HIV/AIDS, TUBERCULOSIS, AND MALARIA: TOWARDS THE LAST MILE OF THEIR ELIMINATION

 current concerns 2-003

HIV/AIDS, TUBERCULOSIS, AND MALARIA: TOWARDS THE LAST MILE OF THEIR ELIMINATION

-by Dr. Uzodinma Adirieje / +2347015530362 (WhatsApp) / druzoadirieje2015@gmail.com

 

HIV/AIDS, Tuberculosis (TB), and Malaria remain three of the most pressing global health challenges of our time. Despite decades of global effort, these diseases still claim millions of lives, especially in countries of Africa and other low- and middle-income countries. As the world moves toward the ambitious goal of eliminating them by 2030, the journey into the “last miles” will require extraordinary effort, innovation, and commitment. Significant progress has been achieved over the past two decades. New HIV infections have declined sharply, and millions of people now access antiretroviral therapy that allows them to live healthy lives. TB-related deaths have dropped globally, thanks to better diagnostics, treatment access, and global health strategies. Malaria deaths have also fallen substantially due to the widespread use of insecticide-treated nets, effective drugs, and vector control efforts.

 

Yet, challenges remain—and they are formidable. Drug resistance is increasing across all three diseases. Multidrug-resistant TB, treatment-resistant strains of malaria, and rising HIV drug resistance in some regions threaten to undo progress. Weak health systems, limited access to diagnostics, healthcare worker shortages, brain drain, and underfunded national programmes continue to slow progress, particularly in rural and conflict-affected areas. The COVID-19 pandemic disrupted essential health services, delayed diagnoses, and caused treatment interruptions, especially for TB and malaria. With the United States withdrawal of funding support especially through the USAID, funding gaps have widened as global attention and donor resources shift toward new health threats. Social barriers—such as stigma, gender inequality, and poverty—further deepen the burden.

 

To move closer to elimination, a multidimensional strategy is essential. Improving early diagnosis and treatment remains a top priority. Innovations like rapid diagnostic tests and self-testing kits can extend services to hard-to-reach populations. Community-based screening programmes must be expanded, particularly in areas with limited healthcare infrastructure.

Prevention efforts are also evolving. New long-acting preventive treatments for HIV, next-generation malaria vaccines, and promising TB vaccine candidates offer hope for stronger protection. But these tools must be accompanied by strong health delivery systems to ensure accessibility, equity, and uptake.

 

Community engagement plays a vital role in the last mile. Civil society organizations (CSOs), peer educators, and affected communities are crucial in reducing stigma, supporting treatment adherence, and holding systems accountable. Rights-based approaches that prioritize inclusion, dignity, and trust are vital for reaching key populations that are often left behind.

Integrated service delivery is another critical element. Offering HIV, TB, and malaria services in the same location saves time, reduces stigma, and improves care. Digital health tools—like mobile apps, telemedicine platforms, and electronic records—can improve follow-up and empower patients.

 

Political will and domestic investment must be scaled up. Countries need to reduce dependency on external donors by increasing health budgets, improving procurement systems, and strengthening governance. Leaders must commit to accountability, innovation, and sustained action, even amid competing priorities. There have been encouraging examples across Africa and the Global South. Some countries are approaching HIV epidemic control, and others have made significant strides in TB and malaria elimination through community health programmes and innovative partnerships. Regional cooperation through health alliances has helped pool resources and share best practices.

 

Scientific innovation remains a cornerstone of the path forward. Breakthroughs in vaccine development, treatment regimens, genetic technologies, and disease surveillance offer powerful tools. However, technology alone is not enough. Success will depend on our ability to adapt these innovations to local realities, invest in delivery systems, and address all the social determinants of health. Reliable monitoring and evaluation (M&E) systems are essential. Timely, inclusive, and disaggregated data help identify gaps, guide interventions, and ensure resources reach those most in need. National dashboards and real-time reporting systems must be strengthened to track progress and support evidence-based decision-making.

 

In conclusion, the last miles in the fight against HIV/AIDS, TB, and malaria appears to be the hardest and most crucial stage. It is a test of global solidarity, national leadership, community engagement, and collective resolve. The tools to end these diseases are within reach. With the right investments, community leadership, and humane, targeted, science-driven policies, we can move from control to elimination—and ultimately to a world free from the burden of these preventable diseases viz HIV/AIDS, TB, and malaria. Yes, we can!

 

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, development planning, project management, sustainable development goals (SDGs), governance, health/community systems strengthening, policy advocacy, and monitoring and evaluation (M&E). He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South. He was the Chair of Nigeria’s national World Malaria Day Committee in 2019; National President and fellow of the Nigerian Association of Evaluators (NAE) during 2019 – 2022; and Chair of the Resource Mobilization sub-committee of Nigeria’s national World Tuberculosis Day Committee in 2025.