Gathering strength needed to stop AIDS, tuberculosis and malaria

Every year, AIDS, tuberculosis and malaria cause the deaths of three million people. The challenges are many, but there is still hope of achieving the UN goal of stopping these diseases by 2030. In two weeks, world leaders will announce how much contribution they are willing to make to the Global Fund against AIDS, Tuberculosis and Malaria in the next three-year period. It is time for a gathering of forces, write representatives of RFSU, RFSL, Médecins Sans Frontières, the Swedish Medical Association's Committee for Global Health, the World Infection Fund, Karolinska Institutet and HIV-Sweden.

When the government announced that it would reduce its contribution to the Global Fund against AIDS, Tuberculosis and Malaria (Global Fund) due to increased costs for the reception of refugees in Sweden, no less than 159 civil society organizations from around the world joined forces to ask Stefan Löfven and Sweden not to disappoint their commitment. Sweden's reputation as a reliable donor took a real hit. The Global Fund is one of the most important financing mechanisms for global health, so the news that the grant is now being restored to the promised SEK 850 million for 2016 is gratifying.

Every year, the three diseases cause AIDS, tuberculosis and malaria, killing around three million people. Tuberculosis is the infectious disease that causes the most deaths globally, malaria leads to hundreds of thousands of deaths each year and the AIDS epidemic is far from over. During the period 2010-2014, the number of new cases of HIV per year has decreased by only eight percent, and every day 5 children, young people, men, women and trans people are infected with HIV. AIDS is the most common cause of death among women of reproductive age.

The challenges are many, but there is still hope of achieving the goal adopted by UN member states to stop AIDS, tuberculosis and malaria by 2030. We therefore want to highlight the following:

- Too few are aware that they have HIV. About half of all people living with HIV do not know about it. It must be easier for people to test themselves. Initiatives such as knocking on doors to offer testing have shown good results.

- 17-19 million people still lack access to life-saving treatment. As a result, one million people die unnecessarily each year. People living with HIV must be given access to treatment as soon as possible in accordance with the so-called test and start method. Then the chances of living a long life increase and the risk of passing on HIV decreases radically. In West and Central Africa, 76 percent of those who need life-saving medication are still waiting for treatment.

- Knowledge about how to protect oneself against HIV remains low in affected countries. For example, only about a third of all young people in sub-Saharan Africa have a basic knowledge of how to prevent the transmission of HIV. The HIV prevention agenda needs to be reformulated and better integrated into the broader work for sexual and reproductive health. Among other things, investments are needed in sexual education that questions norms about gender and sexuality, as well as school health care that provides condoms and contraceptives.

- More must be invested in increasing the availability of tuberculosis treatment and in measures to overcome the increased spread of multi-resistant tuberculosis. Tuberculosis is the most common cause of death for people living with HIV.

Criminalization and discrimination of homosexuals, bisexuals, transgender people and people with queer expressions and identities must be counteracted. Fear of imprisonment, persecution, violence and harassment are serious obstacles for people to seek counseling and health care.

In other words, a gathering of forces is required. Innovative thinking and robust financing of initiatives in hard-hit countries are necessary if the world is to succeed with the set goals.

In two weeks, the fifth donor conference will be held where world leaders will announce how much contribution they are willing to make to the Global Fund over the next three-year period. The Global Fund plays an invaluable role in achieving the UN's goals. A financing model with multi-annual assistance creates a long-term perspective, and thereby opportunities for the countries concerned to plan initiatives in line with their national health strategies. Sweden's voice has been decisive in shaping the Global Fund's new strategy for 2017-2022. As a result of Swedish advocacy work, the new strategy focuses to a greater extent on sexual education, sexual and reproductive health and rights, gender equality and human rights. Now the financial contribution for the coming three-year period must demonstrate the same determination.

We who work daily to fight AIDS, tuberculosis and malaria want Sweden to send a clear signal that we will fulfill our commitments to stop these epidemics before 2030. If a gathering of forces does not take place, the risk of setbacks is great, despite the international HIV work has been very successful in recent years. We can not afford that option.

Maria Andersson, Secretary General of RFSU

Mikaela Hildebrand, sexual policy expert RFSU

Mari Mörth, Secretary General of Médecins Sans Frontières

Anna Sjöblom, medical humanitarian adviser, MSF

Frida Sandegård, union president RFSL

Tobias Alfvén, chairman of the Swedish Medical Association's Committee for Global Health

Claes Ånstrand, Chairman of the World Infection Fund

Gunilla Källenius, professor at Karolinska Institutet and board member of the World Infection Fund

Anna Mia Ekström, professor / chief physician, Karolinska Institutet and Karolinska University Hospital

Christina Franzén, Chairman of HIV-Sweden

Farhad Mazi Esfahani, business developer HIV-Sweden

This is a debate article. The author is responsible for analysis and opinions in the text.

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