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High numbers of people dying from AIDS in sub-Saharan Africa, MSF reveals.
AN unacceptably high number of people continue to develop and die of AIDS[1]-related diseases across sub-Saharan Africa. They remain left out of the global HIV response without access to treatment that prevents AIDS or the medical care they need, says international medical humanitarian organisation Médecins Sans Frontières / Doctors Without Borders (MSF).
In MSF’s briefing paper “Waiting isn’t Option: Preventing and Surviving Advanced HIV[2]” , data from MSF-supported hospitals presented at the International AIDS Society (IAS) Conference on HIV Science in Paris today, highlights that in MSF-run and MSF-supported hospitals in Democratic Republic of Congo (DRC), Guinea, Kenya and Malawi, people arrive with such severe immune failure that overall mortality for patients presenting with AIDS is between 30-40%. Almost one-third of those deaths occur within 48 hours.
The main causes of illness and death are due to treatment failure or interruption and late diagnosis leading to delayed treatment. Unlike in the early 2000s, when little treatment was available, more than 50% of AIDS admissions at referral hospitals supported by MSF had already started antiretroviral therapy (ART), with many showing clinical signs of treatment failure. “Despite extensive access to antiretrovirals, there has not been the expected drop in late-stage presentations of HIV in developing countries. What’s different is that among people admitted to hospitals, the majority are already diagnosed and many have been on treatment for several years. In Kenya, in Homa-Bay, where antiretrovirals have been available for years, half of the patients hospitalised AIDS cases show signs of treatment failure. We’re pushing to switch these patients to second-line antiretrovirals more rapidly,” says David Maman, MSF Epicentre epidemiologist.
At community level, MSF population surveys also show that a proportion of people living with AIDS in communities in southern and eastern Africa remain untested and untreated. Around 10% of people living with HIV in districts of Malawi, Kenya and South Africa had AIDS, of which 47% had never received testing or treatment. “People are still being diagnosed late. We need new ways to detect those left out, early on, before they arrive at hospital in often fatal condition or die at home without ever receiving care. Stigma and lack of information still remain high, leading to delayed treatment or no testing and treatment at all. This illustrates the need to complement increased antiretroviral coverage at community level with improved care for those on treatment for years,” says Gilles van Cutsem, MSF HIV Advisor.
Clinicians, including from MSF, have increasingly voiced concern over the lack of attention and means going towards the prevention and treatment of AIDS across Africa. The World Health Organisation (WHO) yesterday issued its first ever guidelines for the treatment of AIDS in low-resource settings. While this is a positive step forward, MSF calls for the urgent implementation of the guidelines with additional measures to address potential drug resistance and treatment failure.
Key interventions urgently needed to prevent and treat AIDS include the rapid rollout of ‘test and start’, CD4 baseline testing at ART initiation, routine viral load testing, point of care diagnostics for tuberculosis, improved treatment for cryptococcal meningitis, rapid switch to second-line ART for failing and advanced patients, and swift, effective and accessible treatment for opportunistic infections. MSF is also calling for models of care geared towards prevention, treatment and support for patients with AIDS, and free specialised hospital-based care free of charge for patients[3].
MSF is also concerned that the situation will only be exacerbated as funding for the global HIV response continues to stagnate. Anticipated cuts in US funding to the Global Fund (17%) and PEPFAR (11%) from 2018 onwards will see many countries facing further grant restrictions. Shrinking funding envelopes and the need to preserve ART purchases will imperil community responses, including targeted testing and improved treatment literacy and adherence, while starving essential investments needed for health workers, laboratory and diagnostics.
“Each patient presenting with AIDS is a terrible testimony to the challenges to get timely access to test & treatment and to continue their ART uninterrupted. With global political will and funding for HIV on the decline, not only is the broader fight against the virus at risk go into reverse but specifically these patients arriving at hospitals sick with AIDS will have any hope of reprieve snatched away,” says Mit Philips, MSF Health Policy Advisor.
[1] Acquired Immune Deficiency Syndrome (AIDS) is defined as a CD4 count of less than 200 or WHO clinical stage 3 or 4.
[2] Advanced HIV is synonymous with Acquired Immune Deficiency Syndrome (AIDS).
[3] MSF’s report ‘Les Négligés de L’infection au VIH’ also released at IAS, shows the lack of referral-based hospital care for treating AIDS in Kinshasa
US car giant Ford on Wednesday announced 4,000 more job cuts in Europe, mostly in Germany and Britain, in the latest blow to the continent’s beleaguered car industry.
“The company has incurred significant losses in recent years,” Ford said in a statement, blaming “the industry shift to electrified vehicles and new competition”.
The move will affect 2,900 jobs in Germany, 800 in the UK and 300 in western Europe by the end of 2027, a Ford spokesman told AFP.
“It is critical to take difficult but decisive action to ensure Ford’s future competitiveness in Europe,” said Dave Johnston, Ford’s European vice-president in the statement.
The company also said it was adjusting the production of its Explorer and Capri models, resulting in reduced hours at its Cologne plant in the first quarter of 2025.
Europe’s car industry has been plunged into crisis by high manufacturing costs, a stuttering switch to electric vehicles and increased competition in key market China.
Germany’s Volkswagen has been among those hardest hit, announcing in September that it was considering the unprecedented move of closing some factories in Germany.
“The European automotive industry is in a very demanding and serious situation,” Volkswagen CEO Oliver Blume said at the time.
Ford had already announced in February 2023 that it was planning to cut 3,800 jobs in Europe, including 2,300 in Germany and 1,300 in Britain.
The company said then it was planning to reduce the number of models developed for Europe, concentrate on the profitable van segment and speed up the transition to electric vehicles.
Ford currently has around 28,000 employees in Europe with 15,000 in Germany, according to the company’s works council.
President Bola Tinubu has approved the dissolution of the Governing Council of Nnamdi Azikiwe University (UNIZIK), Awka, Anambra State, and the removal of the institution’s Vice-Chancellor, Prof. Bernard Ifeanyi Odoh, and Registrar, Mrs. Rosemary Ifoema Nwokike.
The council, chaired by Ambassador Greg Ozumba Mbadiwe, comprised five other members: Hafiz Oladejo, Augustine Onyedebelu, Engr. Amioleran Osahon, and Rtd. Gen. Funsho Oyeneyin.
A statement released on Wednesday by presidential spokesperson, Bayo Onanuga, revealed that the council was dissolved following reports of procedural violations in appointing the vice-chancellor.
According to the statement, the council had allegedly appointed an unqualified candidate, disregarding due process, which triggered tensions between the university’s Senate and the council.
The Federal Government expressed dismay over the council’s actions, emphasizing the need for adherence to the university’s governing laws in decision-making.
“The council’s disregard for established rules necessitated the government’s intervention to restore order to the 33-year-old institution,” the statement noted.
In a related development, President Tinubu also approved the dismissal of Engr. Ohieku Muhammed Salami, the Pro-Chancellor and Chairman of the Governing Council of the Federal University of Health Sciences, Otukpo, Benue State.
Salami was accused of suspending the university’s Vice-Chancellor without following the prescribed procedures, a move the Federal Ministry of Education had previously directed him to reverse.
Despite the Ministry’s directives, Salami reportedly refused to comply and resorted to issuing threats and abusive remarks towards the Ministry’s officials, including the Permanent Secretary.
The Federal Government reiterated that the primary role of university councils is to ensure the smooth operation of academic activities, strictly adhering to the laws establishing each institution.
Tinubu warned university councils against engaging in actions that could destabilize their institutions, as his administration remains committed to enhancing the nation’s education system.
The Ekiti State Government has reached an agreement with labour leaders in the state, signing a Memorandum of Understanding (MoU) for the payment of the N70,000 minimum wage approved by the Federal Government.
Addressing journalists at a brief ceremony in Ado-Ekiti on Tuesday, the Head of Service (HoS), Dr. Folakemi Olomojobi, announced that the payment would commence immediately.
She lauded Governor Biodun Oyebanji for prioritizing the welfare of workers despite the state’s limited resources.
“This development demonstrates the governor’s commitment to improving the livelihood of our workers,” Dr. Olomojobi stated, highlighting the proactive measures taken by the administration to ensure prompt implementation.
In their remarks, the Trade Union Congress (TUC) Chairman, Comrade Sola Adigun, and the Nigeria Labour Congress (NLC) Chairman, Comrade Olatunde Kolapo, expressed their appreciation to Governor Oyebanji for fulfilling his promises to workers.
They confirmed that the new minimum wage would apply to all cadres, including employees in ministries, parastatals, agencies, and pensioners.
The Chairman of the Joint Negotiating Committee (JNC), Comrade Femi Ajoloko, described the implementation as a fair and commendable adjustment.
“This decision reflects the governor’s magnanimity and his dedication to fostering a productive workforce in Ekiti State,” he said.
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