African health experts meet in Kenya to address challenges in ending AIDS.

Representatives from various ministries of health and national HIV programs in Africa have just concluded a meeting in Nairobi, Kenya, to tackle issues related to the diagnosis and treatment of advanced HIV disease (AHD).

The muti-country meeting, held on the 20th and 21st of May 2024, was convened by the AHD Alliance and emphasized opportunities to reduce AIDS-related health disparities. The meeting also provided updates on the latest AHD epidemiological data, clinical guidelines, and scientific advances to combat the disease.

“I am particularly delighted by the presence of government officials and leaders from various countries in sub-Saharan Africa,” said Kenya’s head of HIV treatment and prevention services, Dr Rose Wafula, during the opening ceremony. “It is the prerogative of governments to offer leadership and commitment to providing an enabling environment, secure resources, and implement policies towards ending AIDS-related mortalities in Sub-Saharan Africa.”

Dr Rose Wafula, Kenya’s Head of the National AIDS and STI Control Program (NASCOP) during the opening ceremony.

The World Health Organization statistics  estimated that 2 million people are living with HIV in sub-Saharan Africa, and more men than women have the disease.

“Men in sub-Saharan Africa are much more likely to have advanced HIV disease than women, despite fewer men having HIV overall,,” said Ajay Rangaraj, the advanced HIV diseases lead at WHO during the session on AHD epidemiological update and overview.

Kenya had 18,000 AIDS-related mortalities in 2022, the majority of which were caused by TB and Cryptococcal meningitis.  Despite advancements in access to antiretroviral treatment, hundreds of thousands of people with advanced HIV die each year from Cryptococcal meningitis because affordable and accessible medicines to treat these infections are lacking.

“Analysis of our program data shows that up to 1 out 3 persons living with HIV who are either new on treatment, with treatment failure or returning to care after interruption are presenting with AHD. It is therefore our collective responsibility as stakeholders to come together and urgently find solutions and practical ways to prevent, diagnose, treat, and follow up all patients with advanced HIV disease,” said Wafula.

In terms of cryptococcal meningitis, Rangaraj added that sub-Saharan African countries are leading in cases and deaths, led by South Africa, Kenya, Mozambique, DR Congo, Tanzania, Zambia, Nigeria, Malawi, Zimbabwe, and Ethiopia.

The meeting also addressed the latest developments, initiatives, and bottlenecks among key AHD donors, country-level supply chain challenges and solutions, and new tools and technologies in AHD diagnostics and therapeutics.

The Drugs for Neglected Diseases initiative (DNDi) in Nairobi  shared that they are working with its partners to reformulate the current flucytosine treatment into a sustained-release formulation.

“At DNDi, we consider advanced HIV disease a neglected disease because there’s very little research and tools to prevent, screen, diagnose, and treat. While HIV has received a lot of attention over the years, advanced HIV suffers from limited attention paid to either innovating on existing tools or finding new tools for preventing AIDS-related deaths, “said Professor Samuel Kariuki, Eastern Africa Director, DNDi.

Professor Samuel Kariuki, Eastern Africa Director, DNDi during the opening ceremony.

The initiative will help patients adhere to treatment and simplify healthcare workers’ care. Communities were urged to take the lead in the response, and integration of HIV and other health services, such as screening for non-communicable diseases and mental health.

Other covered topics included  community-level progress and challenges, roundtable discussions on the CD4 landscape, advanced HIV disease in children, non-communicable diseases, and AHD.

AHD alliance, comprises DNDi, End AIDS Action Group, Fight AIDS Coalition, Infectious Diseases Institute, Makerere University, Uganda, Médecins Sans Frontières (MSF), Partners in Hope, and St. George’s, University of London.

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