Your Excellency, the Right Honorable Prime Minister;
Honorable Minister of Health;
Shiselweni Regional Administrator;
UN Resident Coordinator;
Head of Mission for MSF;
NERCHA Council Chairperson and representatives,
Members of the Sigwe Inkhundla,
Ladies, gentlemen, and distinguished guests,
During my remarks at the 2016 World AIDS Day Commemoration, I mentioned that, in the coming year, I was looking forward to marking new successes in the fight against HIV. In the past six months, with the release of the ground-breaking SHIMS 2 results, the people and the government of Swaziland can proudly declare they are on the right track to reach epidemic control. Swaziland’s progress stands as a global testament to the impact of data-driven interventions and the power of concerted effort by all stakeholders.
But the sobering truth is that, since the SHIMS 2 results were revealed, more than 3,000 new people will have been infected with HIV in Swaziland. For these people and their families, it does not feel like progress. A new diagnosis might bring more questions and could saddle families with greater financial and medical responsibilities. So, while we can envision the end result of an AIDS-free generation, we must also recognize that the last mile to reach that goal is going to be the most challenging – and the most critical.
As the U.S. government, we have come so far on this journey with the people of Swaziland and our role remains one of commitment, solidarity, and action. Thanks to the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, we now have the opportunity to accelerate our impact and change the course of the pandemic through transparency, accountability, and partnerships. I’d like to discuss what this means practically and how these aspects of our engagement manifest on the ground in Swaziland.
As epidemiologists and researchers continue poring over the results of the SHIMS 2 survey, they will ensure all stakeholders have access to the findings and analyses. This level of transparency allows everyone to work from the same information as projects and interventions are planned. It will also be important to identify and address potential red flags within that data.
As an example, one worrying statistic from the SHIMS 2 Survey results shows that only 66% of HIV-infected people in the 15-24-year-old age bracket know their status, compared to 84% in the overall population. For many young Swazis, who may not recall the worst period of the crisis, we have an urgent responsibility to arm them with accurate information and widespread access to care. Lack of knowledge will continue to fuel poor choices and risky behaviors in lieu of comprehensive education about prevention, treatment, sexual and reproductive health, and other methods of protection. For if this statistic were to hold true over the long-term, Swaziland would risk reversing its tremendous progress.
PEPFAR has long understood the outsized toll that HIV often takes on young women and girls. For this reason, they began the DREAMS initiative, a public-private partnership which aims to make young women Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe. With new data, we now see that in all ten countries with DREAMS interventions, there has been a 25-40% decline in new HIV diagnoses among adolescent girls and young women. In short, DREAMS is helping many young women to realize an HIV-free future.
When I speak of accountability among my counterparts and colleagues, I often point to our efforts on AGOA as a vehicle to advance and protect human rights. The same is true for our health-focused interventions, which are often conducted within disempowered communities. Health institutions and partners not only have the responsibility to strategically invest and track resources, but they also must uphold standards of equality and confidentiality for all patients, regardless of their gender, sexual orientation, professional or socioeconomic status. Without such protections, we abandon the most susceptible members of society at a time when our compassion and support is most needed.
Next year will mark the 15th anniversary of PEPFAR’s creation. And I believe there is plenty for which we all can feel incredibly heartened and inspired. Our last and most valuable asset in the fight to end AIDS is, of course, our amazing partners. Your unceasing dedication is the highest tribute those who have lost their battle against AIDS, a source of comfort to those still living with the virus, and a symbol of the potential to achieve an AIDS-free generation. We will continue to support the work you do. Together, we can reach epidemic control.