Agenda 11: Thematic Segment HIV and Ageing
Shaping the debate – opening dialogue
By Ferenc Bagyinszky
Thank you Chair. Let me start with thanking the speakers for opening the dialogue on HIV and ageing, a very timely choice for the topic of this Thematic Day. These excellent contributions have already highlighted the complexity of the topic.
In April this year I had the opportunity to attend a European conference on ”Ageing with HIV” where among many issues, we were looking at the reasons for faster or in other words premature ageing for people living with HIV. Symptoms and conditions that are related to older age, such as dementia, or reduced bone density occur at an earlier age in PLHIV. The reasons are multiple and complex. They are the side effects of the presence of the virus itself and the inflammation it triggers in our bodies, but are also the side effects of older and more toxic ARVs.
Research shows and there is consensus that thanks to antiretroviral treatment, people living with HIV can have a life expectancy of those without the virus, moreover, since the results of the START study were published in early 2015, we also know that in case of early diagnosis and treatment initiation, there are significant health benefits of reduced side events and co-morbidities.
To avoid premature ageing in people living with HIV, we need early diagnosis and early treatment with more tolerable drugs with improved resistance profile and non-toxic combinations. Can health systems afford them at the current prices, taking into account that the current coverage of treatment, regardless of the significant improvement in the past years is still below 50% globally?
The current costly R&D structure – especially research for a cure – and pricing of medications need to be addressed if we are to provide timely access for all at an affordable price, taking into consideration a country’s economic performance and its burden of the epidemic.
Another urgent issue is the preparedness of health- and social care systems to accept and provide care for people living with HIV. As thanks to treatment, people living with HIV live longer lives, they are also more likely to contact and use health- and social care institutions due to the co-morbidities that are side effect of HIV or ARVs or simply due to their older age. Are our health- and social systems free of HIV and key populations related stigma and discrimination?
There is also need for training for health- and social care workers both on the medical aspects of living with HIV but also on sensitivity towards people living with HIV and other key populations.
We call on the Joint Programme to investigate with its stakeholders alternative and affordable R&D structures and we encourage the member states to include HIV issues in their medical and social education curriculum.
Age-sensitive systems: what the future looks like
By Ferenc Bagyinszky
Thank you Chair. And thanks to all the speakers who showed their visions and described what it takes that people living with HIV could live long, healthy and happy live.
When I saw the title of the last panel of the day, I also gave some thinking of what the future might look like for us, people living with HIV. I would like to invite you on a time travel now.
It is the year of 2030. I have just turned 58, living and ageing with HIV for 24 years. I am at home, getting ready for work. Where exactly home is does not matter, as regardless of my country of residence, I can access the same quality treatment and care all over the world. I can be sure that I won’t be facing stock-outs of medication or diagnostics, as my HIV and general health care is reliable, sustainable, and affordable for the health system.
I can move around freely in the world as all countries have long removed their HIV-related travel- and residency restrictions, and I am not threatened by denial of entry or imprisonment in any country because my life-partner is from the same sex.
The radio is on: the news broadcast covers the story of closing down of the UNAIDS office in Geneva, Switzerland after the world leaders have announced that with global solidarity and unity we have managed to end the AIDS epidemic. They are planning to turn the building into a museum that not only exhibits the history of discrimination against and criminalization of people for who they are, who they loved or what they do but also will serve as an education centre for future generations.
2030 is still far away and there is a lot to do on the way. Ending AIDS does not only mean that we manage to stop an epidemic that we have lost millions of lives to. It also means fundamental social changes towards an accepting, inclusive and multi-coloured world that is free of stigma and discrimination. Where human rights are the guiding principles in all fields of life and poverty, social exclusion and marginalization are pictures of the past.
The future can only be even near to my this vision, if governments are accountable and ensure sustainable and affordable health systems, if member states choose life over patent, if the Joint Programme prepares the world to respect the wisdom of people aging with HIV. Let us work together to end AIDS by 2030 so that future generations and us can live long, healthy and happy lives with or without HIV.
Thank you for your attention.