Low-income countries such as Madagascar lack funds to fight Aids

• Published date: 07 May 2024
• Publication title: Mail & Guardian: Web Edition Articles (Johannesburg, South Africa)

While there was no treatment for HIV at the beginning of the pandemic 40 years ago, more people are living healthy lives as medicines have been rolled out more widely. Today, globally, 29.8 million of the 39 million people living with HIV are on treatment (76%) compared to 7.7 million in 2010

Most people on treatment (93%) are virally suppressed, which means that they cannot transmit the virus to other people. However, gains made against the HIV pandemic are fragile in many low-income countries where international and domestic funding is lacking and many people are still waiting for treatment.

In Eastern and Southern Africa, the region most affected by the Aids pandemic — with more than 20 million people living with HIV — a number of countries are lagging behind in their HIV prevention and treatment efforts.

In Madagascar and South Sudan, a cocktail of problems, including a lack of international and domestic funding, means that Aids continues to claim lives.

This tragic situation also poses a direct threat to global efforts to end Aids by 2030, in line with the UN sustainable development agenda.

For example, Madagascar has recorded a 151% increase in the number of new HIV infections since 2010 and a 279% increase in Aids-related deaths during the same period. In addition, just 18% of the estimated 70 000 people living with HIV in Madagascar had access to treatment in 2022 and 3 200 people died of Aids-related illnesses.

Madagascar, which is one of the poorest countries in the region, has also been hit by a series of natural disasters, including chronic drought in the south and a series of cyclones, making it difficult for the country to recover economically and mount an effective HIV response.

According to the World Bank, natural disasters cost the country's economy 1% of gross domestic product every year, taking away resources that could go into strengthening essential health services.

Dire situation: A busy street in Madagascar's capital Antananarivo. The country has seen a sharp rise in Aids cases and deaths. ©UNAIDS 2024.

Malagasy authorities are equally worried about the HIV situation in the country. According to Dr Rivomalala Rakotonavalona, the director general of preventive medicine at the ministry of public health, "the number of new HIV infections is increasing in Madagascar".

Compounding the problem of rising new infections the authorities are missing the full picture because there is a lack of reliable data due to weak systematic surveillance...