On Tuesday, October 11th, I spoke to one hundred students and people living with HIV who were rallying for increased global health funding. They were at Dartmouth College in New Hampshire, and I talked to them from Kigali via Skype. A transcript of my message is below.
Hello to all - I am so pleased to be able to speak to you from Kigali in Rwanda. Today you all gather in solidarity with people around the world in need of ARVs.
This issue concerns many people in Africa and elsewhere, and concerns vulnerable persons lacking education, employment meaning means to pay for themselves. Let me talk about the most vulnerable in these situations, who live in a context that can lead to HIV because some people don’t feel or don’t think they can ever become employed or find types of survival modes other than to prostitute themselves and to put themselves at risk of HIV; or because they are vulnerable or uneducated (and we know well the link that exists between education and HIV risk).
Now, in the past ten years, we had a great movement of global solidarity around treatment access. This was extremely timely, because I remember the time when I was working in public hospitals and Rwandans were dying without any solution, for HIV treatment - antiretroviral therapy (ARVs) - were not available in Africa. The only solution for people living with HIV/AIDS (PLWHA) when they need ARVs is ARVs.
At that time, the cost of generic ARVs came down from incredibly high prices around 1,000USD per month to today's price of less than 100USD a year. We also know how to follow PLWHA in a very good way in the respect of science, in the respect of the patient, and in the respect of clinical knowledge. We know how to conduct patient follow up in a very cheap way that also maintains quality. So this means that money should not be an obstacle to grant access to care to PLWHA around the world.
In Rwanda, we are fortunate to have achieved universal access to care and treatment for PLWHA, for both adult and children. But make no mistake - we fought hard for that. And that's why I understand your fight; that’s why I am fully in solidarity with PLWHA who want access to care and treatment. I want this for the world and also for Rwanda, because if we have 100,000 people on treatment today we also know that we have almost 100,000 people out there who are already HIV-positive but not yet in the clinical stage to be put on ARVs. But soon these Rwandans will also need ARVs, and when that time will come I want them to have access to the necessary life-saving care and treatment.
So your fight – your movement – is really encouraging for the world because I feel in my day-to-day work what the reality is. We cannot afford to lose the life of PLWHA whom we could save. We have to keep young people alive – those that have just finished education and who are ready and willing to be useful to their nation. We need to keep parents with young children alive – we know that when children are orphaned they have less access to all services including education, and that they are more vulnerable to risk of HIV infection. Orphans are also at higher risk to be trapped in a non-development process.
So we need parents to be alive. We need PLWHA to stay alive. We need to ensure access to care and treatment for all of them. And we need to ensure best practices in follow up that are affordable. It’s just a matter to do things differently. It’s just a matter to manage the health sector differently. It’s just a matter to manage the global solidarity movement differently.
So I know that we don't have time for questions today, but my message to you is about solidarity. I am calling in from a country where we have a well-managed health sector, where we have people alive and living with HIV as a chronic disease in a country where we now start to tackle cancer and other non communicable diseases that are outcomes or not of being HIV-positive – and we are with you.