Sustainable development goals in the context of HIV/AIDS

Sintesi dell’intervento pronunciato a Mosca, Università Lumumba, il 24 Marzo 2016

Everywhere in the world, the first and most important sustainable objective in combatting HIV is to have contact with all persons living with the virus, whether they are aware of their condition or not.

At the same time, the recent introduction of new drugs capable of effectively curing HCV has made it extremely important to identify all HCV carriers in order to have them enter into treatment. And considering that the means of contagion and transmission of HCV and HIV are similar, any public health screening measure addressing HIV should at the same time address screening for HCV.

The fact that HCV is curable and HIV is controllable removes part of the aura of sin and death that has surrounded these diseases, making them nearly “normal” diseases, whose screening should be considered similar to that of any other disease, without the current embarrassing stigmatization and discrimination.

Therefore, in Eastern Europe and Central Asia a great need has arisen for a public health action aimed at identifying all the HIV and HCV carriers in order to refer them to adequate treatment. Many of these live in the shadows, on the margins of society. The offer of screening must be brought out of hospitals and clinics to be done in the streets, reaching the most-at-risk groups that normally refuse any contact with the official health care system. Injecting drug users and sex workers are the groups who mainly fuel the epidemic; therefore, an aggressive strategy is essential to reach, identify and test these groups of the population with high risk behaviours.

In order to achieve this goal, it is essential to remove any barrier that could hinder this contact, such as the fear of negative consequences, particularly fear of discrimination, whether social, legal or moral.

It is necessary to forget the philosophy of the “war on drugs” and of “just say no”, that have caused so much damage and so many deaths in every part of the world.