The global AIDS epidemic is gradually being turned around, with new infections and deaths falling, but UNAIDS warned on Wednesday in its annual report that, at a time of financial cutbacks, continued progress is far from certain.
After nearly 30 years, there are 33.3 million people living with HIV, 22.5 million of whom live in sub-Saharan Africa. About 5.2 million are on drug treatment to keep them alive and well, but 10 million more need it urgently.
For these people, says UNAIDS, “the gains are real but very fragile. Future progress will depend heavily on the joint efforts of everyone involved in the HIV response.”
Last year there were an estimated 1.8 million AIDS-related deaths, a drop from the peak year of 2004, when 2.1 million died. There were an estimated 2.6 million new infections, 19 percent fewer than the 3.1 million infected in 1999. The estimated numbers of orphans has risen from 10 million in 2001 to 16.6 million last year.
The report comes at a time when funding for HIV/AIDS is being reduced in response to the world economic crisis and also the drive to put more resources into other areas of global health, such as preventing the deaths of women in childbirth. The Global Fund to fight AIDS, TB and Malaria recently failed to raise the US$13 billion for the next three years that it needed from donors to keep all the country programs it finances going.
“We have halted and begun to reverse the epidemic. Fewer people are becoming infected with HIV and fewer people are dying from AIDS,” says Michel Sidibe, executive director of UNAIDS, in his foreword to the report. But, he says, it is not yet time to say “mission accomplished.”
“Growth in investment for the AIDS response has flattened for the first time in 2009. Demand is outstripping supply,” he wrote. “Stigma, discrimination and bad laws continue to place roadblocks for people living with HIV and people on the margins.”
There have been dramatic improvements in 33 countries, where HIV incidence has fallen by more than a quarter between 2001 and last year. A third of them are in sub-Saharan Africa. The number of new infections in the region is down from 2.2 million a year in 2001 to 1.8 million last year. Some of that is a result of prevention efforts, which appear to be changing unsafe sexual behavior and increasing condom use in some countries, while some is a result of “the natural course of HIV epidemics,” the report says.
However, those countries that have stabilized still have high HIV levels. South Africa, with an estimated 5.6 million people living with HIV last year, has the largest epidemic in the world and Swaziland, at 25.9 percent, has the highest adult HIV prevalence.
In spite of the progress, many countries will miss millennium development goal (MDG) six, which is to halt by 2015 and start to reverse the spread of HIV/AIDS and other infectious diseases. With a shifting of the world’s focus to MDGs four and five, on children and maternal health, the UNAIDS report points out that tackling infectious diseases is still critical.
“The millennium development goals are intertwined. Without achieving substantive progress towards the HIV-specific Goal 6, few other goals are likely to be reached,” the report says. “Likewise, without integration and significant progress towards most other goals being made, goal 6 will probably not be achieved.”
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