Increasing access to antiretroviral therapy is starting to have a major impact on the global AIDS epidemic, according to a report released by UNAIDS and WHO. Prevention is also having an impact on new infections, although some of the decline in new infections is due to the natural course of the epidemic.
AIDS-related deaths fell by 10% in 2008, and since 2001 there has been a 17% decrease in HIV incidence.
“The good news is that we have evidence that the declines we are seeing are due, at least in part, to HIV prevention,” said Michel Sidibé, Executive Director of UNAIDS. “However, the findings also show that prevention programming is often off the mark and that if we do a better job of getting resources and programmes to where they will make most impact, quicker progress can be made and more lives saved”.
Nevertheless, Paul De Lay of UNAIDS emphasised that the global HIV epidemic was still “very serious”.
In advance of World AIDS Day on December 1st, the United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation released their annual AIDS Epidemic Update.
At the end of 2008, 33.4 million people were living with HIV globally. There were 2.7 million new infections and 2 million HIV-related deaths.
But the generally upbeat report showed that expanding access to HIV therapy was having tangible benefits.
At the end of 2008 4 million individuals were receiving antiretroviral drugs. And this meant that increasing numbers of HIV-positive patients were living longer and healthier lives.
AIDS-related mortality is falling significantly. In Kenya, treatment scale-up between 2002 and 2007 resulted in a 29% decline in deaths attributable to HIV. And in Botswana where 80% of individuals in need of antiretroviral therapy are receiving it, the number of people dying because of HIV fell by half between 2003 and 2007.
Globally, it is now estimated that almost 3 million lives have been saved thanks to HIV treatment.
Furthermore, thanks to HIV treatment, there has been a dramatic fall in the number of children orphaned because of the virus. In Botswana, expanding access to antiretroviral therapy has been accompanied by a 40% fall in the number of children orphaned because of HIV.
Prevention successes were also highlighted in the report. Overall, there has been a 17% fall in new HIV infections since 2001.
The biggest prevention gains have been seen in sub-Saharan Africa where an estimated 400,000 new infections have been prevented since 2008.
Access to antiretroviral therapy expanded in key prevention groups. The proportion of HIV-positive pregnant women who received anti-HIV drugs to prevent mother-to-child HIV transmission rose from 35% in 2007 to 45% by the end of 2008.
Efforts to prevent vertical HIV transmission are estimated to have averted 200,000 infections since 2001.
However, the report also showed that much still remains to be done.
There were 2 million new HIV infections in 2008. For every two individuals who started HIV treatment last year, five were newly infected.
Appropriate targeting of prevention resources remains essential, and the report highlights how there are multiple and evolving HIV epidemics around the world (see this separate aidsmap.com report. Especially serious is the epidemic in Eastern Europe and Central Asia, the only world regions where HIV incidence is still increasing.
The report concludes that HIV remains one of the world’s most serious public health challenges and that responding to it is a “moral imperative.”