Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63...Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2021 with, six in seven new HIV infections among adolescents aged 15 - 19 years being girls. Key populations accounted for 70% of HIV infections globally in 2021, with 51% of these new HIV infections in sub-Saharan Africa. Reflecting on the 4 decades’ journey of HIV epidemic amidst local, national and international efforts, the UN target of ending AIDS as a public health threat by 2030 remains questionable unless new innovative ways are used. This study aimed at analyzing existing HIV/AIDS interventions, discuss UN interventions in line with ending HIV/AIDS by 2030 then, suggest and discuss new innovative ways of ending HIV scourge by 2030. Methods: Systematic literature review methodology was used to extract existing published information on HIV prevention strategies from 1981 to 2023. The articles were previewed by 2 experts for quality and grouped by intervention. Of the 637 articles accessed, on HIV prevention/control only 45 met the inclusion criteria. Data were synthesized using a narrative synthesis approach following standard guidelines on synthesis without meta-analysis. Descriptive analysis was done, strength and limitations were identified. UNAIDS recommendations for ending HIV/AIDS by 2030 identified and analyzed. New Innovations in HIV/AIDS were presented and discussed. The scope of the reviewed literature was limited to HIV preventive strategies practiced between 1981 and 2023. Results: Findings show that, Uganda’s HIV prevalence was at a peak in 1991 of 15% (30% among pregnant women in urban areas). ABC strategy is claimed to have turned sharply downward the prevalence through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001. Analysis of the strategy showed that the achievements of the strategy could not be sustained, subsequently HIV prevalence rose again. This is because none of the ABC components can independently reduce HIV problem. In the real world, 100% abstinence has failed, condom use only reduces infection by 90% (WHO), and lifelong monogamy is impractical. Such limitations weaken ABC strategy. The study established that Post-exposure prophylaxis (PEP) i.e. taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV infection is a safe, effective and a globally practiced HIV preventive intervention in emergency situations of HIV exposure. However, PEP is limited to care sought within 72 hours after exposure and yet timely access especially in rural areas and for key populations remains a big challenge. Oral PrEP was also identified as effective HIV preventive measure that can reduce HIV risk from sex by about 99% and from injection drug users by 74%. However, like PEP, timely access especially in rural areas and for key populations remains a big challenge. The UNAIDS 95-95-95 strategy (i.e. 95% of people know their HIV status, 95% with +HIV status be on sustained ART and 95% on ART get viral load suppression) formed the basis for setting the target of ending HIV/AIDS epidemic by 2030. However, our analysis shows that this target is unrealistic given the above highlighted limitations/ barriers in preventive measures and the unlikely perfect adherence (100%) to ART by all enrolled HIV positive persons. Conclusion: Ending HIV/AIDS by 2030 cannot be achieved by implementing the current preventing strategies and control measures. This study established that most of the existing HIV preventive strategies and control measures have a number of limitations. However, with sustained UN 95-95-95 strategy supplemented with additional innovative ways, there is hope that the UN dream of ending HIV/AIDS though not necessarily by 2030, can in the long run be achieved.展开更多
Global Warming is the recent and ongoing increase in global average surface temperature.We are currently experiencing serious changes in earth usual temperature,a notable climate change in totality referred to as glob...Global Warming is the recent and ongoing increase in global average surface temperature.We are currently experiencing serious changes in earth usual temperature,a notable climate change in totality referred to as global warming.Climate change is the long-term shift in weather patterns and average temperatures.Ordinary weather shifts can be in a particular place or the entire earth in totality as it is for the current earth warming.Whereas natural changes in sun’s activity,large volcanic actions and earth orbital movements accounted for such climate changes in the past,since 1800 Human activities like burning of fossil fuels;coal,oil,deforestation and industrialization accounted for the unprecedented Greenhouse gases(GHGs)emissions in the 21st century,leading to exceedingly greater global average surface temperatures.The current extreme warming is a global climate change in totality.This paper aimed at exploring global warming and its implication as climate change reality of the 21st century,suggesting cost-effective youth inclusive mitigation strategies.Results:Published literature reveal two underlying causes of climate change as,Natural processes and Human activities.The two,are major sources of Green House-gas emissions that directly bring about global warming-climate change effect.GHGs,form a stratospheric layer that prevent excess heat escape,thereby excessively warming the earth-atmosphere surface.Greenhouse gases,Carbon dioxide(CO_(2)),Water vapour(H_(2)O),Methane(CH_(4)),Nitrous oxide(N2O),Ozone(O3)are natural GHGs,but also man-made(synthetic GHGs)like Fluorinated Gases(F-Gases);Hydrofluorocarbons(HFCs),Perfluorocarbons(PFCS),Sulphur Hexafluoride(SF6)with more Global warming potential than natural GHGs,together cause extreme warming of earth.GHGs form a blanket wrapped around the Earth,trapping the sun’s heat and cause global warming.Consequences include raising sea levels with flooding of coastal towns,longer and more damaging wild fires,shrinking of ice sheets and snow cover,thawing permafrost,Ocean acidification,famine/hunger,Eco-Anxiety,Drought effects on flora and Fauna and extinction of species.Urgent Youth inclusive mitigation actions include,moving away from use of fossil fuels to renewable energy use like solar power,wind energy and geothermal,ensure energy efficiency and adopt sustainable means of transport like buses,youth inclusive awareness campaigns,afforestation and reforestation,reduced waste production,restoration and conservation of ecosystems wetlands,emission reduction policy implementation of 2015 Paris Agreement on climate change,as well as use of Carbon Capture technologies.Conclusion:Global warming is real.The effects are catastrophic than ever before in the 21st century due to accumulation of GHGs in atmosphere from Human activities.Urgent mitigation needed today is everyone’s role including youth.Together,we can save our planet by making it green again.展开更多
文摘Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2021 with, six in seven new HIV infections among adolescents aged 15 - 19 years being girls. Key populations accounted for 70% of HIV infections globally in 2021, with 51% of these new HIV infections in sub-Saharan Africa. Reflecting on the 4 decades’ journey of HIV epidemic amidst local, national and international efforts, the UN target of ending AIDS as a public health threat by 2030 remains questionable unless new innovative ways are used. This study aimed at analyzing existing HIV/AIDS interventions, discuss UN interventions in line with ending HIV/AIDS by 2030 then, suggest and discuss new innovative ways of ending HIV scourge by 2030. Methods: Systematic literature review methodology was used to extract existing published information on HIV prevention strategies from 1981 to 2023. The articles were previewed by 2 experts for quality and grouped by intervention. Of the 637 articles accessed, on HIV prevention/control only 45 met the inclusion criteria. Data were synthesized using a narrative synthesis approach following standard guidelines on synthesis without meta-analysis. Descriptive analysis was done, strength and limitations were identified. UNAIDS recommendations for ending HIV/AIDS by 2030 identified and analyzed. New Innovations in HIV/AIDS were presented and discussed. The scope of the reviewed literature was limited to HIV preventive strategies practiced between 1981 and 2023. Results: Findings show that, Uganda’s HIV prevalence was at a peak in 1991 of 15% (30% among pregnant women in urban areas). ABC strategy is claimed to have turned sharply downward the prevalence through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001. Analysis of the strategy showed that the achievements of the strategy could not be sustained, subsequently HIV prevalence rose again. This is because none of the ABC components can independently reduce HIV problem. In the real world, 100% abstinence has failed, condom use only reduces infection by 90% (WHO), and lifelong monogamy is impractical. Such limitations weaken ABC strategy. The study established that Post-exposure prophylaxis (PEP) i.e. taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV infection is a safe, effective and a globally practiced HIV preventive intervention in emergency situations of HIV exposure. However, PEP is limited to care sought within 72 hours after exposure and yet timely access especially in rural areas and for key populations remains a big challenge. Oral PrEP was also identified as effective HIV preventive measure that can reduce HIV risk from sex by about 99% and from injection drug users by 74%. However, like PEP, timely access especially in rural areas and for key populations remains a big challenge. The UNAIDS 95-95-95 strategy (i.e. 95% of people know their HIV status, 95% with +HIV status be on sustained ART and 95% on ART get viral load suppression) formed the basis for setting the target of ending HIV/AIDS epidemic by 2030. However, our analysis shows that this target is unrealistic given the above highlighted limitations/ barriers in preventive measures and the unlikely perfect adherence (100%) to ART by all enrolled HIV positive persons. Conclusion: Ending HIV/AIDS by 2030 cannot be achieved by implementing the current preventing strategies and control measures. This study established that most of the existing HIV preventive strategies and control measures have a number of limitations. However, with sustained UN 95-95-95 strategy supplemented with additional innovative ways, there is hope that the UN dream of ending HIV/AIDS though not necessarily by 2030, can in the long run be achieved.
文摘Global Warming is the recent and ongoing increase in global average surface temperature.We are currently experiencing serious changes in earth usual temperature,a notable climate change in totality referred to as global warming.Climate change is the long-term shift in weather patterns and average temperatures.Ordinary weather shifts can be in a particular place or the entire earth in totality as it is for the current earth warming.Whereas natural changes in sun’s activity,large volcanic actions and earth orbital movements accounted for such climate changes in the past,since 1800 Human activities like burning of fossil fuels;coal,oil,deforestation and industrialization accounted for the unprecedented Greenhouse gases(GHGs)emissions in the 21st century,leading to exceedingly greater global average surface temperatures.The current extreme warming is a global climate change in totality.This paper aimed at exploring global warming and its implication as climate change reality of the 21st century,suggesting cost-effective youth inclusive mitigation strategies.Results:Published literature reveal two underlying causes of climate change as,Natural processes and Human activities.The two,are major sources of Green House-gas emissions that directly bring about global warming-climate change effect.GHGs,form a stratospheric layer that prevent excess heat escape,thereby excessively warming the earth-atmosphere surface.Greenhouse gases,Carbon dioxide(CO_(2)),Water vapour(H_(2)O),Methane(CH_(4)),Nitrous oxide(N2O),Ozone(O3)are natural GHGs,but also man-made(synthetic GHGs)like Fluorinated Gases(F-Gases);Hydrofluorocarbons(HFCs),Perfluorocarbons(PFCS),Sulphur Hexafluoride(SF6)with more Global warming potential than natural GHGs,together cause extreme warming of earth.GHGs form a blanket wrapped around the Earth,trapping the sun’s heat and cause global warming.Consequences include raising sea levels with flooding of coastal towns,longer and more damaging wild fires,shrinking of ice sheets and snow cover,thawing permafrost,Ocean acidification,famine/hunger,Eco-Anxiety,Drought effects on flora and Fauna and extinction of species.Urgent Youth inclusive mitigation actions include,moving away from use of fossil fuels to renewable energy use like solar power,wind energy and geothermal,ensure energy efficiency and adopt sustainable means of transport like buses,youth inclusive awareness campaigns,afforestation and reforestation,reduced waste production,restoration and conservation of ecosystems wetlands,emission reduction policy implementation of 2015 Paris Agreement on climate change,as well as use of Carbon Capture technologies.Conclusion:Global warming is real.The effects are catastrophic than ever before in the 21st century due to accumulation of GHGs in atmosphere from Human activities.Urgent mitigation needed today is everyone’s role including youth.Together,we can save our planet by making it green again.
