HIV infection in Eastern and Southern Africa: Highest burden, largest challenges, greatest potential

Parker, Erica; Judge, Melinda A.; Macete, Eusebio; Nhampossa, Tacilta; Dorward, Jienchi; Langa, Denise C.; Schacht, Caroline De; Couto, Aleny; Vaz, Paula; Vitoria, Marco; Molfino, Lucas; Idowu, Rachel T.; Bhatt, Nilesh; Naniche, Denise; Le Souëf, Peter N.

BACKGROUND: The burden of HIV is especially concerning for Eastern and Southern Africa (ESA), as despite expansion of test-and-treat programmes, this region continues to experience significant challenges resulting from high rates of morbidity, mortality and new infections. Hard-won lessons from programmes on the ground in ESA should be shared. OBJECTIVES: This report summarises relevant evidence and regional experts’ recommendations regarding challenges specific to ESA. METHOD: This commentary includes an in-depth review of relevant literature, progress against global goals and consensus opinion from experts. RESULTS: Recommendations include priorities for essential research (surveillance data collection, key and vulnerable population education and testing, in-country testing trials and evidence-based support services to improve retention in care) as well as research that can accelerate progress towards the prevention of new infections and achieving ambitious global goals in ESA. CONCLUSION: The elimination of HIV in ESA will require continued investment, commitment to evidence-based programmes and persistence. Local research is critical to ensuring that responses in ESA are targeted, efficient and evaluated.