Agenda item 6.2
Delivered by Valeriia Rachynska, Europe Delegate
Thank you, Madam Chair,
Speaking about the effectiveness of the implementation of the Joint United Nations Program on HIV / AIDS, we must always remember that the objectives of the program are 90-90-90. Of these, the third 90 is not only an indicator of the effectiveness of treatment, but also an indicator of the effectiveness of the entire work – of how the programme is changing quality of people’s lives. If the indicators of treatment effectiveness are low, this means that part of the resources spent for the purchase of medicines, programs aimed at increasing adherence to treatment, are wasted. And it means that the money spent on the first 90 and second 90 were also partly lost.
In the example of the Eastern Europe and Central Asia region, we can see that the rapid growth of the epidemic is directly related to the lack of access to treatment and its effectiveness. At the end of 2016, only 28% of PLHIV were on treatment, and only a shocking figure of 25% had a suppressed viral load. And for us, it’s not just statistics, but people and figures say that out of every 100 PLWH in the region, 72 will die or fall ill with tuberculosis due to lack of access to treatment. Between 2010 and 2016, the number of new HIV cases increased by 60%, deaths increased by 27%. In India, we gather the government has just started promising that the last 90 will be measured in phased order, the action is yet to come.
Both deaths and new infections could be avoided. Transition from branded drugs to generic ones, optimization of treatment schemes, patent opposition, – those measures could significantly reduce the cost of purchasing ART, and thereby save the funds that are so always critically lacking in programs for the prevention, care and support of PLHIV and key populations. Also, poverty is one of the main drivers of the epidemic. In Ukraine, according to a survey conducted in 2016, 61% of PLHIV live in poverty, 21% of them lack money for food. Often, because of critical poverty, people refuse treatment or stop it. As a result of the project, which was implemented in Ukraine in 2017-2018 by the All-Ukrainian Network of PLWH in partnership with World Food Programme, the effectiveness of treatment among PLWH who received monthly food assistance from WFP was 93% with an average treatment effectiveness of 38% in Ukraine. Please take a moment and accept that it is possible, but still not happening. Please take a moment and look at the 2 figures: 38% vs 93%. Imagine what the indicators would look like if similar, effective programmes have been invested with the full and meaningful involvement of communities and civil society. In contrast, in India, the PLHIV network runs the country’s care and support programme and raise local funds to support communities needs and make treatment effective.
And this means that the recipe for success for reaching 90-90-90 already exists: buy ART at affordable prices, provide access to PLHIV and key populations for services and food security, ensure the inclusion of key groups in the processes of determining country needs in response to the epidemic and a year later, we will report on significant progress in achieving the goals of 90-90-90. Well, besides this, with effective implementation of the Joint Programme, if a young person does not fall ill with tuberculosis, a woman gives birth to a healthy child, and no one has to die due to the current conditions of access to treatment in the EECA region, it is already a great success.