Can Ghana end AIDS? maybe…

Somewhere in Efiduase, a suburb of Koforidua in the Eastern Region of Ghana, Alfred Owusu, popularly known as “Advisor”, welcomed me to his serene but semi-populous family house.

Owusu, a father of two, is one of the estimated 313,063 persons the National AIDS Control Programme (NACP) says are living with HIV in Ghana as at 2017.

He has lived with HIV for about 18 years. He does not look trim as HIV was portrayed years ago. My host looked strong, healthy, and happy -- something he never envisaged when he was tested HIV positive in the year 2000.

‘’It never occurred to me that I would be able to live a normal and a happy life when I was first told I had HIV. I felt I was going to die. I contemplated suicide but here I am, feeling proud I never took my life,’’ he said grinning.

Owusu’s latest medical reports indicates his viral load is still suppressed. Achieving viral suppression means the amount of HIV in the blood of the persons living with it has been rendered weak to a level that it is below what a laboratory test can find. This can only be attained by sustained high-quality antiretroviral therapy and living healthily.

“An estimated 35.0 million people have died from AIDS-related illnesses globally since the start of the epidemic, what has kept you going all these years?” I asked.

“Nothing special; I strictly adhere to my Antiretroviral medication, I have a great family support, and I don’t feel stigmatised,” he responded.

At a time when Ghana is actively working to meet the global target of ending the AIDS epidemic by 2030, Owusu’s story, like that of many members of the Network of Persons Living with HIV in Ghana (NAP+ Ghana ) mirrors the successes Ghana has chalked in the global HIV Response even in the face of declining resources for development agencies.

Ghana has maintained a low adult HIV prevalence, declining from 1.8 percent in 2012 to 1.6 percent in 2015. As at 2017, the estimated Adult National HIV Prevalence was 1.67%, relatively low compared to figures from the West African subregion.

AIDS-related deaths has also reduced from 34 000 in 2005 to 15 000 in 2016. Antiretroviral Therapy (ART) sites have increased across the country and more than before, there are about 100.000 persons on treatment owing to the implementation of the 'Treat All' Policy where every person who tests HIV positive is put on treatment.

Similarly figures from the National AIDS Control Programme shows that HIV prevalence among antenatal clients now stands at 2.1%, a decrease from the 2016 prevalence of 2.4%. Coverage of pregnant women living with HIV accessing antiretroviral medicine has equally moved from 29% in 2010 to 56% in 2016, says UNAIDS.

However, many stakeholders, including Owusu who now works as an HIV counsellor at one of the health facilities in the Eastern Region, believes it will be premature to pop the champagne, and I agree.

At the recent National HIV & AIDS Research Conference (NHARCON) organized by the Ghana AIDS Commission, the Country Director for the UNAIDS, Angela Trenton-Mbonde cautioned that even though Ghana has made significant gains in its HIV and AIDS response over the years, Ghanaians should not be complacent, as it may derail the glory recorded.

“AIDS is not over globally and therefore not over in Ghana. But it can surely be. Our biggest enemy is complacency. It is easy to be complacent as AIDS in Ghana is not as visible as it is in East and Southern Africa where the burden of the epidemic has been greatest,” Ms Trenton-Mbonde told delegates.

“With the political will, the passion, the hearts and brains, the science and the policies, the knowledge of effective interventions, we have the entire arsenal needed to fight the AIDS epidemic,” she advised.

Ms Trenton Mbonde’s concerns are genuine. The West African country can’t afford to be complacent if the global quest of ending the AIDS epidemic by the year 2030 is anything to go by.

In 2014 Ghana joined the rest of the world to commit to the Fast-Track targets aimed at ending the AIDS epidemic by 2030. The agenda was simple: to ensure that by 2020, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV will be on sustained antiretroviral therapy, and 90% of all people receiving antiretroviral therapy will have viral suppression. But two years to the 2020 deadline, HIV testing and treatment coverage in Ghana is still below the global average, painting an alarming picture.

Data from UNAIDS shows that less than 50% of the persons living with HIV in Ghana know their status, with just about 34% of the persons who knew their status on antiretroviral treatment as the end of 2016. This is a major blot towards achieving the third 90 of viral suppression.

Again, though the 2017 HIV Sentinel Survey report released by the National AIDS and STI Control Programme (NACP) of the Ghana Health Service showed a decrease in HIV prevalence in Ghana, it is imperative to note that there were an estimated 19,101 new HIV infections in Ghana in 2017, out of which 3,422 were children.

Yes, the country has made weighty strides in its AIDS response through integrated multisectoral approaches with a lot of results to show but more needs to be done, especially at a time when studies by UNAIDS and its partners have shown that the global efforts to reach the 90–90–90 targets is leaving countries like Ghana and others in Western and Central Africa behind.

Successive Presidents of the Republic of Ghana, including the incumbent, Nana Akufo-Addo, and the First Lady, Rebecca Akufo-Addo, the Premiere HIV Advocacy Ambassador have shown commitment to end AIDS, and the Elimination of Mother to Child Transmission of HIV, but more needs to be done, if we are to catch-up with the rest of the world.

I understand that UNAIDS has come up with a catch-up plan to supplement national strategies and existing plans, to accelerate the region’s AIDS response, and soon Ghana will launch a National HIV Prevention Coalition under the leadership of the Honourable Minister of Health, Kwaku Agyemang Manu.

I hope this initiative will not only be good on paper but will renew the national commitment towards the response.

Countries in Eastern and Southern Africa, home to more than half of people living with HIV globally, have made huge advances towards meeting the 90–90–90 targets to the extent that three out of four people living with HIV in the region are aware of their HIV status, nearly four in five who know their HIV status are on treatment, and more than four in five who are on treatment have suppressed viral loads.

Countries in this region did not do this by just drafting nice policies and programmes but through sustained commitment. The dynamics may be different but we can do same. The year 2030 is not far but it is not too late to correct the wrongs.

The increasing HIV prevalence in the young population must be halted. An amount of 28,203 children Living with HIV is still high. Stigma and discrimination towards persons living with HIV is at this stage is unacceptable.

The Ghana AIDS Commission needs to be adequately resourced. Stakeholders must be engaged to scale up the response. We need to catch-up!

Long Live Ghana !!!