We see a lack of HIV testing

Far too many people don’t even realise they are HIV-positive, which is a big part of the problem. Many wait until they actually fall ill before finding out that they have the virus. By then, it’s dangerously late to start treatment, and they may be too ill to recover. People who don’t know they are HIV-positive are also less likely to use condoms during sex, which increases the risk of spreading the virus to others.

Why not get tested?

There are all kinds of reasons why people don’t get tested. Maybe they are scared of finding out the result, or worried about other people’s attitudes. Maybe the clinic is miles away, and they can’t afford to travel there. Or maybe the clinic staff don’t have time to carry out the tests, or have run out of HIV testing kits.

WE SEE A LACK OF HIV TESTING

Have you seen how few people are tested for HIV? AIDS is not over yet. see.msf.org #seewhatwesee #MSF
In the past, we relied on people’s own initiative to come and get tested. But if you want to identify everybody who has HIV, this just doesn't work. You have to reach out to them.
Matthew Reid , MSF Project Coordinator, South Africa

Going door to door

To encourage people to get tested, we train health workers to go from door to door in villages and towns, testing people in their own homes. We have also successfully pioneered HIV testing in local community centres and bars.

People whose HIV tests are positive are referred to a nearby clinic. At the clinic, counsellors are on hand to explain what it means to be HIV-positive, and to talk people through the treatment.

Make testing easier

We need to encourage more and more people to find out their HIV status by making it easier for them to get tested. This way, people who are HIV-positive can start treatment before they become too ill, and the risk of spreading the virus to others will be reduced.

Testing people for HIV is crucial in order to pur more people on treatment. Nelisiwe in South Africa visits remote communities to help make testing available to all. Visit see.msf.org to open your eyes to the ongoing HIV/AIDS epidemic.

We see people starting HIV treatment too late

To have a good chance of survival, people with HIV need to start treatment early, before the virus has weakened their immune system. Early treatment gives a better chance of staying healthy and fighting off potentially lethal infections such as TB. Early treatment is less intensive, less costly, and can take place at home rather than in hospital.

Starting treatment early also dramatically reduces the risk – by a massive 96 percent – of people spreading the virus to sexual partners. ARV treatment also prevents mothers from infecting their children.

Many barriers to accessing treatment

But all sorts of barriers prevent people from starting treatment when they need it. Just getting tested for HIV can be a challenge, particularly if you live in a region where HIV testing services barely exist, or in a remote rural area with no clinic nearby.

WE SEE PEOPLE STARTING HIV TREATMENT TOO LATE

Have you seen how many people start HIV treatment too late? AIDS is not over yet. see.msf.org #seewhatwesee #MSF
Every day, we see people arriving at our clinic desperate and penniless, in the late stages of the infection. For the poor, being diagnosed with HIV really is a death sentence.
Maria Machako, MSF doctor, Democratic Republic of Congo

Drug shortages

Once a person has tested positive for HIV, they can still have problems getting hold of the antiretroviral drugs they need to stay alive. Funding issues, corruption and the poor management of supplies can prevent drugs from reaching clinics, resulting in people who need treatment being turned away.

Earlier treatment, better medicines

The 2013 guidelines from the World Health Organization (WHO) recommend that people are started on HIV treatment even earlier, using new approaches and more effective antiretroviral drugs. Countries that are short of funds and health staff will find it a challenge to put the recommendations in place. They will need all the help they can get.

The health system in Democratic Republic of Congo is one of the weakest in the world. Many people have no access to HIV treatment. Visit see.msf.org to open your eyes to the ongoing HIV/AIDS epidemic.

We see children with HIV being neglected

Every day, 900 babies are infected with HIV by their mothers, either in the womb, during birth or when they breastfeed. The untreated HIV virus develops into AIDS far more quickly in children than it does in adults, and the majority of these babies will die before they reach their first birthday.

Special treatment

Babies and children with HIV need special treatment that the health systems in many developing countries – often desperately short of funds and resources – don’t provide.
In sub-Saharan Africa, there are an estimated two million children with HIV.

Not child-friendly

Treating a child with HIV is complicated. Many of the tests and drugs used for adults are unsuitable for children, and it can take years for a child-friendly version to reach the market. 

WE SEE CHILDREN WITH HIV BEING NEGLECTED

Have you seen how many children with HIV are being neglected? AIDS is not over yet. see.msf.org #seewhatwesee #MSF
We see mothers arriving at our clinic with HIV-positive babies. If they’re not diagnosed in time, many will die before they reach the age of one. It is so frustrating to see this when it could have been prevented.
Gilles Van Cutsem, MSF doctor, South Africa

A gradual approach

Coming to terms with having HIV is always tough, whatever your age. But for children and teenagers especially, finding out you have an incurable virus that requires lifelong treatment can be too much to handle. MSF is using a strategy called ‘progressive disclosure’ to educate young people about HIV/AIDS over a period of time, before they learn about their own HIV status. This way, the news is less of a shock, they understand the condition better and they are more likely to stick to their treatment.

More to be done

Pregnant women with HIV need to be routinely put on treatment to prevent the virus being transmitted to their unborn children. Child-friendly tests and formulations of antiretroviral drugs also need to be made available. And governments need to commit to making sure that children with HIV are not neglected.

Amahle from South Africa was born HIV-positive. Her mother died from HIV/AIDS and Amahle now lives with her aunt. Visit see.msf.org to open your eyes to the ongoing HIV/AIDS epidemic.

We see pregnant women dying from HIV

Three out of four pregnant women with HIV are not receiving treatment – all of them in developing countries. Without treatment, the virus weakens their immune systems, increasing their risk of dying from complications during pregnancy or soon after giving birth.

In southern Africa, one in four women are HIV-positive. In Lesotho and Zimbabwe, more than 40% of all pregnancy-related deaths are caused by HIV/AIDS.

TB threat

One of the most dangerous complications for pregnant women and newborns is TB. If a pregnant woman is HIV-positive, she is ten times more likely to develop active TB.

WE SEE PREGNANT WOMEN DYING FROM HIV

Have you seen that pregnant women are dying from HIV? AIDS is not over yet. see.msf.org #seewhatwesee #MSF
No pregnant woman dies of HIV in Europe. Here in Lesotho, more than half of all maternal deaths are related to HIV. This is unacceptable.
Sofie Manatsoa, MSF project medical referent, Lesotho

Keep mothers and babies healthy

Putting pregnant women with HIV on treatment is critical to saving more lives, including those of children. Treatment protects their unborn babies and allows them to stay healthy and take care of their children.

Mamotsieleli from Lesotho is pregnant and has just been diagnosed with HIV. If she receives regular treatment she can lead a normal life and the virus will not be passed on to her new baby. Visit see.msf.org to open your eyes to the ongoing HIV/AIDS epidemic.

We see discrimination against HIV patients

People with HIV/AIDS may face negative reactions from family, neighbours, employers and even health staff. Once people find out they are HIV-positive, they may lose their friends, homes and jobs, and become the victim of abuse and violence. It’s not surprising that people are reluctant to get tested, or treated, or receive the support they’re due, out of fear of others finding out.

Blame and shame

Feelings of fear, blame and shame are all too common amongst those with HIV/AIDS. Many people associate HIV/AIDS with sex work, premarital and extramarital sex, men having sex with men and drug use – all of which carry their own stigma.

In MSF’s projects, patients are helped to cope with their situation through counselling sessions and peer support groups. This gives patients the opportunity to share their experiences and to discuss the best ways of dealing with discrimination.

WE SEE DISCRIMINATION AGAINST HIV PATIENTS

Have you seen how HIV patients face discrimination? AIDS is not over yet. see.msf.org #seewhatwesee #MSF
If you have HIV, you are punished twice: first by having to live with the disease, and then by facing discrimination from society.
Dorian Job, MSF country health director, Myanmar

Counter prejudice with knowledge

Prejudice against those with HIV/AIDS is usually a result of a lack of knowledge about the disease and how it spreads. More effort needs to be made to raise awareness about HIV/AIDS amongst society in general and to banish people’s misconceptions, so that those diagnosed with HIV no longer have to live in fear. Health workers also need to show respect, empathy and ensure confidentiality for their patients.

People living with HIV often face stigma and discrimination. Ko Tin Than from Myanmar lost everything when people found out he was HIV-positive. Visit see.msf.org to open your eyes to the ongoing HIV/AIDS epidemic.

See What We See: The Film

Urge incrementar el ritmo al cual los pacientes son puestos bajo tratamiento. Las personas VIH-positivas necesitan ser diagnosticadas a tiempo para que empiecen el tratamiento antes de caer gravemente enfermas. Debe prestarse especial atención a los grupos vulnerables como las mujeres embarazadas y los niños. Para muchas personas con VIH, los costes y las largas distancias a las clínicas son obstáculos abrumadores que les obligan a abandonar el tratamiento. Por lo tanto, los sistemas de salud deben adaptarse e introducir modelos que lleven la atención médica más cerca de los pacientes.

Los gobiernos deben mostrar un compromiso político continuo para garantizar que los recursos necesarios sean asignados donde se requieren, de tal manera que el acceso de los pacientes al tratamiento se incremente considerablemente y que aquellos ya en tratamiento puedan continuarlo sin dificultades.

Únete a nosotros para mantener la presión sobre quienes toman las decisiones y asegurar que abran los ojos ante la persistente emergencia del VIH/sida.

SEE WHAT WE SEE - AIDS IS NOT OVER YET

AIDS kills 1.6 million people per year. Open your eyes to the HIV emergency. AIDS is not over yet. see.msf.org #seewhatwesee #MSF
AIDS is not over yet. Continued political commitment is crucial to expand access to treatment. Visit see.msf.org to open your eyes to the ongoing HIV/AIDS epidemic.

Why Care?

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1981
AIDS is recognised as a disease
1984
The HIV virus is identified as the cause of AIDS
1996
Lifesaving antiretroviral (ARV) treatment is developed - although it is not available in the worst affected countries for several years. Treatment costs US$10,000 per patient per year.
2000
MSF starts its first patient on ARV treatment in Thailand, and begins to provide treatment in a number of countries in southern Africa.
2001
Thanks to the efforts of HIV activists, the price of ARV treatment falls dramatically, making its widespread introduction feasible in poorer countries.
2006
UN member states pledge to achieve universal access to antiretroviral treatment by 2010
2007
MSF reaches the milestone of providing ARV treatment to 100,000 patients
2008
International donor funding for HIV/AIDS suddenly stalls, after 10 years of regular increases
2010
The Global Fund - one of the major funding institutions for HIV - faces a major funding shortfall
2011
Research shows that starting ARV treatment makes a person 96% less likely to transmit the HIV virus to a sexual partner

The Situation Today

Hoje, 9,6 milhões de pessoas com HIV/Aids estão seguindo um tratamento que salva suas vidas, os medicamentos antirretrovirais custam uma fração do que costumavam custar, existem muito mais centros de teste e tratamento e novos modelos de cuidados estão aproximando o tratamento dos pacientes. Nos locais onde as pessoas conseguem acessar esses serviços, o número de novas infecções está sendo reduzido a cada ano. Essas conquistas positivas transformaram o que antes era uma sentença de morte em uma doença crônica administrável – para quem consegue tratamento.

Entretanto, não podemos esquecer que a epidemia continua a atingir 1,6 milhão de vidas por ano. Hoje, de acordo com as novas diretrizes da Organização Mundial da Saúde (OMS), mais de 18 milhões de pessoas ainda precisam começar o tratamento. Em muitos países do sul da África, a Aids continua sendo a causa de morte número 1 entre adultos, fazendo com que muitas crianças cresçam órfãs. A Aids continua a destruir vidas e comunidades de maneira chocante.

Nos últimos anos, ouvimos muito falar que o fim da epidemia de Aids estava próximo. Mas, para isso, o progresso não pode ser limitado ou impedido pela implementação muito lenta de estratégias eficientes para combater o HIV. Existem também sinais preocupantes de estagnação do compromisso de líderes internacionais para lutar contra a Aids. Importantes instituições doadoras enfrentam um completo declínio de recursos, o que impede que o tratamento seja oferecido a mais pessoas.

Em alguns países afetados pela epidemia de HIV, a situação ainda é crítica. Se isso não for reconhecido, os planos de tornar o tratamento acessível a mais pessoas serão colocados em risco, assim como a introdução de medidas que comprovadamente impedem a disseminação da doença de forma efetiva.

Convidamos você a abrir seus olhos para o que vemos diariamente em países onde trabalhamos, como República Democrática do Congo, Lesoto, África do Sul e Mianmar.

35,000,000

estimated number of people across the world living with HIV/AIDS

18,000,000

people in need of treatment are not receiving it

30,000,000+

people have died from AIDS-related causes since the start of the epidemic

280,000

patients are receiving HIV treatment from MSF in 21 countries

9,000,000+

people are on ARV treatment

Today, 9.6 million people with HIV/AIDS are on lifesaving treatment, antiretroviral drugs cost a fraction of what they used to, many more testing and treatment centres exist, and new models of care are bringing treatment closer to patients. Where people
are able to access these services, the number of new infections is declining each year.

These positive achievements have turned what used to be a death sentence into a manageable chronic disease – for those on treatment. Yet we cannot forget that the epidemic continues to claim 1.6 million lives each year. Today, according to new guidelines by WHO, more than 18 million people still need to be put on treatment. In many countries in southern Africa, HIV/AIDS remains the number one killer of adults, leaving many children to grow up as orphans. HIV/AIDS continues to destroy lives and communities in a shocking way.

MSF's HIV Activities

We have been providing prevention and care for patients with HIV-related illnesses since the mid-1990s, and started our first patient on antiretroviral treatment in 2000. Today, we provide ARV treatment to more than 280,000 people with HIV/AIDS in 21 countries around the world. All of the medical care and treatment that we provide is completely free of charge.

The care we provide is a vital lifeline for people in countries where HIV treatment is scarce, substandard or non-existent. As well as helping countries introduce ARV treatment on a large scale, we have pioneered several innovative HIV treatment models which make care more accessible to patients. MSF has also pushed for policy changes that have enabled ARV treatment to be scaled up and have helped bring down the cost of drugs and diagnostic tools.

We remain committed to fighting HIV/AIDS in those communities worst affected by the epidemic.

Over the last few years, we hear increasingly that the end of the AIDS epidemic is within reach. But in order to achieve this, further progress cannot be limited or blocked by too slow implementation of effective strategies to fight HIV. There are also worrying signs that the commitment of world leaders to fight HIV/AIDS is stagnating. Important donor institutions face stark funding shortfalls, which prevent the ambition to put more people on treatment.

In some countries affected by the HIV-epidemic, the situation is still critical. A failure to recognise this will put at risk the plans to make treatment available to more people, and will hinder the introduction of measures which have been proven to effectively prevent the spread of disease.

We invite you to open your eyes to what we see on a daily basis in countries we work in, such as Democratic Republic of Congo, Lesotho, South Africa and Myanmar.

4,000 Adults

die of AIDS every day

900 BABIES

BORN WITH HIV EVERY DAY

600 CHILDREN

die of AIDS every day

With support from the Swedish Postcode Lottery