Eritrea is on a rapid march towards achieving the UN’s Millennium Goal related to controlling and combating communicable diseases like tuberculosis, malaria and other communicable diseases. The incidence of these diseases has been declining.
HIV incidence reached its peak in Eritrea in 1996. However thanks to the coordinated efforts by multi-sectoral partners, under the leadership of the Ministry of Health (MoH), it dropped over the last 20 years: from the peak of 1.15 per 1000 in 1996 to 0.16 per 1000 at the end of 2015 –a reduction of 86%!
New infections, too, slowly decreased, especially in the age group of 15-24, from 0.29% in 1996 to 0.03% at the end of 2015, which is almost a 90%reduction.
Sister Nigsti Tesfamichael, Coordinator of HIV/AIDS control program at the MoH, said that the situation of HIV in our nation is promising. She says that based on the surveys conducted regularly, HIV/AIDS control in Eritrea shows encouraging results. Surveys are done: every two and five years, targeting different members of the society, specifically populations at high risk of getting infected, like female sex workers, soldiers and long distance truck drivers. Sister Ngsti said that data collected from service providing sites like health facilities, volunteer counseling and testing centers (VCT) as well as antenatal clinic (ANC) attending pregnant women.
The survey at ANC for attending pregnant women shows a clear range of infected members. The UNAIDs requires any nation to examine its infected population focusing especially on infected mothers attending ANC centers. The Ministry of Health works with interest to easily identify the infected population. Sister Ngsti added that there are persistent efforts in preventing new HIV infections and improving the style and quality of infected people’s lives. Concerted efforts are made to reduce stigma and discrimination, which are essential in controlling the spread of HIV.
The recently released United Nations Programme on HIV/AIDS (UNAIDS) Gap Report also shows that Eritrea is amongst a handful of countries in the region to have HIV prevalence rates below the 1% mark in 2013, where the estimate of HIV prevalence amongst adults is 0.6%, down from 1.3% in 2005. The average for Sub-Saharan countries was 4.7% in 2013.
In 1997, the National AIDs Control Programme (NACP) adopted the first comprehensive and multi-sectorial strategic plan on HIV/AIDS. Since then, prevention of infection has remained the backbone of the Eritrean response against the epidemic. The country has been focusing on the prevention of mother to child transmission, condom promotion and distribution, counseling and testing for HIV, treatment and control of sexually transmitted infections, transfusion of safe blood knowledge and awareness about HIV/AIDS.
The numbers of HIV counseling and testing sites increased 13 fold from 19 in 2001 to 255 at the end of 2015, increasing access to HIV testing. In Eritrea, premarital HIV testing is universal. Besides, testing of pregnant women for HIV at ANC sites increased from 2.4% in 2004 to 89% in 2015. Due to the confidence of HIV positive pregnant women in the Prevention of Mother to Child Transmission (PMTCT) services, 85% of the HIV positive pregnant mothers who attend ANC are known HIV positive who are already on anti-retroviral therapy (ART). Furthermore, facilities which provide antiretroviral therapy increased from 5 in 2005 to 28 in 2015 with more than 8000 people living with HIV AIDs receiving antiretroviral therapy. This contributed to the marked reductions in AIDs related deaths.
Eritrea has established The Association of People Living with HIV/AIDS (BIDHO). The organization combats stigma and discrimination, offers supportive measures for people living with HIV/AIDS (including micro-finance programs). In Bidho, taking care of patients is regarded as equally important as the notion of prevention. Building on the work of BIDHO, “The Good Samaritan Programme” has also been a useful initiative in reducing stigma. In collaboration with the Catholic Church, the program offers home-based care, as well as spiritual and psychosocial counseling to patients. It also assists people living with HIV/AIDS to access ART and follow up care, thus supporting them in maintaining employment, schooling, or other important activities.
The National Union of Eritrean Youth and Students (NUEYS) plays a big role in awareness raising programs within the community. The union promoted education and awareness of HIV/AIDs across all demographic groups. NUEYS has been working actively in the social marketing of condoms, communicating safe practices, offering educational programs, and providing youth or peer counseling.
People with high risk of infection such as female sex workers and long distance truck drivers were identified and made primary target for peer-based education in improving the general understanding for change of sexual behaviors. According to the Eritrean Population and Health Survey a marked reduction was seen in HIV prevalence among sex workers from 22% in 2002 to 5.8% in 2011.
However, even with the remarkable progress that has been made, Eritrean authorities are acknowledging that there is still work to be done. The goal, as outlined in the fourth national plan on HIV/AIDS, is to move towards ‘Zero New HIV Infections, Zero Discrimination And Zero AIDS-Related Deaths’. The major pillars towards this goal are scaling up access to HIV prevention services; scaling up access to treatment, care and support services; strengthening health systems and strengthening community systems. In addition to fighting the epidemic, improving the quality of life of the people affected is an objective.
Nurse Nigsti recommended that the people should cooperate with the ministry and together march towards zero new infections, zero discrimination and zero AIDs-related deaths. She advised people to be aware of their health situation and regularly visit VCT centers. This will be a definite acceleration towards a possible full control of HIV in Eritrea. Nurse Nigsti said towards the end that the ministry sympathizes with rape victims and “all they have to do is fearlessly report and make sure to visit us within 72 hours.”
A praiseworthy note goes to the Eritrean community which is keen to assist infected people living amongst them. They help them to be accepted and become productive members of the society!