Progress towards the 2020 Fast Track targets in Eastern sub-Sahara Africa region and in Ethiopia; using Global Burden of Disease 2017data

Abstract BackgroundSustainable Development Goal (SDG) 3.3, targets to eliminate HIV from being a public health threat by 2030. For better tracking of this target interim Fast Track millstones for 2020 and composite complementary measures have been indicated. This study measured the Fast Track progress in Eastern sub-Saharan Africa (ESSA) region and in Ethiopia across ages using Global Burden of Disease (GBD) 2017 data. Methods The National Data Management Center for health research team at Ethiopian Public Health Institute has analyzed the GBD 2017 data for the year 2010 to 2017 for Ethiopia and ESSA countries. GBD 2017 data sources were census, demographic and health surveys, prevention of mother-to-child HIV transmission and anti-retroviral treatment programs, sentinel surveillances and UNAIDS spectrum modeling. Age standardized and age specific HIV/AIDS incidence, prevalence, mortality, Disability Adjusted Life Years (DALYs), incidence:mortality ratio and incidence:prevalence ratio were calculated with corresponding 95% confidence limits. Results Slow progress has been recorded in reducing new HIV infection in ESSA since 2010; only Uganda would achieve the 75% target by 2020. Ethiopia, Tanzania and Uganda have already achieved 75% mortality reduction target set for 2020. With incidence: prevalence ratio of < 0.03, Ethiopia, Rwanda and Uganda are on track to end HIV by 2030. Ethiopia has an incidence: mortality ratio <1 due to high mortality; while Kenya, Rwanda, Tanzania and Uganda, have a ratio >1 due to high incidence. Ethiopia has reduced the HIV incidence rate by 76% among under 5 children and seem to be on track to attain the 2020 national target but far behind achieving the target among the 15-49 age group. Conclusion The ESSA countries have made remarkable progress towards achieving the 75% HIV/AIDS mortality reduction target by 2020 since 2010, although they progress poorly in reducing HIV incidence. Having an incidence:prevalence ratio of less than 0.03, Ethiopia, Rwanda and Uganda are well heading towards epidemic control. The high HIV/AIDS mortality rate in Ethiopia for its incidence requires innovative strategies to bring undiagnosed cases to treatment and care services across age. For sustainable epidemic control, Ethiopian needs to build strong institutional capacity to generate strong evidence to support policy decision.