Gay sex, Aids: Pragmatism needed

The latest data from UNAIDS released during this year’s World Aids Day show that East Africa continues to lead the continent in curbing the spread of HIV, expanding antiretroviral treatment and eliminating stigma and discrimination.

Average prevalence across the region now stands at between 6 and 7 per cent of the adult population, significantly lower than the 15 per cent recorded in the mid-1990s.

About 800,000 HIV-positive East Africans are also now on life-saving antiretrovirals.

Despite this progress, East Africa must not delude itself that it has won the war against HIV/Aids.

New challenges continue to emerge, even as old oversights complicate the situation.

To maintain its leadership in the control and management of HIV, East Africa must wake up to the changing reality of the infection and formulate more pragmatic and comprehensive programmes.

One area that could benefit from greater pragmatism is the challenge of HIV transmission between men who have sex with men (MSM).

Another area needing greater focus is mother-to-child transmission, as well as treatment of HIV among the young.

The current global economic downturn has demonstrated that complete reliance on donor funding is imprudent, as shocks to the international system can lead to crippling funding disruptions and cutbacks.

One way to build sustainability is for East Africa to scale up its capacity to produce its own generic ARVs.

With a market now approaching a million people this is both viable and economically sensible, given such other benefits as the creation of employment.