“Engaging communities to bridge the case detection gap”.
On this very important day, I would like to join the global community in observing the World AIDS Day, 2019. This is a good opportunity for all of us to come together in raising mass awareness, to show our support for the people living with HIV (PLHIV), and to remember those who have died from an AIDS-related illness. It is also a day to acknowledge the dedication and hard work put in by those working in the area of HIV and AIDS prevention, care and treatment services.
Today, the total estimated people living with HIV in the world have reached 37.9 million with 1.7 million new infections in 2018 alone. In Bhutan since 1993, the cumulative number of cases reported as of November 2019 is 687 (52% male and 48% female). About 15% of the total reported cases are between the ages of 15-24 years and 70% lies between 25-49 years at the time of detection. Ninety-Three per cent of them have acquired HIV infection through the heterosexual route, 5.5% mother to child transmission, 0.15% from anal sex and 0.44% each through injecting drug use and blood transfusion (Outside the country).
This year’s theme for the World AIDS Day is “Communities make the difference” to highlight the importance of engaging the communities in reaching the unreached populations with the comprehensive HIV and STIs prevention services. The involvement of these communities (key and affected populations) from the planning perspective to the implementation of the programs has become crucial than ever before with the changing face of the HIV epidemic. In line with the global theme, the Ministry of Health will be observing this year’s World AIDS Day with the national theme, “Engaging communities to bridge the case detection gap”. We are committed to strive harder in making people know their HIV status through innovative means of HIV testing and link them with appropriate care, support and treatment services. Therefore, community participation is very important for developing realistic interventions and getting them tested on time. This will ultimately help us prevent further transmission of the virus and will ensure a quality life for those infected with HIV through timely care, support and treatment services.
Our united effort through the active participation of the communities and other stakeholders will help us to bridge the current case detection gap of 45%. Within one year (Nov 2018-Nov 2019) we have diagnosed about 60 HIV cases, which is the highest number ever recorded since the detection of the first case in 1993. This has resulted in bringing down the case detection gap from 50% in 2018 to 45% in 2019, thus narrowing the gap by 5%. However, we still need to accelerate our effort to enhance the case detection by embracing the best and innovative testing methods like community lead testing and self-testing to enable 569 PLHIV of the estimated 1265 HIV cases in Bhutan to know their status by the year 2025. Today the testing facilities are available in all the hospitals, basic health units (BHUs) and at HISC (Health Information and Service Centers) in the major towns of Bhutan. In addition to these facilities, we have also initiated Mobile HIV Testing services including the testing services in the private diagnostic clinic to provide better choices for our people. We urge all of you to come forward for testing because it is the only means to know your status for timely treatment.
The consistent effort from the Ministry of Health, our developmental partners, Civil Society organizations and the communities have made good progress in responding towards the prevention and control of HIV over the last two decades. However, we still need to put more effort in realizing the national goal of 90-100-90 targets. We want to achieve 90% diagnosis of the estimated 1265 cases, 100% of those diagnosed to be put on treatment and then 90% of those on treatment to achieve viral suppression by 2023. One of the biggest challenges is in achieving the 1st 90 that is mainly because of the prevailing stigma and discrimination both at the societal level and within the key affected populations thus delaying the testing and treatment. HIV-related stigma and discrimination are all based on actual or perceived health status, race, socioeconomic status, age, sex, sexual orientation or gender identity which makes our people vulnerable to HIV and STIs. Therefore, it is important for everyone not to discriminate the key affected communities but to show support in breaking the barrier of stigma and discrimination.
On this World AIDS Day, I would like to take this opportunity to express my heartfelt gratitude to Her Majesty Gyalyum Sangay Choden Wangchuck for pioneering HIV and AIDS prevention activities across length and breadth of our country in last two decades through the high-level advocacy initiatives. I am also pleased to acknowledge the generous support rendered to us by our developmental partners and civil society organizations. We all must pledge to be responsible in the prevention of HIV and AIDS, so that together we can pave the way for achieving the 90-100-90 target to end the AIDS as a public health threat by 2030 in Bhutan.