The numbers do not lie. And clearly show how the goal of going towards the control of HIV infection is still away to reach. Think: according to the surveillance report on the HIV/AIDS 2024 published by the Regional Office for the WHO for Europe and the European Center for the Prevention and Control of Diseases (ECDC), the number of New HIV diagnoses in Europe has increased in 2023.
Since the beginning of the massive diffusion of the HIV/AIDS virus in the early eighties, in the 53 countries that make up the European region of the World Health Organization (WHO), they have been diagnosed More than 2.6 million people with the HIV infection. According to the report, in 2023 there were 113 thousand new HIV diagnoses in 47 European countries, with a 2.4 percent increase compared to 2022. In short, we are not put well. Also because, with the paths that are being presented, there is a risk of slowing down again on a world scale in the challenge to the pathology, which should lead us to end of the epidemic by 2030, as established by the United Nations.
Despite the progress of scientific research and antiretroviral therapies, the lack of information, the low diffusion of the prep, the persistent stigma and the silence that still wraps the HIV prevent the decrease in the number of new infections. The last Italian data they indicate that in 2023 they were still recorded over 2,300 new diagnosesof which 60% occurred when the immune system is already compromised. These are just some of the key points that emerged during the conference “HIV Summit: ending the HIV Epidemic in Italy“, Held in Rome.
Prevention is possible
Prevention represents a key tool for changing the course and achieving the goal of drastically decreasing the number of new infections. And obviously passes through a simple but at the same time difficult concept to achieve. It is necessary to focus on a formula: U = u. Which means undetectable = UNTRANSMITTABLEor not detectable, not transmitted).
Therapeutic innovation, in fact, on the one hand allows you to think of effective and flexible pre-exposure protection, on the other the therapies capable of lowering the viral charge so much that it prevent the transmission of the virus by the person with HIV.
“Despite these undeniable successes, they still remain criticality that it is necessary to face globally. greater access to therapies Both to prevent infection and to take care of those who have contracted it. The history of HIV teaches us that each goal has been achieved thanks to the collaboration between scientific research, activism and political will. This is the model that we must relaunch today, to overcome the inequalities in accessing the treatments, to strengthen therapeutic adherence and put prevention to the center “
It is the comment of Stefano Vella, infectiousologist and teacher of global health at the Catholic University of the Sacred Heart of Rome.
The situation in Italy
Current prevention options, in particular the Pre-exposure prophylaxis (Prep), do not always fully respond to the needs of those who want or need protection against HIV. For many, existing solutions are not enough, and there is a growing request for prevention methods more accessible, effective and practical.
“At present, it is estimated that in Italy there are about 140,000 people living with HIV. To truly face the epidemic, it is essential to put in place structured prevention strategies, which make tools such as the HIV test, the condoms and above all the prepP accessible. Serve a decisive investment On information, culture of perception of risk and territorial services, such as checkpoints, which must also be strengthened thanks to public resources. Only with a shared and intersectoral response can we bring out the submerged, stop the new infections and build a truly effective prevention network “
Andrea Antinori, director of the clinical department of the National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS in Rome, said.
Difficult to achieve goals
The common goal is the construction of a concrete Roadmap, and not only for Italy, for the achievement of the UNIDS 95-95-95 targets, fundamental for End the HIV epidemic by 2030. But it does not seem really simple to achieve, also for the cuts that the USAplants for agencies that deal with public health, such as Usaid and CDC, in addition to the decrease in the commitment in WHO. This was recently mentioned by the general manager of the World Health Organization Tedros Adhanom Ghebreyesus. The risk is that for HIV you risk replicating what could happen with the resumption of cases of malaria.
“The suspension of most of the financing for Pepfar, the President’s Emergency Plan for AIDS Relief, has caused an immediate interruption of services for treatment, tests and prevention of HIV in over 50 countries”
It was his comment. But that’s not enough. The Fall of support programs For HIV they could lead to over 10 million additional cases of infection and 3 million deaths associated with it.
As for theEurope, the situation does not appear to be satisfactory. The old continent is not on the right way to achieve the sustainable development objectives (SDG) for 2030 on HIV as well as for tuberculosis, viral hepatitis B and C and sexual transmission diseases. To say it is the first monitoring report on the SDG published by the ECDC, the European Center for the prevention and control of diseases.
In short, it does not seem to end a story that began over 40 years ago. It was the month of March 1981, when the Centers for Disease Control (CDC) of Atlanta, in the USA received the report that in New York at least eight young homosexual men were affected by an aggressive form of Kaposi Sarcoma, a very rare tumor that is usually characterized by the benign trend and the predilection for advanced age. The following month, the CDCs were warned that the cases of pneumocystis Carinii pneumocystis are also increasing, also very rare up to that moment. Two more months and on June 5, 1981, the epidemiological bulletin of the MMWR Weekly CDCs published the article “Pneumocystis Pneumonia – Los Angeles“, Which marks theOfficial debut of the AIDS epidemic. Then, in May 1983 Luc Montagnier, of the Institut Pasteur in Paris, reported having isolated the new virus and calls him Lav (Lymphadenopathy-Associated Virus). But only in 1986 the new virus was officially “baptized” with its current name: HIV virus (Human Immunodficiency Virus).
