On Monday the Joint United Nations Program on HIV/AIDS (UNAIDS) released a new report on the state of global AIDS, which shows that nearly half of people living with HIV/AIDS who qualify for treatment are receiving it. The 2011 UNAIDS World AIDS Day Report estimates that 6.6 million of the estimated 14.2 million people eligible for treatment in low and middle income countries accessed antiretroviral therapy (ART) in 2010, in increase of 1.35 million since 2009. The report also highlights that there are early signs that show scaling up ART is reducing the number of new HIV infections.
An estimated 34 million people were living with HIV/AIDS at the end of 2010. Last year, 2.7 million became infected with the disease, while 1.8 million died from AIDS-related illnesses. Deaths from AIDS-related illnesses decreased by 21 percent since 2005, while new infections were reduced by 21 percent since 1997. These numbers show that new infections and deaths have fallen to the lowest levels since the peak of the epidemic.
New infections have significantly reduced in most parts of the world, with the number of new infections in Sub-Saharan Africa dropping by 26 percent from the peak of the epidemic in 1997. However, new infections are continuing to rise in Eastern Europe and Central Asia, Oceania, and the Middle East and North Africa.
The report estimates that 2.5 million lives have been saved since 1995 thanks to scaled-up treatment. The report also suggests that new infections are averted as countries scale up their treatment efforts. For example, in Botswana, sexual behavior patterns have remained stable since 2000, when less than 5 percent of people received treatment. Today, more than 80 percent of people are receiving ART. New infections have declined by two-thirds since the late 1990s and data suggests that the number of new infections is 30-50 percent lower today than it would have been without ART.
UNAIDS reports that thanks to renewed prevention efforts, new infections have notably reduced or stabilized in most parts of the world. Changes in sexual behavior, particularly among young people, are spurring a decline in new infections. Prevalence among young people declined in at least 21 of 24 countries with national prevalence of 1 percent or higher. Young people are reducing their number of partners, increasing condom use, and are waiting longer before becoming sexually active.
An increase in medical male circumcision is also delivering results: studies show that 2000 new infections were averted in the Nyanza province of Kenya after a scale up of voluntary medical male circumcision. The report highlights that circumcising 20 million men in Eastern and Southern Africa would avert 3.4 million new infections by 2015. The report also shows that prevention of mother-to-child transmission (PMTCT) efforts have averted thousands of new infections among children: 400,000 vertical transmissions in children have been averted since 1995 thanks to PMTCT. Currently 48 percent of all pregnant women living with HIV have access to PMTCT.
The report also maps out UNAIDS’ new framework for AIDS investments. The framework is based on six program activities:
- focused interventions for key populations at higher risk (particularly sex workers and their clients, men who have sex with men, and people who inject drugs)
- prevention of new HIV infections in children
- behavior change programs
- condom promotion and distribution
- treatment, care and support for people living with HIV
- voluntary medical male circumcision in countries with high HIV prevalence.
Scaling up global AIDS funding to $22-24 billion by 2015 is required if the new framework were to be implemented. This number is in line with the targets set out in the 2011 United Nations Political Declaration on HIV/AIDS. At the end of last year, about $15 billion was devoted to the AIDS response in middle and low income countries. The report claims that a new strategic approach to investments would achieve extraordinary results: 12.2 million new infections would be averted – including 1.9 million among children between 2011 and 2020, and 7.4 million deaths would be averted by 2020 as well.