Global effort to halt, reverse HIV/AIDS showing results
Global efforts to halt and even reverse the spread of HIV/AIDS are showing welcome results, with the number of people newly infected declining and AIDS-related deaths falling, according to the latest report from the United Nations agency leading the fight against the disease.
The Report on the Global AIDS Epidemic 2010, produced by the Joint UN Programme on HIV/AIDS (UNAIDS), contains basic HIV data from 182 countries and includes country-by-country scorecards. It shows that an estimated 2.6 million people became newly infected with HIV, nearly 20 per cent fewer than the 3.1 million people infected in 1999. In 2009, 1.8 million people died from AIDS-related illnesses, nearly one-fifth lower than the 2.1 million people who died in 2004.
UNAIDS said that together, this is contributing to the stabilisation of the total number of people living with HIV in the world, although much more still needed to be done, especially in light of reduced funding for the global response to AIDS.
“We are breaking the trajectory of the AIDS epidemic with bold actions and smart choices,” said UNAIDS Executive Director Michel Sidibe. “Investments in the AIDS response are paying off, but gains are fragile -- the challenge now is how we can all work to accelerate progress.”
According to the report, from 2001 to 2009, the rate of new HIV infections stabilised or decreased by more than 25 per cent in at least 56 countries around the world, including 34 countries in sub-Saharan Africa.
Of the five countries with the largest epidemics in the region, four countries -- Ethiopia, South Africa, Zambia and Zimbabwe -- have reduced rates of new HIV infections by more than 25 per cent, while Nigeria’s epidemic has stabilised.
Sub-Saharan Africa continues to be the region most affected by the epidemic with 69 per cent of all new HIV infections. In seven countries, mostly in Eastern Europe and Central Asia, new HIV infection rates have increased by 25 per cent. Among young people in 15 of the most severely affected countries, the rate of new HIV infections has fallen by more than 25 per cent, led by young people adopting safer sexual practices.
Condom use and availability have increased significantly. Eleven countries -- including Burkina Faso, India and Peru -- report more than 75 per cent condom use at last higher-risk sex. Data from 78 countries show that condom use among men who have sex with men was more than 50 per cent in 54 countries. Reports of condom use by sex workers are also encouraging -- in 69 countries, more than 60 per cent of sex workers used a condom with their last client.
Access to HIV prevention services, including harm reduction programmes for people who inject drugs, has reached 32 per cent -- far short of what is needed to protect drug users from HIV worldwide, the report noted. Even though many countries have included male circumcision in their prevention programmes, uptake at a population level remains low, and has not made a significant impact on the rate of new HIV infections.
However, UNAIDS noted in its report that even though the number of new HIV infections is decreasing, there are two new HIV infections for every one person starting HIV treatment. Investments in HIV prevention programmes as whole have not been adequate or efficiently allocated. HIV prevention investments comprise about 22 per cent of all AIDS-related spending in low- and middle-income countries.
In relation to the report’s findings that more people are living longer and AIDS-related deaths are declining as access to treatment has expanded, UNAIDS said that the total number of people on treatment increased by seven and half times over the last five years with 5.2 million people accessing life-saving drugs in 2009, compared to 700,000 in 2004.
Over the course of the last year alone, an additional 1.2 million people received treatment -- a 30 per cent increase compared to 2008. In addition, there has been a secondary dividend of stopping new HIV infections with increased access to HIV treatment. But nearly twice the number of people -- 10 million -- are waiting for treatment. New evidence shows that scaling up treatment has led to reductions in population mortality in high-prevalence settings.
As more countries are using effective treatment regimens to prevent HIV transmission to babies, the total number of children born with HIV has decreased. An estimated 370,000 children were newly infected with HIV in 2009, representing a drop of 24 per cent from five years earlier.
The report also contains new data which shows that human rights efforts are increasingly being integrated into national AIDS strategies, with 89 per cent of countries explicitly acknowledging or addressing human rights in their AIDS strategies and 91 per cent having programmes in place to reduce stigma and discrimination. However, punitive laws continue to hamper access to AIDS-related services -- 79 countries worldwide criminalise same sex relations and six apply the death penalty.
UNAIDS estimates that a total of $15.9 billion was available for the AIDS response in 2009, $10 billion short of what is needed in 2010, and that funding from international sources appears to be falling. Donor governments’ disbursements for the AIDS response in 2009 stood at $7.6 billion, lower than the $7.7 billion available in 2008.
The agency said that the declines in international investments will affect low-income countries the most -- nearly 90 per cent rely on international funding for their AIDS programmes -- and that there is an urgent need to sustain and scale up good investments and for countries to share the financial burden of the epidemic.