Shahina MaqboolWednesday, November 21, 2012
From Print Edition
From Print Edition
people accessing antiretroviral therapy; 35% decline in AIDS-related deaths between 2005 and 2011.There has been a 35 per cent decline in AIDS-related deaths between 2005 and 2011, and a 63 per cent increase in the number of people accessing antiretroviral therapy. However, despite the encouraging progress in stopping new HIV infections, the total number of new HIV infections remains high-2.5 million in 2011.
These data have come to the fore in a World AIDS Day report released worldwide by the Joint United Nations Programme on HIV/AIDS (UNAIDS). Launched ahead of World AIDS Day 2012, the report, which is available on the UNAIDS website, outlines some significant progress made in the AIDS response in recent years. The new results come as the AIDS response is in a 1000-day push to reach the Millennium Development Goals and the 2015 targets of the UN Political Declaration on HIV/AIDS.
According to the report, 25 countries have seen a 50 per cent or greater drop in new HIV infections since 2001. Half of all reductions in new HIV infections in the last two years have been among newborn children, showing that elimination of new infections in children is possible.
Unprecedented acceleration in the AIDS response, the report notes, is producing results as a more than 50 per cent reduction in the rate of new HIV infections has been achieved across 25 low- and middle-income countries-more than half in Africa, the region most affected by HIV.
In some of the countries which have the highest HIV prevalence in the world, rates of new HIV infections have been cut dramatically since 2001; by 73% in Malawi, 71% in Botswana, 68% in Namibia, 58% in Zambia, 50% in Zimbabwe and 41% in South Africa and Swaziland.
In addition to welcome results in HIV prevention, sub-Saharan Africa has reduced AIDS-related deaths by one-third in the last six years and increased the number of people on antiretroviral treatment by 59% in the last two years alone. In 2011, more than 8 million people living with HIV had access to antiretroviral therapy. The number of people accessing HIV treatment has increased by 63% from 2009 to 2011. In 10 low- and middle-income countries, more than 80% of those eligible are receiving antiretroviral therapy. However, 7 million people eligible for HIV treatment still do not have access. Moreover, 72% of children living with HIV who are eligible for treatment do not have access, the report points out.
The area where maximum progress is being made is in reducing new HIV infections in children. Half of the global reductions in new HIV infections in the last two years have been among newborn children, the report informs. In the last two years, new HIV infections in children decreased by 24%.
The report shows that antiretroviral therapy has emerged as a powerful force for saving lives. In the last 24 months, the numbers of people accessing treatment has increased by 63% globally. There were more than half a million fewer deaths in 2011 than in 2005. In 2011, 1.7 million [1.5 million-1.9 million] people died from AIDS-related causes worldwide-24% fewer deaths than in 2005. However, two regions experienced significant increases in AIDS-related deaths; Eastern Europe and Central Asia (21%) and the Middle East and North Africa (17%).
Impressive gains have also made in reducing TB-related AIDS deaths in people living with HIV; these deaths have fallen by 25% since 2004. In the last 24 months, a 13% decrease in TB-related AIDS deaths was observed. This accomplishment is due to a record increase of 45% in the number of HIV/TB co-infected people accessing antiretroviral treatment. The report urges all people living with TB and HIV to start antiretroviral therapy immediately as it can reduce the risk of TB illness among people living with HIV by up to 65%.
An estimated 6.8 million people are eligible for treatment and do not have access. UNAIDS also estimates that an additional 4 million discordant couples (where one partner is living with HIV) would benefit from HIV treatment to protect their partners from HIV infection.
Of the 34 million people living with HIV, about half do not know their HIV status. If more people knew their status, they could come forward for HIV services, the report states.
In addition, there is an urgent need to improve HIV treatment retention rates; reduce the cost of second- and third-line treatment; and explore new ways of expanding access to treatment, including domestic production of medicines and innovative financing.The report outlines that to reduce new HIV infections globally, combination HIV prevention services need to be brought to scale.
The report shows that HIV continues to have a disproportionate impact on sex workers, men who have sex with men, and people who inject drugs. HIV prevention and treatment programmes are largely failing to reach these key populations. According to 2012 country progress reports, national HIV prevalence among people who inject drugs in Pakistan and Indonesia is more than 25% and 35%, respectively; the reported HIV prevalence in Bangladesh among people who inject drugs was far lower, at less than 2%.
With respect to funding, the report informs that in spite of a difficult economic climate, countries are increasing investments in the AIDS response. The global gap in resources needed annually by 2015 now stands at 30%. In 2011, US $16.8 billion was available and the need for 2015 is between US $ 22-24 billion.
In 2011, for the first time ever, domestic investments from low- and middle-income countries surpassed global giving for HIV, the report states. However, international assistance remains a critical lifeline for many countries and countries must take steps to reduce their dependence, the report underlines.
The report also shows that countries are assuming shared responsibility by increasing domestic investments. More than 81 countries increased domestic investments by 50 per cent between 2001 and 2011.