CBC Radio: Aging with HIV is an absent reality for Africa, says Stephen Lewis

Advocate says 'desperation still exists' as millions are in need of treatment

SOURCE: CBC Radio
May 17, 2018

[Listen to this full episode of The Current on CBC Radio Podcast. Segment begins at 1:01:48.]

With modern advances in medicine, a growing number of Canadians are living longer with HIV. It's a privilege other parts of the world don't have, according to the former UN Special Envoy for HIV/AIDS in Africa.

Stephen Lewis has seen firsthand the lack of access to treatment and services available for people living with HIV in Africa and other countries. 

Lewis, who is also the co-director of AIDS-Free World and the board chair of the Stephen Lewis Foundation, spoke with The Current's Anna Maria Tremonti, after listening to our discussion about the implications for Canadians aging with HIV.

What stood out for you as you listened to that last conversation?

One of the things that stood out for me is the fact that we don't talk about the very difficult situation of Indigenous peoples in northern Saskatchewan and northern Manitoba and the downtown east side of Vancouver where the more sophisticated medical responses to aging and HIV are nowhere apparent. So within Canada there is also a divide.

But of course what stands out for me most vividly is the reality of a continent like Africa where the desperation still exists, and where millions of people are still without treatment. Ironically, there is tremendous community strength but there isn't the funding, and there isn't the full support of governments to do the kinds of things that are being done in Canada.

So what's the average life expectancy for someone in an African nation with HIV-AIDS?

It varies greatly but probably not beyond the 50s and early 60s. It has been itching upwards over the last many years as more and more treatment is available, and people are living longer.

But a lot of people still die relatively young.

Yes, about a million deaths a year — the great majority in east and southern Africa — and a couple of million of new infections a year. So we by no means [have] overcome the reality of HIV, although the world has to some extent lost interest.

And when you talk about new infections, there are some troubling statistics on the number of people who actually get diagnosed.

There are many people who don't know they're HIV-positive. And many people who don't come to a facility to be tested until the disease is quite advanced, so it's quite heartbreaking. There are select populations who are particularly at risk. We've never been able to address women and girls. There are thousands — literally weekly — of young women between 15 and 24 who are being infected. So obviously prevention has to be focused on.

So what are the barriers to getting treatment? We're talking about a lot of countries but where are the barriers the greatest?

The single greatest barrier continues to be funding. There's a terrible funding problem, which the world is largely not recognizing.

The Global Fund on AIDS, tuberculosis and malaria is the primary funder for many countries in the world that are desperately in need. But the Global Fund never asks for sufficient money at their replenishment conferences, so we're always running short.

Countries are beginning to get a little frantic about communicable and non-communicable diseases going after the same limited resources. What is needed is a much more generous, and careful, and urgent response to HIV AIDS, to malaria and tuberculosis. Tuberculosis is now the greatest single killer amongst infectious diseases in the world. More people die of TB than malaria and AIDS put together, so we have a real cauldron of perversity here.

This transcript has been edited for clarity and length.