Some 38 million people are living with HIV/AIDS, over two-thirds of them in sub-Saharan Africa. The HIV crisis in Central African Republic (CAR) is particularly acute—fueled by extreme poverty, pervasive violence, a dire shortage of health facilities and health staff, long-existing supply chain issues for lifesaving antiretroviral (ARV) medications, and significant barriers to early detection and treatment.
HIV remains a leading cause of death in the country. Last year, around 4,800 people died of HIV/AIDS in CAR, while some 5,500 new cases are confirmed annually.
A deadly obstacle course
“While CAR has the highest HIV prevalence across the West and Central African region, fewer than half of the estimated 110,000 people living with HIV are on ARV treatment,” says Laurent Lwindi Mukota, HIV medical advisor for Doctors Without Borders/Médecins Sans Frontières (MSF). “The situation is even more alarming for children under 15: of those who are aware of their HIV status, fewer than a quarter are on treatment.”
Life expectancy in CAR is the lowest in the world, partly due to years of conflict and insecurity. The country is completely dependent on external funding for its response to HIV—and international support so far has fallen short of the needs. Few of the limited number of health facilities offer HIV testing and care, and many people living with HIV have to make long and often dangerous journeys to find a clinic where HIV services are available. Those who do manage to reach a clinic sometimes find empty shelves instead of much-needed drugs, making it impossible for them to continue their ARV treatment.