A pandemic only ends if it is defeated everywhere and for everyone. That is the fate that could befall the world’s deadliest pandemic if, and only if, our world leaders decide to keep their promise to end the AIDS pandemic by 2030. They can still do it, believes the Joint United Nations Programme on HIV/AIDS (UNAIDS), but not without a major shift, because they have fallen behind schedule.
It must be said that, in our rich countries, life with the human immunodeficiency virus (HIV) has become almost commonplace. Thanks to early screening and treatment that make the viral load undetectable and prevent transmission of the virus. Thanks also to pre-exposure prophylaxis (PrEP), which works real miracles to avoid contracting the virus.
If only we could use these trump cards to their full potential. Not even that, lamented the doctor Réjean Thomas and the virologist Bluma Brenner in a letter to the Duty. It is true that PrEP is still largely underused, when it is not the subject of unfair bad press. The two experts note that the end of the paralyzing fear of the darkest decades of the epidemic has relegated the fight against HIV/AIDS to the background when it should remain “a public health priority.”
This explains that: the return of a certain carefree attitude has overcome certain usual precautions. Did you know? Across Canada, the HIV epidemic is experiencing a resurgence. In 2022, 1,833 new cases were reported, an increase of almost 25% compared to the previous year. With an average of 4.9 cases per 100,000 inhabitants, Quebec is slightly above the national rate (4.7).
Globally, 2023 saw 1.3 million people contract HIV. This figure is light years away from the target of 370,000 new infections or fewer set by our leaders for 2025. In its global report published this week, UNAIDS also notes a worrying decline in awareness campaigns, either because they have faded into general indifference or because they have been drowned out by moralizing speeches that are becoming increasingly loud.
But where human rights are at risk, so is the fight against HIV/AIDS, the organization warns, noting that legal and social obstacles and barriers related to rights and gender persist, if not intensify in some parts of the world. The organization also notes a decline in funding around the world. Adjusted for inflation, resources are sadly at their lowest level in more than a decade.
Yet AIDS still kills. Every minute, someone dies of AIDS-related causes, a heavy toll that hits children particularly hard. Children aged 0 to 14 account for 12% of all AIDS-related deaths, even though they make up only 3% of people living with HIV. They are also less likely than others to receive antiretroviral therapy. Shame on them!
In total, approximately 9.3 million people are living with HIV without treatment. Yet solutions are within reach, including one that could deliver an unstoppable blow to the pandemic, if only the pharmaceutical industry would do its part. At the 25e At the International AIDS Conference this week, researchers calculated that a generic version of Gilead’s antiretroviral lenacapavir could slash its price from $40,000 a year to… $40.
UNAIDS Executive Director Winnie Byanyima has urged the US giant to “make history” by allowing generics of its antiretroviral. The case is less far-fetched than it seems. A few years ago, the same team of researchers estimated that Gilead’s hepatitis C treatment — then priced at $84,000 — could plummet to $100 if generics were approved. The bottom line: treating hepatitis C now costs less than $40.
Gilead’s antiretroviral not only has the power to significantly reduce the financial burden of the epidemic. It also has the potential to radically change the daily lives of people living with or affected by HIV. First, because it requires only two injections per year, making it easier to follow than daily pill therapies. But also because it has been tested as a preventive medicine (PrEP) to prevent infection, and this, with 100% effectiveness, according to a recent preliminary study.
What is missing to eradicate AIDS is no mystery to anyone. The success of the bet that our leaders have committed to lies flatly in sufficient AND sustainable resources. At a time when the international community is falling out and getting angry over anything, this common struggle could very well contribute to bringing its members closer together by reminding them of the meaning of solidarity in addition to providing them with a path to get closer to it.