The world is going through the second difficult year of fighting against the COVID-19 pandemic. At a time when the health sector is in a pinch, it is important to ensure maximum continuity in the prevention of sexually transmitted diseases (STDs), particularly human immunodeficiency virus infection (HIV) and acquired immunodeficiency syndrome (AIDS). The pandemic will continue to devastate people’s lives unless “mankind commits to equal health coverage and reshape AIDS and other pandemic responses”, as UNFPA Executive Director Dr. Natalia Kanem said.

Today is World AIDS Day. It is an annual observation occurring every December 1. It is an opportunity for people worldwide to unite in the fight against AIDS, show support for people living with this infection, and commemorate those who have died from an AIDS-related illness. Founded in 1988, World AIDS Day was the first-ever global health day.

Since the first case of AIDS infection was registered in Mongolia in 1992, 304 cases of HIV/AIDS were reported as of November 2020. Among them, 32 resulted in deaths due to AIDS. The total number of HIV carriers and AIDS patients in Mongolia reached 316 after two new AIDS cases were registered in June 2021, according to the National Statistics Office (NSO).

The office reported that all of the infections were sexually transmitted, and no blood, blood products, medical care or mother-to-child transmission had been identified. A total of 17 HIV-infected mothers reportedly gave birth to 25 children in 2020.

These children are growing up healthy, NSO confirmed. More than half of the HIV-infected are people between the ages of 25 and 45.

Everyone, no matter who they are or where they are, should be able to receive AIDS care. However, the lack of accessible services in Mongolia has delayed the goal of early detection and prevention of the spread of this chronic condition. In particular, under the standards of the Mongolian health organizations, 63 doctors specialized in STDs must be deployed in rural areas but only 23 are currently working. Specifically, Uvs, Govisumber, and Dundgovi provinces do not have specialists, and in some provinces, other specialists provide services for sexually transmitted infections, Minister of Health S.Enkhbold noted.

The expansion of HIV care has been slowed due to COVID-19, which has failed to meet the 90-90-90 target for the year 2020 (diagnose 90 percent of all people living with HIV, treat 90 percent of people who know their status, and suppress the virus in 90 percent of people on treatment). The fact that the world has not achieved its goal of ending the AIDS pandemic in 2020 is a sign that we should not back down but intensify our efforts.

The continued spread of COVID-19 and AIDS lays bare stark social, health, legal and economic inequalities faced by vulnerable communities across the globe. The third Sustainable Development Goal aims to end the epidemic of HIV/ AIDS by 2030 based on the lessons during the last two decades. However, the progress to end HIV transmission is off-track not because of a lack of knowledge or tools, but because these inequalities are obstructing access to HIV prevention and treatment, Dr. Kanem stated.

Therefore, this year’s World AIDS Day is highlighting the urgent need to end the inequalities that drive AIDS and other pandemics around the world. Without bold action against inequalities, the world risks missing the targets to end AIDS by 2030, as well as a prolonged COVID-19 pandemic and a spiraling social and economic crisis. Economic, social, cultural and legal inequalities must be ended as a matter of urgency in order to end AIDS by 2030, experts assess.

Tackling inequalities is a long-standing global promise. In 2015, all countries pledged to reduce inequalities within and between countries as part of SDGs. The Global AIDS Strategy 2021-2026 and “Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030”, adopted at the 2021 United Nations High-Level Meeting on AIDS, have the target of ending inequalities at their core.

Researchers view that addressing this problem can advance the human rights of key populations and people who are living with HIV, make societies better prepared to beat COVID-19 and other pandemics and support economic recovery and stability. Fulfilling the promise to tackle inequalities will save millions of lives and benefit society as a whole. But ending inequalities requires transformative change. Political, economic and social policies need to protect the rights of everyone and pay attention to the needs of disadvantaged and marginalized communities.

The response to the AIDS pandemic can be halted, but it will require strong political leadership, action, and accountability on all sides to end. Investing in more resilient health systems will reduce inequalities, increase growth and provide greater security for everyone, as advised by UNFPA Executive Director Natalia Kanem.

In this context, Mongolia is planning a number of activities, Minister of Health S.Enkhbold said. Particularly, the Ministry of Health aims to train professional specialists for STDs and AIDS, employ them in accordance with the standard, establish a public health center to provide targeted public health services based on the center, ensure the active participation of soum and local self-government and administrative organizations in establishing the continuity and sustainability of public health services, and increase their funding.

Moreover, the ministry plans to work with educational and media organizations to promote health and develop the right knowledge, attitudes and practices for adolescents and young people, implement a comprehensive program to prevent HIV, AIDS, tuberculosis and hepatitis in the workplace in other sectors, as well as increase the coverage of HIV and syphilis testing by intensifying activities aimed at providing health care services through non-governmental organizations and private health organizations.

Minister S.Enkhbold stressed that the human and financial resources of the health sector are fully mobilized to fight against and prevent the spread of the COVID-19 pandemic, and at the same time the ministry is working to ensure that other health services are accessible to the population. In other words, the line ministry is paying some attention to the spread, prevention and treatment of other communicable diseases in these difficult times of COVID-19.

500 MILLION MNT ANNUALLY SPENT ON AIDS TREATMENT

Highly active antiretroviral therapy, recommended by the World Health Organization, is used in the treatment of HIV infection. “Treatment as prevention” refers to the use of antiretroviral medication to prevent HIV transmission. It involves prescribing antiretroviral to those who are living with HIV in order to reduce the amount of virus in their blood to undetectable levels so that there is effectively no risk of transmission of HIV.

Antiretroviral therapy was introduced in Mongolia in 2003 and was purchased and used between 2003 and 2013 with a 94,919 USD grant from the Global Fund-supported AIDS project. However, since 2013, 300 million to 500 million MNT has been allocated annually from the state budget to procure relevant drugs and diagnostics and deliver treatment, diagnosis and care.

Although access to HIV/AIDS testing and treatment has increased, scientists say it is not enough to meet global goals. Therefore, in addition to HIV testing, community-based testing, prevention and care are recommended. In this regard, it is crucial to create a tradition of regular check-ups throughout the country.

SEX EDUCATION IS IMPERATIVE FOR PREVENTING STDs

As mentioned earlier, scientists believe that the most important way to reduce the spread of STDs among the population is preventive screening. Another important issue is to provide comprehensive and accurate sex education to people from an early age.

However, primary, middle, and high school children do not receive adequate sex education in Mongolia. According to the recommendations and information provided by the Family, Child and Youth Development Agency and Princess Center, children need to be taught and counseled about sex education age-appropriately.

Scientists say that the age of 6 to 9 is the best time for a child to get the basic knowledge about sexual development and sexual life. However, in Mongolia, primary school children do not currently receive health education or basic sex education.

Most children hit puberty between the ages of 9 and 12. From this point on, children’s behavior changes and they tend to become more shy and introverted. Therefore, psychologists recommend parents and teachers to take the time to talk and understand them. It is also important to have a psychologist in each school to provide sexual education counseling to adolescents.

According to Psychologist of Family, Child and Youth Development Agency G.Ariun-Erdene, hormonal changes in adolescents aged between 13 and 19 make them psychologically unstable. Up to this point, if parents and teachers provide accurate information about sexual development and sex education to children, the risk of STDs can be reduced.

Psychologist G.Ariun-Erdene also said, “In addition to schooling, parents should discuss sexual development with their children from an early age. Most parents, on the other hand, do not talk openly with their children, especially when it comes to sexual development and sexuality. Such a closed child-parent relationship poses many risks to the child in the future. Furthermore, it can lead to bad habits and low self-esteem.”

Despite the uncertainties and anxieties stemming from the COVID-19 pandemic, all sides should not forget to take special measures to reduce the spread of AIDS, such as ending inequalities, providing sex education, and intensifying early detection and diagnosis.