UNAIDS report: Great progress, lagging attention to most vulnerable in changing funding landscape

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UNAIDS2013-2With a 52 percent reduction in new HIV infections among children and a 33 percent drop in new HIV infections overall, the 2013 UNAIDS report on the epidemic outlines remarkable achievements, but also warns of stagnating progress towards meeting other targets and elimination commitments.

The report’s data includes:

  • An estimated 35.5 million people were living with HIV in 2012.
  • There were 2.3 million new HIV infections globally, down 33 percent from 2001 when 3.4 million were newly infected.
  • Deaths from HIV have dropped by nearly a third in seven years; the deaths of 1.6 million people were attributed to AIDS last year, down 30 percent from 2.3 million AIDS-related deaths in 2005.
  • Last year 9.7 million had access to antiretroviral therapy in low and middle income countries, representing 61 percent of those eligible for treatment under 2010 WHO guidelines and 34 percent of those eligible under 2013 guidelines
  • While global HIV funding has stalled since 2008, funds from low and middle-income countries directed to treatment have risen: $18.9 billion was available for the global HIV response last year, of which 53 percent came from low and middle income countries.

While the reduction of mother-to-child-transmission of HIV is one of the most noteworthy accomplishments detailed in the report, treatment coverage among children living with HIV in 2012 was less than half the coverage for adults. An estimated 3.3 million children live with HIV, according to the report.

The report says that the world is within reach of providing antiretroviral treatment to 15 million people by 2015. While that’s welcome news, under new WHO guidelines on treatment eligibility, 28.3 million now should be receiving treatment. This means that by current guidelines, almost 20 million people needing treatment for HIV are not receiving it. The impact of that gap can be considered in light of another success highlighted in the report: UNAIDS estimates that 6.3 million AIDS-related deaths were averted between 1996 and 2012 thanks to antiretroviral therapy.

UNAIDS also reports that the world is within reach of achieving the 2015 target of a 50 percent reduction in tuberculosis-related deaths among people living with HIV. Since 2004, TB-related deaths have declined by 36 percent among people infected with HIV. The report says an increase in collaborative HIV-TB activities averted 1.3 million deaths from 2005 to 2012. Progress has slowed in recent years, though. While antiretroviral treatment prevents TB disease, the report says, “Inadequate use is currently being made of this life-saving tool.”

The biggest shortfall, the report shows, remains in efforts to protect the most vulnerable. In addition to the continuing treatment gap for children living with the virus, prevention efforts continue to lag for those who have been called “key populations,” — those in situations that present the highest risks. HIV transmission among people who inject drugs remains undiminished, according to the report. Prevention coverage for them remains low, with only two of 32 reporting countries providing the recommended minimum of at least 200 sterile syringes per injection drug user per year. Efforts related to reduce transmission among other key populations, such as sex workers and men who have sex with men, remain insufficient as well, the report states.


Laws affecting vulnerable populations (click on image to enlarge)

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