The 2016 World Aids Day: Hands Up For HIV Prevention
The first world AIDS day was held about 28 years ago (1988) after health ministers from around the world met in London and agreed to such a day as a way of highlighting the enormity of the AIDS pandemic and nation's responsibility to ensure universal treatment, care and support for people living with HIV and AIDS.
The idea was conceived in 1987 by two public information officers, James W. Bunn and Thomas Netter, who were workers of the WHO's global programme on AIDS but the final approval was given by Dr Jonathan Mann ,former head of the Global programme on AIDS but now known as UNAIDS. It is observed annually on the first day of December. It is recognized by UNO and all her affiliate international organisations and member countries. The theme for this year is ‘Hands Up For HIV Prevention’.
BRIEF HISTORY AND DESCRIPTION
In 1981, medical practitioners in USA, working with the Centre for Disease Control and Prevention ( CDC) discovered a strange illness among a small number of gay men. The illness was given several names until it was finally called HIV AIDS. It is one of the leading causes of death globally. HIV progressively infects cells of the immune system (especially CD4 cells of the white blood cells), breaking down the body's ability to fend off some infections and other diseases .AIDS is the most advanced stage of HIV infection, defined by the occurrence of any of the more than 20 opportunistic infections or related cancers.
MODES OF TRANSMISSION
HIV can be transmitted through: transfusion of contaminated blood and blood products; unprotected vaginal or anal sexual intercourse ; oral sex with an infected person; transmission between an infected mother and her baby during pregnancy, childbirth and breastfeeding ; sharing of contaminated sharp instruments and the use of contaminated and unsterilized hospital equipment such as needles and syringes.
STATISTICS AND DATA
According to WHO fact sheet:
- HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2015, 1.1 (940 000–1.3 million) million people died from HIV-related causes globally.
- There were approximately 36.7 (34.0–39.8) million people living with HIV at the end of 2015 with 2.1 (1.8–2.4) million people becoming newly infected with HIV in 2015 globally.
- Sub-Saharan Africa is the most affected region, with 25.6 (23.1–28.5) million people living with HIV in 2015. Also sub-Saharan Africa accounts for two-thirds of the global total of new HIV infections.
- HIV infection is often diagnosed through rapid diagnostic tests (RDTs), which detect the presence or absence of HIV antibodies. Most often these tests provide same-day test results; essential for same day diagnosis and early treatment and care.
- There is no cure for HIV infection. However, effective antiretroviral (ARV) drugs can control the virus and help prevent transmission so that people with HIV, and those at substantial risk, can enjoy healthy, long and productive lives.
- It is estimated that currently only 60% of people with HIV know their status. The remaining 40% or over 14 million people need to access HIV testing services. By mid-2016, 18.2 (16.1–19.0) million people living with HIV were receiving antiretroviral therapy (ART) globally.
- Between 2000 and 2015, new HIV infections fell by 35%, AIDS-related deaths fell by 28% with some 8 million lives saved. This achievement was the result of great efforts by national HIV programmes supported by civil society and a range of development partners.
- Expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030.
UNAIDS reports that in Western and Central Africa, about 6.7 million people are living with HIV,60% of whom are women. In South Africa, the National Institute of Health, reports that about 1000 are infected daily with HIV. Also 5400 sexually active people have volunteered for the HIV vaccine trial in South Africa. Globally, 18 million people living with the Virus cannot access Anti-Retroviral medications and 40 %( about 14 million) of those living with the virus are not aware that they have it.
In Nigeria, UNAIDS reports that about 60,000 babies are born with HIV annually .The figure has remained unchanged since 2009 and Nigeria remains the highest contributor of children acquiring HIV. The USA Consul-General says that about 600,000 Nigerians on Anti-Retroviral medications.
As of 2013, AIDS has killed more than 36 million people worldwide (1981-2012), and an estimated 35.3 million people are living with HIV,  making it one of the most important global public health issues in recorded history. Despite recent improved access to antiretroviral treatments in many regions of the world, the AIDS epidemic claims an estimated 2 million lives each year, of which about 270,000 are children. 
SIGNS AND SYMPTOMS
The symptoms vary according to the stage of the disease .About 49 % of the people living with the virus are unaware .This is worsened by the fact that the disease may be symptomless for a period of time or may present with influenza-like illness such as fever ,headache ,rash or sore-throat.
However,as the infection progresses ,it will affect the immune system adversely hence the person can show features such as swollen lymph nodes,diarrhoea and cough lasting for more than a month, unaccounted weight loss etc. When treatment is not started and the infection is allowed to progressed uncontrolled,the patient may develop opportunistic infections and other AIDS-related diseases such as Pulmonary Tuberculosis ,Cancers such as Lymphomas,Kaposi's sarcoma etc
THE WAY FORWARD
The first requirement is for everybody to go for Voluntary Counselling and Testing (VCT) in order to ascertain one's HIV status .When positive,the individual should leave positively and if negative,the individual should avoid being infected .For us to maintain an HIV free generation, the following must be considered and properly implemented:
Nigeria and other African countries should abhor some obnoxious cultural practices that help in the spread of the virus. On May 8th 2006, a Johannesburg High court acquitted Jacob G. Zuma, the current president of South Africa and current president of the governing political party,African National Congress (ANC) ,of rape charge brought against him in December 6th 2005. The accuser (the victim), a daughter of Zuma's deceased friend was known to Zuma to be HIV positive. President Zuma argued in court that he had shower immediately after having an unprotected sex with the known HIV patient to cut down the risk of contracting the dreaded disease .The court finally dismissed the case on the grounds that the sex was consensual but Zuma's defence of having showers after the unprotected sex with a known HIV patient was condemned by health experts, AIDS activists and the general public.
Also, a former president in that country once said that the happiest day in his life was the day he was circumcised. Although from medical perspectives, circumcision reduces the rate of HIV transmission but the way people were circumcised in South Africa where one sharp object was used for everybody present,really helped in the spread of the virus in other country .
THE ACTIVITIES OF SOME RELIGIOUS LEADERS
I have witnessed,in the course of my medical practice, many lives that were lost due to the activities of these religious leaders. Some of them claim to have cure for HIV all other diseases hence anybody that is newly diagnosed with HIV will prefer wasting his/her time with these religious leaders only to come back to the hospital when the disease has reached an advanced stage,when the opportunistic infections and HIV related cancers must have been established. At that stage ,medical science may have little or nothing to offer to these individuals .
This situation occurs when one partner tested positive to the virus while the other partner remains negative. The partner that is positive must be placed on ART no matter the CD 4 count in order to protect the other partner that is negative from being infected . They should also use barrier method of contraception according to WHO standard unless when they are ready for conception .
INCESSANT STRIKES IN THE HEALTH SECTOR
When a particular group wants to embark on any strike,the group must ensure that an alternative arrangement is made so that the HIV patients can get their drugs as at when due .
OTHER WAYS :
Federal Road Safety Corps (FRSC) should make it compulsory for each vehicle to have a packet of medical hand gloves .This is because many Nigerians are getting enlightened that one can get infected through contaminated blood hence at times when a road accident occurred ,victims that would have been saved had they been rushed to the nearest hospital ,normally lost their lives because people would wait for FRSC officials to arrive with safety hand gloves. More unfortunate is the fact that it may take some time for the FRSC officials to arrive at the venue . I will certainly not blame those who refuse to help the accident victims without medical hand gloves .
Also, I think the National Agency for the Control of Aids ( NACA) should map out strategies to go to our rural settings to enlighten the masses because many people in those settings are still naive of this deadly virus .NACA can as well go to secondary schools in order to enlighten the fledgling students there and Sex education can also be included in our academic curricula .
People should be enlightened on the ways of transmission of the virus and how to avoid them through safe sexual and good hospital practices , Safe antenatal and postnatal care ,Proper use of uncontaminated sharp objects/instruments and safe disposal of contaminated objects etc .The Government,at the federal,state and local government levels, needs to do more in ensuring that not only the ART drugs but also other tests and services should be rendered free to the HIV patients .In some settings ,some of them are mandated to pay for laboratory services hence those that don't have the money for the tests may not be able access full medical treatment.
If Nigeria is truly the Africa's largest economy ,I think we don't need to overemphasized on the need for all services and treatments to be rendered free to the victims of HIV infections .A legislation can also be enacted to ensure that each of these multinational companies contributes a particular percentage ( even if it is 1%) of their income to the HIV campaign . All forms of discrimination against people living with the virus must be discriminated at all costs.
Dr Paul John
Port Harcourt, Rivers state, [email protected], 08083658038