On 1 December, WHO joins partners to commemorate World AIDS Day and urges Member States to address inequalities holding back progress in ending AIDS. Under this year’s theme “Equalize”, WHO calls on global leaders to come together and equalize access to effective and quality HIV prevention, diagnostics, treatment and care services.
Inequalities in addressing AIDS undermine progress
Although the world has made significant progress against AIDS, the HIV-AIDS epidemic continues to be a major public health issue affecting millions across the globe. Progress against HIV has been marred by reduced investments and the disruption of health services during COVID-19 which has reduced access to essential HIV testing, prevention and care services. As highlighted by the EQUALIZE theme, it is time to equalize access to essential HIV services, particularly for children, and key populations and their partners - men who have sex with men, transgender people, people who use drugs, sex workers, and prisoners.
Almost 38 million people around the world live with HIV. In 2021, an estimated 1.5 million people were newly infected with the disease, and 650 000 people died from causes related to HIV. Sri Lanka continues to maintain a low-level HIV epidemic (where HIV prevalence remains less than 1% in the general population and below 5% in any of the key populations listed above). Currently, 3 600 people are estimated to be living with HIV in Sri Lanka and the disease has claimed up to 100 lives to date.
Global efforts
Recognizing that insufficient progress has been made in reducing HIV infections globally, in 2021, the UN General Assembly adopted the “Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030”.
WHO’s global health sector strategies on HIV, viral hepatitis, and sexually transmitted infections 2022–2030 (GHSSs) guide the health sector in implementing strategic interventions to achieve the goals of ending AIDS, viral hepatitis B and C and sexually transmitted infections by 2030. The strategies recommend country-specific actions supported by WHO and partners taking into account the country’s context and global advancements in this field. Likewise, the WHO Integrated Regional Action Plan in South-East Asia 2022-2026 (I-RAP) provides a comprehensive Regional Framework covering 23 shared and 37 disease-specific actions to guide countries and partners in their efforts to end the HIV epidemics. In addition, the I-RAP identifies seven key actions that WHO must take to support the implementation of the plan.
National Response
The National STD/AIDS Control Programme (NSACP) of the Ministry of Health is the sole government institution tasked with coordinating the national response to HIV and sexually transmitted diseases (STDs). The NSACP works in collaboration with national and international stakeholders in controlling HIV in Sri Lanka, including the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), UNAIDS and WHO.
The NSACP has undertaken crucial decisions to push progress on ending the AIDS epidemic in the country. The programme provides prevention, treatment, care and control of STD services through the central and 41 district clinics located island-wide, which have contributed towards maintaining low disease prevalence.
The country achieved the WHO certification for the Elimination of Mother to Child Transmission (EMTCT) of HIV and Syphilis in 2019 and underwent successful revalidation in 2021. Sri Lanka was the
WHO’s support to national HIV efforts
The WHO Country Office works closely with the NSACP in providing technical guidance to support strategically focused interventions for effective responses to HIV that reach the people most affected and at risk for the disease. WHO provided technical assistance for the development of the National HIV/STI Strategic Plan 2023-2030 which will mainly focus on intensifying and coordinating actions across government and nongovernment stakeholders and scaling up community-centred HIV prevention and care services. WHO has also provided support to updating guidelines on HIV testing, care services and management of opportunistic infections, ensuring that WHO standards and best practices in addressing inequities are integrated. Additionally, WHO capacity-building initiatives have strengthened 41 sexual health clinics across the country to ensure the delivery of quality services by healthcare providers and address issues related to stigma and discrimination. WHO has also created opportunities to foster sharing of innovations and new knowledge for effective responses to HIV and STIs through support for annual sessions of the Sri Lanka College of Sexual Health and HIV Medicine as the key academic and authoritative professional body in this field.
More recently, Sri Lanka has faced obstacles to the provision of community-based HIV prevention activities due to the disruption of essential health services as a result of the C
On this World AIDS Day, WHO reiterates its commitment to support the Government of Sri Lanka in its efforts to end AIDS - which can only be achieved by tackling the inequalities which perpetuate it. Equalizing access to essential HIV services and ensuring a targeted focus to reach the people most affected and at risk for the disease, is essential to ending AIDS.
References
1. Annual Report-2021 National STD /AIDS Control Programme, Ministry of Health
2. Are Key populations Really the Key to ending AIDS in Asia- putting Asia’s HIV response back on track -2018
3. Integrated Regional Action Plan for viral Hepatitis, HIV and sexually transmitted infections in South-east Asia-2022-2026
4. https://www.who.int/news-room/fact-sheets/detail/hiv-aids
5. Sri Lanka College of sexual Health and HIV Medicine 2022