Southern Africa’s AIDS epidemic takes nosedive

By John Cohen — December 1, 2016


Today is World AIDS Day, and three neighboring countries in southern Africa that have been hard-hit by HIV received remarkably good news.

As part of a massive, first-of-its-kind survey, researchers randomly visited households in Malawi, Zambia, and Zimbabwe and tested about 80,000 people for HIV. In each country, more than 86% of the people receiving antiretroviral treatment had fully suppressed HIV, which means viral levels are so low they are not detectable on standard blood tests. This not only staves off AIDS, but makes it highly unlikely that they will infect others. The rate of new infections has also plummeted by more than 50% in the region since 2003. “We were amazed when we saw this,” says Wafaa El-Sadr, an epidemiologist who heads an international health-strengthening program called ICAP at Columbia University Mailman School of Public Health in New York City, which led the survey. “It’s really a credit to these countries—and they’re not the world’s richest places.”

The three countries since 2004 collectively have received nearly $4 billion from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which gave ICAP $125 million to conduct what are known as population-based HIV impact assessments (PHIAs) in 12 sub-Saharan African countries and Haiti. The aim is to help the countries and PEPFAR better target prevention and treatment efforts. The preliminary findings announced today are the first data reported from these assessments. “It’s pretty doggone amazing,” says Deborah Birx, who heads PEPFAR in Washington, D.C. “This really shows us why it’s so important to get community level survey data.”

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