Interview with the Executive Director of UNAIDS, Michel Sidibe on the state of the Worlds HIV/AIDS Epidemic during his visit recently to Tanzania.
Questions by Stella Vuzo, UNIC Dar es Salaam: What brings you to Tanzania this time around?
Executive Director, Michel Sidibe: “I think we have to come to Tanzania, Tanzania has always been known as a country for inclusiveness. So, Tanzania has been demonstrating over the years that in the rotation in terms of change in policies and orders they have been promoting stability.
So were here because we want to see what is happening on the HIV/AIDS fronts, and it has been very encouraging to see that a lot of progress has been made in terms of putting more people on treatment, in terms of reducing the number of babies born with HIV, and trying to decentralize completely the problem. Of course, we manage to discuss some critical issues which HIV response has been always about reaching people who have been left behind. Has always been about reaching people who are hiding because they are stigmatized and scared that they will be excluded from services. You will never end the epidemic, so we have been having a very good discussion with the government and civil society today to understand what are the barriers and challenges and how we can help to remove them. One of them is of course to make sure that anyone in Tanzania need to have access to services whatever it is whether its injecting drugs, or unfortunately being a sex worker, we need to just give them the possibility to have access to life saving services.”
Q: You had a meeting earlier with the minister of health in Tanzania… what was the outcome?
Executive Director, Michel Sidibe: “The outcome was very positive very committed to transformation more accountability, more transparency, efficiency. to make sure we can produce more with less but also, she was very transparent she said that key populations and vulnerable groups need to be reached with our services No one should be excluded from our existing services, information should be given to anyone to protect themselves and if you need a lifesaving medicine you need access to them, we are so focused on adolescent girls. They are critical for us, because we cannot win the epidemic in this country if we don’t reach out to adolescents. We have early pregnancy which is a very serious issue at 27 percent, we have unfortunately 40 percent of new infections are occurring among young people but 80 percent of them are young adolescent girls. So, I think vulnerable groups plus key populations are critical if we have less than 5 percent of prevalence of HIV among general population .We are seeing a decline of prevalence but amongst key population, so we cannot let the epidemic grow unchecked.”
Q: In your meeting with the U.N. Country Management Team was there any specific message that you wanted to clearly reach out to all the 23 U.N. agencies in Tanzania?
Executive Director, Michel Sidibe: “I think I want to say that they should continue to do the great work that they are doing and they need to really to pay attention to issues of social justice, helping countries to have a plan to sustain their gain, making sure that 7 percent economic growth is distributed so that it can reach the people where they are. And I think an agenda for more transparency, accountability, efficiency, with equity base can bring a lot.”
Q: Where are we now, how good are we in terms of the journey to the Sustainable Development Goals for 2030?
Executive Director, Michel Sidibe: “I think for the first time we can say in HIV/AIDS really that we broke the backbone of this epidemic, this is the first time we have people on treatment rather than waiting for treatment. For the first time including Tanzania we are reaching the tipping point, so less new infections than people newly put on treatment which is important to control this epidemic. We have countries showing they don’t have babies being born with HIV anymore. Tanzania is also showing they are covering over 85 percent to 90 percent of the pregnant women who are HIV positive. So were seeing great… great progress, but it is not over, we still have 17 million people waiting for treatment and we really need to put prevention at the center of our approach. Reaching young people and making sure education and lifestyle of people are issues we need to address collectively as the U.N.”
Q: are you worried that an increasing number of people using antiretroviral drugs are not using the drugs as effectively as they used to?
Executive Director, Michel Sidibe: “I think I’m more scared of complacency, because I think people can become complacent because they think AIDS is over and then they will reduce resources and if we have reduction on resources then we can have the rebirth of the epidemic. But I don’t think I’m so scared that people are stopping their treatment because they know exactly when they stop what is happening to their body, they know what it happening to their health; they start becoming sick. Now today were lucky, we move from almost 18 pills a day to 1 pill a day so it’s become easier for administrators to treat people. So, I’m not scared of that issue, I’m more scared of complacency and becoming victims to our own success stories so that people don’t invest anymore into HIV and we can have a rebound, we can have a resistance, we can have many other issues which can reverse our gains.”
Q: Africa has carried the burden of the HIV epidemic, what is the situation now compared to other continents? Are we still lagging behind?
Executive Director, Michel Sidibe: “I think Africa is a success story today, Africa has been able to demonstrate that we can break conspiracy of silence so that we can really increase the number of people put on treatment. Today we have the biggest treatment program in South Africa, 4 million people on treatment, 2 billion dollar pay on budget. We’re seeing a success story in Swaziland, who could believe the prevalence, was a 36 percent a few years back, who could believe that Swaziland would have reached a 90-90-90 and suppress the activity of the virus in the blood better than the U.S., and today they reduce new infection by 50 percent within the last 5 years. So were seeing success stories every single part of Africa today. My worry is Eastern Europe, central Asia; where I’m seeing the fastest growing epidemic happening, 60 percent increase during the last 6 years, 10 percent increase every year. Because the people who are injecting the drugs are considered as criminals and are hiding and don’t have access to services and there’s a huge increase on your infection. And this is moving from people who inject drugs to general population that happens when you don’t address the epidemic amongst key populations they don’t live in isolation and have intercourse with those who don’t inject drugs, aren’t necessarily sex workers, or aren’t gay.”
Q: Kenya is testing out the trial vaccine for HIV today?
Executive Director, Michel Sidibe: “I think one of our best trial vaccines we have today is happening in South Africa”
Q: Are you planning to spread to other African countries in East Africa?
Executive Director, Michel Sidibe: “I think they are waiting for a report and to see exactly what is coming, but the new drugs which we have been able to negotiate with Kenya and South Africa are very effective drugs. These are the first line medicine which are used just in the developed world and are now being approved for 90 others currently, and the price is 75 dollars only and the best first line medicine in the world today.”
Q: How about funding for HIV/AIDS globally?
Executive Director, Michel Sidibe: “I think globally we still have the gap of 7 billion dollars but we managed to mobilize 20 billion dollars last year so I think it’s time to start thinking about Sustainability in Africa, we cannot continue to put people on treatment and that those people on treatment will be able to stay on treatment for the next 30 years based on the resources which are coming from abroad, today most of our people are on treatment because of global fund money, so it’s important for countries to develop a sustainability transition plan. And that is one of the issues we have been discussing in Tanzania.”
Michel Sidibe is the Executive Director of UNAIDS.
Stella Vuzo if the Information Officer in Charge of the UN information Centre in Dar es Salaam
Transcribed by UNIC intern