Bloodborne HIV: Don't Get Stuck!

Another Millennium Development Goal (MDG) scapegoat. It sounds like bloody cheek to suggest that Kenya’s failure to reduce new HIV infections as quickly as predicted is a result of health personnel strikes. True, there have been strikes, but the country’s health services were decimated years ago by the strictures of international financial institutions and sheer neglect, and allowed to rot. Successive governments have also done an appalling job when it comes to industrial relations.

According to the article, Prevention of Mother to Child Transmission (PMTCT) coverage “fell by 20 percent in 2011-2012”, from 66% to 53%, representing 13,000 children newly infected with HIV. The 2015 target is close to 100% but, at 38%, Kenya seems unlikely to reach it, and the same could be said for most other African countries. However, there is nothing to back up the ridiculous claim that strikes played a significant part in such a massive fall in coverage.

The article does state that “Experts agree on the main reason behind the reduction in PMTCP – disruptions in the health services”, but that’s hardly a smoking gun. There have been numerous antiretroviral drug stockouts and other disruptions, for various reasons, and these may have a lot more to do with such a large drop in coverage.

Another possible problem in meeting the MDGs could be a transition process that PEPFAR funded programs have been going through. In South Africa it is estimated that “between 50,000 and 200,000 people may have fallen out of care in the transition”. Indeed, there are probably several reports available that would point to the reason for the fall in coverage, but journalists and politicians don’t seem to like reading reports.

Yes another article from Kenya has come up with an even more impertinent suggestion. It claims that there has been an ‘upsurge’ in gay sex, which is slowing the ‘war’ on HIV. The article suggests that Kenya has achieved a lot, with prevalence dropping from 7.2% to 5.6%. Perhaps they are expecting the next set of results to be less flattering.

Men who have sex with men face very high risk of being infected with HIV, and of transmitting it. But Kenya and most other African countries have refused to accept that this is a group that needs special attention, preferring to accept the HIV industry’s contention that most HIV transmission in African countries is a result of unsafe heterosexual sex. It sounds far more manly, doesn’t it.

Because transmission has decreased in some populations, the contribution of infections from men who have sex with men may look like it is increasing. But the claim that the country may not meet some of its MDGs because of an ‘upsurge in gay sex’ is as outrageous as the claim that industrial disputes are disrupting progress in reducing new HIV transmissions.

These are cheap shots at health personnel, gays and traditional birth attendants. But governments, NGOs, UNAIDS, donors and the lucrative HIV industry need all the help they can get when it comes to explaining why billions of dollars did not seem to result in particularly rapid declines in HIV transmission. There will be more to come.