The false dilemma between prevention and treatment of HIV/AIDS have caused unnecessary losses, wasted precious time and should be avoided in the future, according to a keynote speaker at this week’s annual session of the UN Commission on Population and Development.
In calling for an end to competing strategies aimed at combating the pandemic, Dr. Paulo Roberto Teixeira, Senior Consultant for the National STD/AIDS Program in Brazil’s Ministry of Health, told a press briefing today that prevention works, even when it involves groups of people that are difficult to reach.
But the positive impact of anti-retroviral treatment – even in settings characterized by abject poverty – is also real and could no longer be ignored, he added, stressing the same message he delivered yesterday to the Commission, which this year is focusing on population, development and HIV/AIDS, with particular emphasis on poverty.
“To conduct effective strategies, countries need to recognize that sexual activity is an inherent part of human behavior and that clear messages and inputs, like male and female condoms, were indispensable,” he said.
Dr Teixeira draws on his experience as one of the architects of Brazil’s pioneering national AIDS strategy, which was created in 1983 after only four known cases of the disease had been diagnosed there.
A follow-on national plan during the 1990s has been hailed worldwide for controlling the spread of the epidemic, and for maintaining very low levels of prevalence in that huge country.
One of its key aspects has been free and universal provision of antiretroviral drugs and the promotion of local manufacturing of those drugs, he added.
Dr. Teixeira said that without exception, in all the countries where the epidemic had been curbed or decreased, policies to promote the use of condoms had been adopted.
There was no evidence that moral recommendations, such as abstinence and fidelity, had any impact on infection prevention and curbing the epidemic.
Although the promotion of safer sex involved serious cultural, ethical and religious matters, that could not be allowed to become a barrier to prevention.
“We need a global strategy that takes into account the AIDS epidemic in all actions to promote development and to fight poverty, including economic adjustment plans and foreign debt relief,” he stressed
Although most of the countries affected have already adopted public policies and allocated funds to fight the epidemic, he felt a much greater effort would be necessary, nationally and internationally, to face the spread of the infection, to treat the people affected and to minimize its impact on populations.
According to Dr. Teixeira, some of the urgent issues that needed to be given priority in national agendas included: moving forward with strategies to reduce the costs of antiretroviral and other drugs and providing universal and free access to those drugs to guarantee the necessary compliance and regularity of treatment.
He also proposed reducing the vulnerability of women by fully implementing the Action Plan adopted by the 1995 International Conference on Population and Development (ICPD), as access to adequate sexual and reproductive health services was the only possibility of controlling the epidemic among that group.