Greece was never known for the quality of its health system. But in 2009, at least among drug users, HIV was not a major threat — just 15 were diagnosed with the virus that year.

Then came the financial crisis and the harsh austerity that followed. In 2011, another 256 drug users learned they had HIV. In 2012, the number was 484. The reason for the explosion: the Greek financial crisis and the harsh austerity measures that followed.

The ballooning epidemic illustrates the importance that politics and policy plays in the fight against AIDS. Though there’s still no cure, experts say we already have the tools to eliminate HIV as a threat to human health.

The problem is not the science. It’s the political will — and the fact that the most vulnerable tend to live on the margins of society. Lingering homophobia in some countries holds back men who have sex with men from getting care. Where they’re accepted, sex workers and migrants are still at risk — and blamed for the spread of the epidemic.

“These groups are generally discriminated [against] and stigmatized,” making them less likely to seek help with prevention and treatment, said Nedret Emiroglu, the chief for communicable diseases in the World Health Organization’s European Region. HIV isn’t just a medical condition; it’s “a social disease,” she added.

Marios Atzemis was one of the Greek drug users diagnosed with HIV in 2011. He had been addicted to heroin and a regular in Athens’ open-air drug markets well before the crisis. Then in 2010, street services to help drug users stay safe lost a third of their funding. Atzemis stopped seeing the vans that used to distribute fresh syringes, even as new users were entering the scene, shooting newer, cheaper drugs.

“As a community of drug users, we didn’t have an effective means of defense,” said Atzemis, now a harm-reduction coordinator with the Association of People Living with HIV Greece (Positive Voice). “It was very easy for us to be targeted and to be scapegoats.”

The doctor refused to put him on anti-AIDS antiretrovirals medication until he got clean at a rehab clinic — even though the clinic was on the brink of being shut down for lack of funding.

For Atzemis, now 44, this was enough motivation to wean himself off the drugs. “It didn’t work the same for other people,” he said.

Whether it’s inconsistent funding for programs that are working or social stigma blocking help from getting to the people who need it most, activists and public health professionals say even relatively wealthy countries are struggling to close the remaining gaps in the fight against the epidemic. Worldwide, just four countries — Burundi, the Dominican Republic, the Democratic Republic of Congo and Portugal — are on track to meet the global goal to reduce AIDS deaths by 75 percent between 2010 and 2020, according to UNAIDS.

AIDS is in many ways a 21st century success story. The epidemic tore communities apart in the 1980s and 1990s. In 2000, only 680,000 people were on antiretroviral therapies. Today, 62 percent of people with HIV — some 23.3 million people — have access to the life-saving drugs. New infections are down 40 percent since their peak in 1997, according to UNAIDS.

Early diagnosis and speedy treatment create their own virtuous side effect. The drugs that prevent HIV from exploding into full-blown AIDS also prevent HIV-positive people from transmitting it to others.

London serves as an example of what is possible. An estimated 95 percent of people with HIV in the British capital have been diagnosed with the virus. And of those, 97 percent of them have such low levels of the virus that it’s undetectable (and therefore not contagious).

On top of that, some antiretrovirals taken in advance of exposure, a treatment known as PrEP, can actually drastically reduce people’s chances of getting infected in the first place. Lower-tech methods like condom campaigns and needle-exchange programs help prevent HIV’s spread further. There’s justified optimism that London can end HIV transmission in the coming years.

Then there’s what happened among drug users in Greece. Backsliding threatens progress worldwide. Complacency is another major threat.

Funding to fight HIV dropped in 2018 compared with the previous year, the NGO Doctors Without Borders warned in a report published this month. This dip in donations, the first since the turn of the century, could trigger an “epidemic rebound” in some poor African countries that can’t afford to pick up the slack left by the loss of international aid.

HIV diagnoses are down in the EU as a whole; however, in a third of the bloc’s countries, the trend is moving the wrong way. Ireland, for example, saw a record high number of diagnoses in 2018. Public health officials pointed the finger at migrants, but activists argue the country needs better access to PrEP and self-testing kits.

Indeed, late diagnosis is a problem around the EU, where about half of patients don’t find out they’re HIV positive until several years after infection, according the the European Centre for Disease Prevention and Control.

Sex between men is still the top mode of transmission in the EU, but it’s also a bright spot: Diagnoses among this population are down 20 percent between 2015 and 2017. PrEP has the potential to drive further improvements, but it’s not reimbursed in many countries, and the principal developer, Gilead, has found itself in some bitter pricing disputes.

Russia represents a horrifying story of complacency, denial and discrimination. The epidemic there didn’t take off until the mid-1990s, and then mainly among people who inject drugs. But the country refused to fund harm-reduction measures, and in 2013, it outlawed targeting information to gay men. More recently, its rate of infections has been increasing by 10 to 15 percent annually, with 100,000 infected in 2017 alone, and most transmissions are between heterosexual couples.

In Greece, government officials, civil society and activists were relatively quick to acknowledge the problem. While the government faced heavy criticism from human rights advocates when it posted photos of alleged HIV-positive prostitutes, the public health community also rallied, doubling the number of needle exchanges in 2011 and cutting wait times for addiction treatment. Greece also introduced a novel system of paying drug users €5 to get tested and €3 for referring others, while connecting them with treatment and other services. That approach is now considered a model for responding quickly to outbreaks.

For better or worse, Greece shows that a country doesn’t need to fix its entire health system to deal with HIV. As a case in point, its progress on AIDS hasn’t translated into progress on correlated problems like hepatitis C. Those rates rose during the debt crisis and haven’t ebbed much; based on 2017 data, around 62 percent of drug users in Greece have tested positive for hepatitis C.

The crisis-era HIV outbreak marked “the first time that all the stakeholders — NGOs, state structures, every single one — worked together to face this epidemic,” said Atzemis. “And probably the last time.”

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SYDNEY — No one needs a scientific study or trip to the doctor to know that being overweight or obese is generally unhealthy, but a recent study has illustrated just how detrimental that excess weight can be. According to a study by Australian researchers at the George Institute for Global Health and the University of Sydney, young adults who are classified as obese are more likely to die up to 10 years earlier than those who aren’t obese in their 20s.

Taken as a whole, the study estimated that 36.3 million years of life will be lost over the lifetime of present-day Australia’s adult population due to excess weight and obesity. Men are expected to lose 27% more years of life expectancy on average than women.

“We know that excess weight has an impact on your health, but to have excess weight as a young adult is really significant on life expectancy. We are talking about losing up to 10 years of your life,” says lead author Thomas Lung, of the George Institute of Global Health, in a statement.

The statistical model used by Dr. Lung calculated the expected amount of weight adults will add each year depending on their age, gender, and current weight. It also took into account current life expectancy in Australia, along with a higher mortality rate among people with excess weight.

The model predicted the remaining life expectancy for Australian individuals in their 20s, 30s, 40s, 50s, and 60s in four weight categories, ranging from healthy to severely obese. The model also calculated the number of years lost for overweight people in each age group compared to individuals with a healthy weight.

While these statistics are only regarding Australia, researchers say they can conceivably apply to to other high-income countries like the United States, Canada, or the United Kingdom.

Among the study’s key findings:

• Men and women currently in their 20s with average to healthy body weight can expect to live another 57 to 60 years. However, individuals in their 20s in an obese weight category will lose an average of six years among women and eight years among men. Those who are severely obese have even shorter projected lifespans; severely obese women will lose eight years of their lives, and men will lose 10 years.
• Differences among genders mean that Australian men in their 20s today will lose 5.6 million years of life due to excess weight, while women in the same age bracket will lose 3 million years.

There has been a threefold increase in obese Australians since 1995, and researchers say their findings emphasize the urgent need to institute better public awareness, education, and support facilities in order to combat this growing problem.

“There is the assumption that overweight and obesity is a problem for people in middle age, and that people in their 20s and 30s are in the prime of their lives. Yet currently, only 43% of Australian men in their 20s and 34% in their 30s are in a healthy weight range, which is worrying.” comments co-author Associate Professor Alison Hayes.

“Our model predicts adult obesity prevalence will increase to 35% by 2025. We need to act now and have an obesity prevention strategy targeting adults at all ages and in particular young adults,” Dr. Lung concludes.

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I may be retired from the news business, but I still know a good story when I see one. Reports now tell us that more children than ever are growing up free of deadly diseases such as AIDS, tuberculosis, and malaria.

Just 20 years ago, a very different picture was being painted. AIDS was ravaging an entire generation; hundreds of thousands of children were dying before their 5th birthday simply due to a single bite from a malaria-infected mosquito; and TB spread like wildfire in many impoverished communities, leaving family members sick and unable to work.

My dear friend, the late former United Nations Secretary-General Kofi Annan called the fight against this loss of humanity “the greatest challenge of our generation” and quickly asked the United Nations Foundation, which I had recently launched at the time, to help be a part of the solution.

We joined with a range of partners to support the Global Fund to Fight AIDS, Tuberculosis and Malaria, which brings together governments, advocates, and experts to mobilize resources, coordinate efforts, and invest in innovative programs that are turning the tide against these three devastating diseases.

The work of the Global Fund has changed the landscape when it comes to AIDS, TB, and malaria: 18.9 million more people are now living long lives with HIV treatment and 131 million mosquito nets were distributed just last year to protect children around the world from the threat of malaria. Because of public and private sector partners uniting to take a stand, the Global Fund partnership has saved nearly 32 million lives and reduced the number of deaths caused by these three diseases by 40% in countries where the Global Fund invests its support.

Think about that: 32 million lives saved. That’s more than three times the population of the state of Georgia being given the opportunity to live healthy, productive lives all because people came together in partnership to fight, refusing a world where AIDS, TB, and malaria are allowed to destroy our communities.

This is a good news story so far — but how it ends is still to be determined. Right now, the progress we’ve made against these diseases is very fragile and, in some cases, such as with malaria, it’s stalled due to insufficient resources and lack of political will to carry on the fight.

It’s up to all of us to decide whether we protect the progress we’ve made and keep moving forward or become complacent and watch on as these diseases gain ground once again. If we lose progress on health, so much more around the world is at risk — from the stability of communities to the productivity of businesses.

We’re a mere 10 years out from the 2030 deadline to achieve a better future for people and our planet to which we committed under the Sustainable Development Goals – the world’s shared to-do list, adopted by nations worldwide four years ago. The success of the Global Fund’s efforts is linked to the success of these global goals — from ending poverty to achieving gender equality to ensuring health for all.

On Oct. 10 in Lyon, France, many countries and private sector partners stood up for progress, pledging more than $14 billion for the Global Fund’s work over the next three years. While these pledges are very important, they are not enough. All of us, especially engaged citizens like you and me, need to keep raising our voices to make sure that the fight against AIDS, TB, and malaria remains a priority on the global agenda.

We need others to step up the fight and contribute to achieving the world that my friend Kofi envisioned. We need more compassion, more engagement and most importantly, more collective action than we currently see in our often-fractured world. I call on private sector partners, country governments, and global citizens to help us all deliver on our promise for a better world.

The post Opinion: Continuing the fight against AIDS, TB, and malaria appeared first on MyMedicPlus.