No Drugs or Test Kits for Tigray HIV/AIDS Patients

To:

• The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)
• Center for disease Control (CDC) -USAID – UN AIDS
• Global Fund

Ethiopia Denied HIV Medicines to people living with HIV in Tigtray

Since its first recognition in 1981 the global pandemic HIV/AIDS has claimed millions of lives, especially people residing in low- and middle-income countries mainly before the advent of Anti-Retroviral Therapy (ART). Before the launch of PEPFAR in 2003, the world was facing a crisis, particularly in Africa where people were dying in thousands because the antiretroviral therapy (ART) that was being used in the United States (U.S.) was not available in Africa. However the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in collaboration with other partners introduce free ART, free HIV test kits, Condoms and other intervention for the past two decades as a result millions of lives have been saved, pregnant women were educated about preventing HIV transmission to their unborn children by actively receiving treatment, babies were born HIV-free and children who were infected were treated. Ethiopia is one of the greatest beneficiary of the PEPAR’s global fight against HIV/AIDS donation, as a result of this Ethiopia has attained dramatic decline in HIV incidence, prevalence, mother to child transmission of HIV & HIV related morbidity and mortality. Similarly before the war, Tigray was in a good position in HIV epidemic control mainly focusing on prevention, care & treatment. The region was executing HIV prevention and control activities in 94 districts, 260 PMTCT and 141 ART sites. However, as a result of the war, Tigray’s health system has completely collapsed due to widespread and deliberate looting, vandalizing, as well as total destruction of 70-80% health facilities by Eritrean and Ethiopian troops (1. 2). Moreover, a complete siege was applied by the federal government of Ethiopia that has caused severe shortage of medications and medical supplies. ART medications are donated for free to the country but people living with HIV (PLHIV) in Tigray are denied of accessing and IIIV patients are suffering.

Currently the major problem in the HIV care pros ision in the region are the folliming:

1. Unavailability of HIV preventive methods like condom, IIIV post and pre Exposure prophylaxis (PEP, PrEP):
   Currently in Tigray the HIV risk factors like rampant unprotected intentional sexual violence. displacement of people. and stock out of ART drugs are immense. If IIIV preventive methods like condom. PEP. PrEP were available at this critical time many lives would have been saved from contracting I-II V . Look at annex-2-table-1 for the details
2. Unavailability of HIV test kits
   Before the beginning of the war in Tigray there were around 800.000 tests (targeted testing and testing to all pregnant and lactating mothers) per year and with 5.000 -6.000 new positives found annually. But now due to the absence of HIV test kits, pregnant and lactating mothers are not getting HIV test so the number of infants acquiring HIV infection will rise. Besides, if the high risk test groups are not tested it will bring high IIIV transmission in the community. Look at annex-2-table-1 for the details
3. Absence of Anti-retroviral drugs
   The absence of ART drugs victimizes 46,000 clients in Tigray. For a certain period of time the clients were on salvage ART drugs or expired drugs, but now all are exhausted. The plan for dispatching HIV supplies from Federal EPSA to Mekelle EPSA was used to be 6 times per year, but we receive only once that was facilitated by WHO in 2022. Look at annex-1 figure-I and annex-2-table-1 for the details
4. Around 2400 HIV exposed infants are now remained without prophylaxis
5. Near to 2,600 pregnant & lactating mothers arc left without medications
   Thus, the absence of ART drugs, HIV test kits, CD4 and viral load determination will cause severe consequences like:
   • Wide spread emergence of HIV drug resistance
   • Increase IIIV transmission in the community
   • Increase in AIDS related morbidity and mortality
   • Rise in fIIV positive infant