The latest World AIDS Day report from the Joint United Nations Program on HIV/AIDS (UNAIDS), released on Tuesday, shows unprecedented reductions in new HIV/AIDS infections, overall prevalence, and HIV/AIDS related deaths, while more people than ever have access to antiretroviral therapy (ART) – all thanks to an acceleration in the global AIDS response.
The report, entitled Results, shows that 25 low- and middle-income countries have seen a 50 percent reduction in the rate of new HIV infections between 2001 and 2011. More than half of these countries are in sub-Saharan Africa, the region most affected by HIV.
Some countries with some of the highest prevalence rates in the world have seen a dramatic cut in the rate of new infections since 2001: by 73 percent in Malawi, 71 percent in Botswana, 68 percent in Namibia, 58 percent in Zambia, and 41 percent in South Africa and Swaziland. An additional nine countries in sub-Saharan Africa have cut the rate of new infections by one-third.
Incidence decreased sharply in the Caribbean, with a drop of 42 percent in new infections. Parts of Asia saw a sharp decrease as well, with Nepal drastically reducing new infections by 91 percent and Cambodia by 88 percent. The rate of new infections increased in the Middle East and North Africa, and in parts of South and Southeast Asia, Eastern Europe, and Russia.
The report indicates that half of the global reductions in new HIV infections in the last two years have been among newborn children. In a release from UNAIDS, Executive Director Michel Sidibé said, “It is becoming evident that achieving zero new HIV infections in children is possible…We are moving from despair to hope.” New HIV infections in children decreased by 24 percent in the last two years, and the number of children newly infected with HIV fell by at least 40 percent in six countries – Burundi, Kenya, Namibia, South Africa, Togo, and Zambia.
The report indicates that ART has emerged as a powerful force for saving lives. Thanks to sustained funding for access to ART, a record number of lives were saved in the past six years: last year more than half a million fewer people died from AIDS than in 2005. Countries with high HIV burden saw significant drops in mortality last year compared to 2005: South Africa saw 100,000 fewer deaths, Zimbabwe saw 90,000 fewer deaths, Kenya saw 71,000 fewer deaths and Ethiopia saw 48,000 fewer deaths.
Impressive gains were also made in reducing TB-related HIV/AIDS deaths in people co-infected with TB and HIV, with a 13 percent decrease in TB-related deaths in the past two years. The report states that this accomplishment is due to record 48 percent of people co-infected having access to ART, but UNAIDS also acknowledges that much more needs to be done.
Globally, the number of people accessing treatment has increased by 63 percent over the past two years. With a record 8 million people receiving ART, for the first time over half of those eligible to receive treatment are getting it. In sub-Saharan Africa alone, 2.3 million people had access to treatment last year.
The report indicates that these gains have been made possible thanks to increased investments in the AIDS response, despite a difficult economic climate. The global gap in resources needed annually by 2015 stands at 30 percent, with $16.8 billion in funds available in 2011 while $22-24 billion is needed by 2015.
Last year domestic investments from low- and middle-income countries surpassed global giving for the first time ever. Countries are also better implementing programs to sustain the rapid growth in ART access. In addition, a drastic reduction in the price of antiretrovirals — from $10,000 per person per year in 2001 to around $100 annually in some countries today — has allowed for greater access to ART and more lives saved.
Although there have been impressive gains in ART access, an estimated 6.8 million people eligible for treatment do not have access, and the total number of new HIV infections remains high, with 2.5 million new infections in 2011. The report also indicates that HIV continues to have a disproportionate impact on key populations, such as sex workers, men who have sex with men, and people who inject drugs. In a release, Mr. Sidibé stated, “Now that we know that rapid and massive scale up is possible, we need to do more to reach key populations with crucial HIV services.”