Unless massive cash resources are made immediately available, there could be 45 million new HIV cases by the end of the decade.
In an article in the 6 July edition of the Lancet, a panel of experts convened by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation (WHO) suggests however, that number of new HIV infections could be cut by 25 million provided that a total of $13.2 billion is spent on HIV prevention programmes between now and 2010. The cost of each new case of HIV prevented is calculated at $1000, insufficient to pay for even a fraction of the treatment and care which each new case of HIV would require.
Prevention money, says the article, should be spent on a comprehensive HIV-prevention programmes consisting of 12 interventions. These include mass media campaigns; public sector condom promotion and distribution; condom social marketing; voluntary testing and counselling programmes; prevention of vertical transmission; school-based education; youth work; work-place initiatives; treatment for sexually transmitted infections; peer education for sex workers; outreach work with men who have sex with men; and harm reduction programmes for injecting drug users. All these interventions have been shown to be effective in reducing new HIV infections in both industrialised and resources limited setting around the world. However, if the full package of prevention measures is not initiated within the next three years, the chance to prevent 14.5 million new HIV infections will be lost, the report warns.
Describing the targets as “challenging”, Bernard Schwartlander of WHO, who co-authored the report said “analyses show that these coverage levels are achievable and that the goals for reducing prevalence levels by 25% by 2010, adopted by all governments at the UN Special Session on HIV/AIDS last year, can be met.”
The success of prevention initiatives is expected to vary between countries, with those with low or falling HIV-prevalence rates, such as Senegal and Thailand, predicted to witness a drop of new infections of around 40%, whilst as many as 70% of new infections in China’s burgeoning HIV epidemic could be prevented. Nearly a third of the money should be spent in China and India, the report suggests, with 40% devoted to countries in sub-Saharan Africa.
However, the authors are also warning that for prevention initiatives to be successful, they must be backed by strong programmes designed to care and support those already living with HIV. These would require additional funding of $4.4 billion between now and 2005.
“Implementing these interventions immediately could avert many new infections and dramatically later the course of the epdidemic” said Neff Walker of UNAIDS, one of the report authors, warning that the consequences of not acting will be dire.