estimates that there are about 1,000 organisations involved in the fight against AIDS in Mozambique, a task in which all help is welcome.Source: Lusa
Children selling on the street accuse municipal police of aggression
Mozambique's government approves list of dangerous work for children
University of the United Nations warns of risk of inequalities in Mozambique
Labour inspectors engage in fight against human trafficking - Mozambique
100,000 families going hungry in Manica - INGC
US$8 billion investment set to return Mozambique to growth