While progress has been made, AIDS remains a significant challenge. Last year, globally, 630,000 people died from AIDS-related illnesses, 1.3 million were newly infected with HIV, and 9.2 million lacked access to life-saving HIV treatment. In Zimbabwe in 2022 alone, there were 20,000 AIDS-related deaths and 17,000 new HIV infections. Against that backdrop, under the motto “AIDS IS NOT OVER: Address inequalities, accelerate inclusion and innovation”, the 22nd ICASA conference was held in Harare, Zimbabwe, from 4-9 December 2023.
Key ICASA2023 objectives were: (1) Mainstream respect for equity, inclusion and diversity in the control and mitigation of the impact of diseases. (2) Sustain and increase domestic financing and community response. (3) Respond to HIV/AIDS, COVID-19, Mpox, Ebola and any other emerging diseases. (4) Mitigate the impact of Hepatitis, Tuberculosis and Malaria through health systems strengthening. (5) Generate and provide evidence-based data for policy formulation.
During the conference, a lot of attention was dedicated to community programs. Communities clearly play a pivotal role in boosting AIDS response progress. The focus on communities was already emphasized on 2023 World AIDS Day, 1 December, and it also featured in a new UNAIDS report, “Let Communities Lead”. The impact of community-led organizations in AIDS response programs extends beyond tackling HIV/AIDS, as they can also play a role in addressing other pandemics and health crises. Empowering communities to lead fosters the development of healthier and more resilient societies. However, numerous communities encounter barriers to assuming leadership roles and community-led initiatives are often undervalued, inadequately funded, and in certain instances, subject to opposition. Globally, funding for communities has decreased by 11% over the past decade, dropping from 31% in 2012 to 20% in 2022.
The 22nd ICASA conference also paid attention to non-communicable diseases (NCDs), which are causing significant mortality in people with HIV. Despite increased life expectancy due to antiretroviral therapy (ART), diagnoses of NCDs for people with HIV are fewer compared to the general population. In Harare, compared with the general population, more (NCD related) deaths occur in individuals on ART, often carrying co-morbidities as tuberculosis, renal failure, cancers, and meningitis. A comparison between patients on ART and the general population over 40 in Zimbabwe showed similar rates of hypertension but lower rates of diagnosed diabetes among those with HIV. The lack of prior diagnoses emphasizes the need for better screening tools in HIV treatment centers. Of note is the availability of the WHO package of essential noncommunicable (PEN) disease interventions for primary health care, a prioritized set of cost-effective interventions for the detection, diagnosis, treatment and care of cardiovascular diseases, diabetes, chronic respiratory diseases, and cancer early diagnosis, designed to be delivered at an acceptable quality of care, even in resource-poor settings. Another suggestion is Access Accelerated’ s Public Health program platform, which shares valuable learnings and knowledge on NCD access programs, with data and information on access to screening and treatment of NCDs in low- and middle-income countries, captured from 2018 to 2021.
ITM alumni meeting
The NCD focus was also a topic of discussion during the ITM Alumni meeting, which was held a few days before the start of the ICASA conference. The meeting was chaired by ITM alumnus Richard Makurumidze (University of Zimbabwe). The event provided an exchange of experiences and expertise by ITM alumni from Zimbabwe and other African countries, focusing on: ‘Managing comorbidities and achieving HIV control’ in different African countries, with presentations by Komivi Mawusi Aho (Togo), Tarisai Kufa-Madzivanyika (Zimbabwe), Christopher Akolo (Nigeria). ). The alumni meeting also focused on financing and inclusive governance to sustain the HIV response with presentations byEric Ssegujja (Uganda) and Tinashe Goronga (Zimbabwe). The meeting served as well as a perfect momentum to discuss alumni needs, challenges & expectations with a special focus on Zimbabwe ITM alumni and a proposal for a renewed collaboration between ITM and Zimbabwe. Throughout the meeting, interactive and engaged Q & A discussions were moderated by Richard Makurumidze, Maria Zolfo and Bernadette Hensen. All in all, the ITM Alumni meeting provided an opportunity to connect and reconnect with ITM alumni representing a diversity of ITM courses: MPH, MTM, PhD, PHARMA, SCREM, DR TB, SC SRH & HIV.
PS: ITM supports Alumni with mobility grants if ITM Alumni meetings are organized linked to a specific conference.