A new United Nations report claims it will be possible to control the HIV and AIDS epidemic by 2030 and eventually end it “in every region, in every country”.
However, a reported 19 million of the 35 million people currently living with HIV are not aware they have the virus, leading the report to conclude:
“Smarter scale-up is needed to close the gap between people who know their HIV status and people who don’t, people who can get services and people who can’t and people who are protected and people who are punished.”
“19 million of the 35 million people currently living with HIV are not aware they have the virus”
“Whether you live or die should not depend on access to an HIV test,” said Michel Sidibé, the Executive Director of the UN’s AIDS programme (UNAIDS). “If we accelerate all HIV scale-up by 2020, we will be on track to end the epidemic by 2030. If not, we risk significantly increasing the time it would take – adding a decade, if not more.”
Sidibé appealed to the international community to seize the opportunity to change the future of the epidemic.
“We have a fragile five-year window to build on the rapid results that have been made,” he said. “The next five years will determine the next 15.”
Decline in infections thanks to increase in treatment coverage
According to new data analysis, for every 10 percent increase in treatment coverage, there is a 1 percent decline in new infections among people living with HIV. Ending the epidemic by 2030 would avert 18 million new HIV infections and 11.2 million AIDS-related deaths globally between 2013 and 2030.
The UNAIDS report shows that once people find out they are HIV positive they seek life-saving treatment. In sub-Saharan Africa, for example, almost 90 percent of people who tested positive for HIV were being treated.
“The number of people infected with HIV is stabilising”
As a result, UNAIDS said the number of people infected with HIV was stabilising at around 35 million worldwide. New HIV infections and deaths from AIDS are said to be decreasing.
According to the report, new HIV infections have fallen by 38 percent since 2001, while AIDS-related deaths have gone down by 35 percent since a peak in 2005.
“More than ever before, there is hope that ending AIDS is possible. However, a business-as-usual approach or simply sustaining the AIDS response at its current pace cannot end the epidemic,” UNAIDS wrote in its global report.
Some 39 million of the 78 million people affected by the epidemic have died since it began it the 1980s.
ART drugs 'helping' viral suppression
The human immunodeficiency virus (HIV) that causes the acquired immunodeficiency syndrome (AIDS) is transmitted via blood, breast milk and semen during sex. It is currently treated with antiretroviral therapy (ART) drugs. Research shows that around 76 percent of those on ART in sub-Saharan Africa have achieved viral suppression, meaning they are unlikely to pass on the virus to their sexual partners. Efforts to increase access to ART are said to be working: at the end of 2013, UNAIDS said, around 12.9 million HIV positive people were receiving the cocktail of required drugs; a marked improvement on 2012, when 10 million were being treated, and 2010 when the figure was just 5 million.
Ending the AIDS epidemic by 2030 would, according to the report, mean the spread of HIV was being controlled or contained. It would also signal significant declines in ill health, stigma, deaths and the number of people orphaned by AIDS. “It means increased life expectancy, unconditional acceptance of people’s diversity and rights, and increased productivity and reduced costs as the impact diminishes,” says Sidibé.
In 2013, some 14.1 billion euros were made available for the AIDS response, according to UNAIDS. The estimated annual funding need by 2015 currently stands at between 16.2 and 17.7 billion euros.
In 2011, UN member states set a target of providing HIV treatment for 15 million people by 2015. But, countries’ scaled-up treatment coverage, combined with evidence showing how early treatment of HIV reduces its spread, pushed the World Health Organisation (WHO) to set new guidelines in 2013; the number of people needing treatment was expanded by more than ten million.
“Just 15 countries accounted for over 75 percent of the 2.1 million newly-diagnosed HIV carriers in 2013”
Just 15 countries accounted for over 75 percent of the 2.1 million newly-diagnosed HIV carriers in 2013, the report reveals. They are Brazil, Cameroon, China, India, Indonesia, Kenya, Mozambique, Nigeria, Russian Federation, South Africa, Uganda, United Republic of Tanzania, USA, Zambia and Zimbabwe. The report shows three or four countries in each region of the world bear the brunt of the epidemic.
However, some countries seem to be left behind; millions of HIV positive people are still not receiving the drugs they need, according to Jennifer Cohn, medical director of the access campaign for Médecins Sans Frontières (Doctors Without Borders).
“Providing life-saving HIV treatment to nearly 12 million people in the developing world is a significant achievement, but more than half of people in need still do not have access,” she remarked. “We know that early treatment helps prevent transmission of HIV and keeps people healthy; we need to respond to HIV in all contexts and make treatment accessible to everyone in need as soon as possible.”
The Central African Republic, Democratic Republic of Congo, Indonesia, Nigeria, Russian Federation and South Sudan, for example, are faced with a triple threat: high HIV burden; low treatment coverage; and little or no decline in new HIV infections. UNAIDS concludes that focusing on such “underserved” populations will be crucial to ending the AIDS epidemic.
Latest UNAIDS statistics show...
At 2.1 million, HIV infections are at their lowest this century. New infections have dropped by 13 percent in the last three years alone.
At the end of 2013, an estimated 35 million people worldwide were living with HIV. AIDS-related deaths have declined by 35 percent, since a peak in 2005.
The leading cause of death among people living with HIV is tuberculosis.
Among children, new HIV infections have fallen by 58 percent since 2001. They have dropped below 200,000 for the first time in the 21 most affected countries in Africa.
Sub-Saharan Africa is home to the highest number of people infected with HIV (24.7 million). Asia and the Pacific have the next largest number, at an estimated 4.8 million people.
At 51 percent, Western Europe and North America are believed to be the areas where the highest number of people is receiving treatment. Latin America is next, with 45 percent. Coverage was found to be lowest in the Middle East and North Africa, at just 11 percent.
The Caribbean has seen the biggest decline in new HIV infections – by 40 percent since 2005. However, in the same timeframe, new HIV infections have risen by 8 percent in western Europe and North America, by 7 percent in the Middle East and North Africa, and by 5 percent in eastern Europe and central Asia.
AIDS-related deaths were found to have risen steeply in the Middle East and North Africa, by 66 percent.
AIDS-related deaths are also increasing in eastern Europe and central Asia, rising by 5 percent between 2005 and 2013.