Since the first case was reported at Kamuzu Central Hospital in Malawi's capital Lilongwe in 1985, HIV prevalence is declining and stabilising.
Malawi has reached a tipping point in its response to the AIDS epidemic, according to the National AIDS Commission (NAC). Since the first case was reported at Kamuzu Central Hospital in the capital Lilongwe in 1985, HIV prevalence is declining and stabilising. Despite this, more needs to be done to prevent the 50,000 new infections which are registered every year.
Today, more people are receiving treatment and fewer people are passing the virus on, which adds up to fewer infections. In 2012, UNAIDS reported that Malawi recorded a 73 per cent reduction in the rate of new HIV infections.
In June 2013, the same UNAIDS report said that Malawi was one of the seven sub-Saharan African countries that had reduced new HIV infections among children by more than 50 per cent since 2009.
Getting to zero new infection
Mara Kumbweza-Banda, NAC board chairperson, said Malawi is one of 13 countries that has reached a tipping point in dealing with the AIDS epidemic.
“We are now at a point where the annual increase in adults on treatment is greater than the number of annual new adult HIV infections. These strides have been driven by a combination of measures that have increased testing and improved access to medication,” said Kumbweza-Banda.
She also said that more than seven million people – almost half of the population – have been tested for HIV and received their results and nearly half a million people have been put on life-prolonging medication. In July 2013, Malawi started moving the final group of antiretroviral therapy clients onto a better treatment regime, which has fewer side effects and is recommended by World Health Organisation.
Option B+
In addition, 2011 saw Malawi pioneering the development of a simplified public health approach for preventing mother-to-child transmission and treatment that offers all pregnant women lifelong antiretroviral therapy.
Starting an HIV-positive pregnant woman on this treatment as early as possible both significantly reduces the risk of passing HIV to her child and protects the mother’s own health. The national rollout of this treatment, referred to as Option B+, has achieved impressive results in Malawi, with 87 per cent of known HIV-infected pregnant women starting lifelong antiretroviral therapy.
The scale-up and expansion of the programme has contributed to the rapid decline in infant infections and maternal deaths.
“The overall achievement is that we have managed to reduce HIV and AIDS from a killer disease to a condition we can live with. This, to me, is a cause for hope that we can indeed view the prospect of achieving zero-AIDS related deaths and an AIDS-free generation,” said Kumbweza-Banda, who is herself living positively.
Challenges
In spite of all these achievements, Kumbweza-Banda said there is one daunting truth glaring right at us: Malawi continues to register 50,000 new HIV cases every year.
“This rate of new infections is unacceptable considering that as a country we have the tools to turn off this tap. It is unacceptable for our children to be born with HIV in this age when we have prevention of mother-to-child transmission services in our health facilities,” she said.
“Malawi is scaling up voluntary medical male circumcision as an HIV prevention tool. I urge all men to take advantage of this innovation and help reduce the chances of contracting HIV.”
Presidential directive
It is almost three decades since the first case was diagnosed in Malawi. This means there are young people in their late teens or early 20s in Malawi who were born with HIV.
Following a directive from Malawi’s president Joyce Banda, NAC and the Malawi Network of People Living with HIV and AIDS (MANET+) are mobilising a network for young people living with HIV. This network will provide a forum for all young people living with HIV to comfortably discuss issues affecting them.
Malawi hosted high level international meetings on HIV and AIDS in June 2013, when President Banda hosted the first face-to-face summit of the UNAIDS/Lancet Commission: From AIDS to Sustainable Health.
Showcase for success
In August 2013, President Banda hosted the first-ever Southern Africa Development Countries (SADC) AIDS Watch Africa breakfast meeting where heads of states and governments discussed HIV and AIDS issues the region is grappling with.
Towards the end of September 2013, Malawi hosted the tenth SADC National AIDS Authorities meeting. All these international meetings gave Malawi an opportunity to learn from other countries on how they are managing their HIV and AIDS responses. They were also an opportunity for Malawi to showcase its success stories to the world.
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Image: In Malawi, the Bridge is a pioneering programme where volunteers refer people in their community to formal health services and community based organizations (CBOs) for support
© International HIV/AIDS Alliance
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