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HIV/AIDS: AIDS epidemic changing course

Photo: Glenna Gordon/IRIN
Prevention efforts are paying off, says UNAIDS
Johannesburg, 24 November 2010 (PlusNews) - A new UNAIDS report claims the world has finally “turned the corner” on the AIDS epidemic, citing a downward trend in new HIV infections and AIDS-related deaths over the past decade and stabilization of the number of people living with HIV globally.

“We are breaking the trajectory of the AIDS epidemic,” said Michel Sidibe, UNAIDS executive director, in a statement.

Global HIV prevalence was 33.3 million by the end of 2009, a slight increase from 2008, in large part because many more people are accessing antiretroviral (ARV) treatment and living longer with the virus.

More than five million people are receiving ARVs and in 2009 alone, 1.2 million people were initiated onto treatment. As a result, AIDS-related deaths are down nearly 20 percent compared with five years ago and in Botswana, one of only two countries in sub-Saharan Africa to have achieved universal access to treatment, AIDS-related deaths have halved since 2002.

The bi-annual UNAIDS report, which provides a detailed snapshot of the epidemic and progress in achieving the Millennium Development Goal of halting and reversing the spread of HIV by 2015, attributes the more than 25 percent declines in HIV incidence seen in 33 countries since 2001 to effective HIV prevention. The most dramatic declines were seen in sub-Saharan Africa, the region worst hit by the epidemic. Only in seven countries, most of them in Eastern Europe and Central Asia, has HIV incidence increased in recent years.

“We are getting there,” said Sheila Tlou, UNAIDS director for eastern and southern Africa, at the launch of the report in Johannesburg on 23 November. “Our vision of zero new infections, zero discrimination and zero AIDS-related deaths is possible.”

While the UNAIDS report suggests that prevention is working, Tlou warned that the response was fragile and needed to be kept alive with adequate funding. “Domestic funding is still too low,” she said. “AIDS programmes need to be made more sustainable and affordable and we need to become less reliant on international donors.”

Fast Facts
33.3 million people are living with HIV
7,000 new HIV infections occur a day
1.8 million people died as a result of AIDS
54% of pregnant women in sub-Saharan Africa received PMTCT
13 women in sub-Saharan Africa contracted HIV for every 10 men
Source: UNAIDS (figures from 2009)
At a time when donors are flat-lining or cutting back their contributions to the AIDS response, UNAIDS estimates that nearly US$16 billion was available for combating HIV in 2009, $10 billion short of what was needed in 2010. Although domestic expenditure is the largest source of HIV financing globally, UNAIDS estimates that nearly half the countries in sub-Saharan Africa are spending less than they can afford and could substantially increase the portion of their AIDS budgets from domestic sources.

Apart from financing, Tlou said the greatest barrier to scaling up the AIDS response was stigma and discrimination, particularly in relation to marginalized and high-risk groups, such as men who have sex with men, sex workers and injecting drug users, who have been driven underground by punitive laws that often prevent them from accessing HIV services.

The report revealed that progress on treatment access has also been uneven. Only 29 percent of children needing ARVs were getting them by the end of 2009 compared with 37 percent of adults.

Brian Pazvakavambwa of the World Health Organization pointed out that access to treatment for tuberculosis patients co-infected with HIV and for pregnant women was also comparatively low and blamed weak health systems and fragmented implementation for the failure to link programmes such as prevention of mother-to-child transmission (PMTCT) with treatment.

While access to PMTCT has increased significantly, resulting in fewer children being born with HIV, only 15 percent of HIV-positive pregnant women received ARVs in 2009.

“A lot of work still needs to be done,” said Pazvakavambwa at the launch. “We need to continue expanding and linking all parts of the response; if we can link our programmes better we can do better in terms of all health outcomes.”


Theme(s): Care/Treatment - PlusNews, HIV/AIDS (PlusNews), Prevention - PlusNews, Stigma/Human Rights/Law - PlusNews,

[This report does not necessarily reflect the views of the United Nations]

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