UNAIDS: Africans with HIV more likely to get ARVs than Eastern Europeans

Keith Alcorn
Published: 18 July 2012

UNAIDS says that international efforts are on target to deliver antiretroviral treatment to 15 million people by 2015, but people eligible for treatment are much more likely to be getting antiretroviral drugs in sub-Saharan Africa compared to Eastern Europe or Central Asia.

UNAIDS released its annual report on global progress towards universal HIV prevention, treatment and care, Together We Will End AIDS, ahead of the Nineteenth International AIDS Conference (AIDS 2012) in Washington DC, which begins on Sunday July 22nd.

Globally, the number of people receiving antiretroviral treatment rose by 20% in 2011. In sub-Saharan Africa, UNAIDS reports that 900,000 people started treatment in 2011, a 19% increase in coverage. Fifty-six per cent of people eligible for treatment in sub-Saharan Africa are now receiving it, compared to 23% in Eastern Europe and Central Asia, and 40% in Asia. The World Health Organisation (WHO) estimates that international donors such as the Global Fund and the US government support around 84% of treatment costs in low-income countries.

Nevertheless, funding for HIV treatment and prevention is increasingly coming from the domestic budgets of low- and middle-income countries. More than 80 countries increased their domestic investments in HIV prevention and treatment by more than 50% between 2006 and 2011, UNAIDS reports, while funding from donors has remained largely unaltered since 2008.

If further increases in donor and domestic funding cannot be secured, UNAIDS projects a funding gap of $7 billion by 2015. “Countries most affected by the epidemic are taking ownership and demonstrating leadership in responding to HIV,” said Michel Sidibé, Executive Director of UNAIDS. “However, it is not enough for international assistance to remain stable­­ – it has to increase if we are to meet the 2015 goals.”

There has also been substantial progress in providing antiretroviral options for prevention of mother-to-child HIV transmission. Fifty-seven per cent of pregnant women estimated to be living with HIV in low- and middle-income countries received an effective regimen in 2011, an increase of nearly 10% in one year. Alongside this improvement in access to drugs, UNAIDS estimates that the number of children newly infected with HIV has declined by 24% since 2009, when WHO recommended a substantial expansion of the use of antiretroviral drugs during pregnancy and breastfeeding in order to reduce new infections.

The reduction in new infections among children has been most pronounced in some of the countries with the highest burden of HIV infection, such as South Africa (-49%), Zambia (-55%) and Zimbabwe (-49%), but other countries in the region have done less well. New infections in children have fallen by only 5% in Mozambique, and by 2% in Nigeria, countries that continue to report high levels of HIV infection in pregnant women.

UNAIDS notes that to achieve the target of zero new infections among children, treatment must reach all the estimated 620,000 women living with HIV who become pregnant each year.

Although the number of new infections among adults and adolescents has declined by 500,000 per year compared to 2001, 2.2 million people became infected with HIV in 2011. New infections have declined by 35% from the peak of the epidemic in sub-Saharan Africa, but UNAIDS reports no change in the rate of infection among key populations such as people who inject drugs and men who have sex with men in Eastern Europe, Central Asia, the Middle East and Asia. Nevertheless, the majority of new infections which occurred in 2011 occurred in sub-Saharan Africa: 1.5 million people acquired HIV.