INTEREST 2020 Joep Lange Award winner publishes editorial on INTEREST 2021

INTEREST 2020 Joep Lange Award winner, Dr. Joseph Baruch Baluku, recently published an editorial recapping INTEREST 2021 while simultaneously providing insight on the ongoing fight against HIV in Africa. The editorial was published in Therapeutic Advances in Infectious Disease. The full editorial can be found here. For more information on Dr. Baluku and his achievements in the field of HIV, read his post-win interview here.

INTEREST 2021 conference: is Africa still hoping against hope in the fight against HIV?

The International Conference on HIV Treatment, Pathogenesis, and Prevention Research of 2021 (INTEREST 2021) was held virtually between 12 and 14 October 2021. INTEREST is a premier conference on HIV in Africa. INTEREST 2021 featured exciting updates on HIV and COVID-19, novel HIV prevention and treatment technologies and the future of HIV in Africa. However, one could not help but notice the glaring inequalities that are still faced by people with HIV (PWH) in Africa.1 Despite the tremendous progress observed in sub-Saharan Africa (SSA), the region is still the worst-affected and most countries are unlikely to achieve targets for annual HIV testing and condom use by 2030.2 The ongoing COVID-19 pandemic has not helped the situation. Interruptions in the supply and access to antiretroviral therapy (ART) and other HIV services were projected to have catastrophic effects in SSA. A 6-month interruption of ART supply across 50% of PWH was projected to result in an excess of 296,000 deaths over a period of one year.3 Furthermore, interruption in services was projected to increase new HIV infections at the population level and results in overall poorer clinical care for PWH due to overstretched health systems. However, health systems in SSA have proven to be resilient by re-orienting HIV health care services. Programmes have adopted multi-month dispensing of ART, telephone and social media counselling, community distribution of ART by mobile vans, delivery of HIV services at home and scaling-up of self and home-based HIV testing.4 It is however unclear how sustainable these interventions will be if countries cannot access the COVID-19 vaccines that would otherwise obviate the need for improvisation. As of June 2021, only four countries in SSA had vaccinated more than 5% of their populations with at least one dose of the COVID-19 vaccine.5 At INTEREST 2021, Dr. John Nkengasong, the director of the Africa Centres for Disease Control and Prevention, woefully remarked how this is not due to vaccine hesitancy in the region but rather a lack of access. In fact, < 1% of vaccines are manufactured in Africa, leaving the continent vulnerable to future pandemics.6 The lack of access to novel therapies is a story all too common in SSA. While ART coverage was  > 80% in certain middle-income countries in the mid-2000s, only 17% of eligible PWH in SSA were on ART.7 As such, countries in SSA had to ration ART using criteria mostly set by international funding agencies.8 One is left to wonder whether the new HIV prevention therapies presented at INTEREST 2021 will be readily available and affordable, particularly for women in Africa who continue to bear the brunt of the HIV epidemic.

This piece was taken from an editorial in the Therapeutic Advances in Infectious Disease Journal.