'Interruption of US aid to HIV response in DRC could cost thousands of lives'
Kinshasa, DRC (PANA) - The UN is concerned about the fate of thousands of citizens of Democratic Republic of Congo (DRC) receiving HIV treatment amid the threat of a cut in US aid funding.
"A funding disruption will have a direct impact on the survival of people living with HIV," warned Susan Kasedde, the DRC director of UNAIDS, the UN programme coordinating the fight against the HIV/AIDS pandemic, in an interview with UN News.
An epidemic still growing
The DRC currently has approximately 520,000 people living with HIV, including 300,000 women and 50,000 children. The epidemic continues to grow, as indicated by the number of new infections almost twice as high as the number of deaths related to the disease.
Around 21,000 new HIV infections were recorded in 2023, including 7,000 among children, and 11,000 deaths from AIDS in the DRC.
The country is among those with the weakest measures to prevent mother-to-child transmission of HIV, as reflected in the large number of infected Congolese children.
Women are more affected
According to Ms. Kasedde, the fact that the majority of adults living with HIV are women is linked to the status of women in the country.
The worrying rates of sexual violence against women in the DRC increase their exposure to HIV and other sexually transmitted diseases, but, according to her, "violence is only a surface factor linked to the condition of Congolese women in general."
"We can talk about financial vulnerability and dependence on others for protection and provision, and so the status of women clearly impacts health, security... and HIV is just one window through which we can see the impact of this," explains the senior UN official.
The protective effect of school
"We know that access to education is really different for a young girl here in the DRC than for a young man," emphasizes Susan Kasedde.
When young girls find themselves working or fetching water instead of going to school, they risk having relationships with older partners or multiple partners. These activities can expose them to HIV, she explains, adding that early marriage is an additional factor, in addition to dropping out of school.
"While boys are in school day in and day out, learning... they are protected by the school environment, which reduces physical risk, environmental risk, but also risk in terms of exposure to opportunities," she adds. "These elements exacerbate the risk that a young girl will, at some point, be exposed to HIV much earlier than a young man."
Nearly 90% of people living with HIV receive treatment
UNAIDS and its partners are working with the Congolese government to implement a national response that ensures access to quality care and prevention, as well as the implementation of policies to ensure the sustainability of effective approaches to combating HIV.
"The country has managed to put 440,000 people living with HIV on treatment, or at least 87% of those in need of treatment," said Ms. Kasedde, noting that much remains to be done to ensure 100% access to treatment for people living with HIV.
Half of treatments financed by the United States
The HIV response in the Democratic Republic of Congo is 80% funded by two major donors: the United States President's Emergency Program for AIDS Remedy (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
PEPFAR's expected contribution for fiscal year 2025 is $105 million and aims to treat half of the people living with HIV in the DRC, or 209,000 people.
"This means that we currently have 440,000 people living with HIV who are on treatment. Thanks to this treatment, they are alive."
Like many aid and development agencies around the world, UNAIDS received the announcement of the US funding freeze in January.
But is aid really suspended?
"It's not clear," observes Ms. Kasedde. "We have received information announcing the continuation of PEPFAR-funded activities, but not all activities, 'some activities.' And it's still a question of which ones."
"And then treatment cannot work without operational capacity, treatment cannot be provided if there is not a well-functioning supply chain," she emphasizes, recalling that the components of the HIV response in the DRC are largely interdependent and mutually reinforcing.
Continuity of treatment: “the priority of priorities”
According to Ms. Kasedde, a funding disruption would have a direct impact on the survival of people living with HIV.
UNAIDS and its partners are working hard to review data, patient by patient, to ensure that patients are being monitored wherever they are.
To illustrate the seriousness of the impact of a possible funding disruption, the UNAIDS Director in the DRC cites as an example the impact of recent treatment disruptions caused by the security crisis that has been raging since the end of January in Goma, in the east of the country, now under the control of the M23 armed group, supported by Rwanda.
According to information gathered by community stakeholders with whom UNAIDS has been working for years, it notes that after only four weeks of discontinuations, "around 40% of people living with HIV who regularly receive support from the organization, at home and elsewhere, no longer have enough medication to ensure the continuation of their treatment."
"And 8% died," she insists.
This highlights the fragility of health and the speed with which it deteriorates when there is a breakdown in access to services, medication, psychosocial support, and community support.
What fate awaits the 209,000 HIV patients who rely on PEPFAR for their treatment?
According to the head of UNAIDS in the DRC, if the freeze continues over time, "we will very quickly see disruptions in access to medication, and then very quickly, deaths."
"We risk losing a huge number of Congolese men and women because of this financial crisis and these decisions... potentially thousands."
-0- PANA MA 13March2025
