Report Shows Progress, More Funding Needed
UNAIDS report, entitled AIDS at 30: Nations at the Crossroads,
was released ahead of last week's UN
General Assembly High Level Meeting on AIDS. According to
the report, nearly 7 million people in low- and middle-income
countries are now receiving treatment -- including 1.4 million
who started in 2010 -- but that number must double to about
15 million to provide universal access to everyone in need.
Approximately 6.6 million people in resource-limited countries
are currently receiving antiretroviral therapy and new
infections have fallen by 25%, according to a UNAIDS report
released this month. But a downturn in funding raises
concern about whether these advances can be sustained.
30th anniversary of AIDS comes on the heels of the welcome
news from the HPTN
052 trial that early antiretroviral therapy (ART) can
reduce the risk of HIV transmission by 96% among serodiscordant
heterosexual couples, adding urgency to the effort to expand
wider access will not come cheap. An analysis by the Investment
Framework Study Group published in the June
11, 2011, issue of The Lancet indicates that global
funding for HIV/AIDS would need to increase by about 30% immediately
-- to US$ 22 million -- and by 20% over the long-term to achieve
adequate treatment and prevention coverage.
is an edited excerpt from a UNAIDS press announcement summarizing
the AIDS at 30 report's findings. The full report is available
free online at www.unaids.org/unaids_resources/aidsat30/aids-at-30.pdf.
AIDS Response Continues to Show Results as a Record Number
ff People Access Treatment and Rates of New HIV Infections
Fall by Nearly 25%
the world marks 30 years of AIDS, UNAIDS estimates 34 million
[30.9 million-36.9 million] people are living with HIV and
nearly 30 million [25 million-33 million] people have died
of AIDS-related causes since the first case of AIDS was reported
on 5 June 1981
Michel Sidibé, UNAIDS Executive Director;
Christina Rodriguez, Co-Founder, Smart Youth;
Asha-Rose Migiro, Deputy Secretary-General at
Press conference on AIDS at 30: Progress of nations,
held at UN Headquarters, New York City on June
(Photo: UNAIDS/B. Hamilton)
York/Geneva -- June 3, 2011 -- About 6.6 million people were
receiving antiretroviral therapy in low- and middle-income
countries at the end of 2010, a nearly 22-fold increase since
2001, according to a new report AIDS at 30: Nations at
the Crossroads, released today by the Joint United Nations
Programme on HIV/AIDS (UNAIDS).
A record 1.4 million people started lifesaving treatment in
2010 -- more than any year before. According to the report,
at least 420,000 children were receiving antiretroviral therapy
at the end of 2010, a more than 50% increase since 2008, when
275,000 children were on treatment.
"Access to treatment will transform the AIDS response
in the next decade. We must invest in accelerating access
and finding new treatment options," said Michel Sidibé,
UNAIDS Executive Director. "Antiretroviral therapy is
a bigger game-changer than ever before -- it not only stops
people from dying, but also prevents transmission of HIV to
women, men and children."
His statement follows the recent HPTN052 trial results which
found that if a person living with HIV adheres to an effective
antiretroviral regimen, the risk of transmitting the virus
to his or her uninfected sexual partner can be reduced by
"Countries must use the best of what science can offer
to stop new HIV infections and AIDS-related deaths,"
said UN Deputy Secretary-General Asha-Rose Migiro. "We
are at a turning point in the AIDS response. The goal towards
achieving universal access to HIV prevention, treatment, care
and support must become a reality by 2015."
HIV prevention efforts showing results
According to the report, the global rate of new HIV infections
declined by nearly 25% between 2001 and 2009. In India, the
rate of new HIV infections fell by more than 50% and in South
Africa by more than 35%; both countries have the largest number
of people living with HIV on their continents.
The report found that in the third decade of the epidemic,
people were starting to adopt safer sexual behaviors, reflecting
the impact of HIV prevention and awareness efforts. However,
there are still important gaps. Young men are more likely
to be informed about HIV prevention than young women. Recent
Demographic Health Surveys found that an estimated 74% of
young men know that condoms are effective in preventing HIV
infection, compared to just 49% of young women.
In recent years, there has been significant progress in preventing
new HIV infections among children as increasing numbers of
pregnant women living with HIV have gained access to antiretroviral
prophylaxis during pregnancy, delivery and breastfeeding.
The number of children newly infected with HIV in 2009 was
26% lower than in 2001.
About 115 low- and middle-income countries are providing optimal
treatment regimens for pregnant women living with HIV as recommended
by the World Health Organization (WHO). There are 31 countries
that still use sub-optimal regimens in many of their HIV prevention
programs. UNAIDS urges all countries using sub-optimal regimens
to revise their treatment guidelines and make the transition
to optimal WHO recommended regimens.
AIDS is not over -- significant challenges remain
According to the latest estimates from UNAIDS, 34 million
[30.9 million-36.9 million] people were living with HIV at
the end of 2010 and nearly 30 million [25 million-33 million]
have died from AIDS-related causes since AIDS was first reported
30 years ago.
Despite expanded access to antiretroviral therapy, a major
treatment gap remains. At the end of 2010, 9 million people
who were eligible for treatment did not have access. Treatment
access for children is lower than for adults -- only 28% of
eligible children were receiving antiretroviral therapy in
2009, compared to 36% coverage for people of all ages.
While the rate of new HIV infections has declined globally,
the total number of HIV infections remains high, at about
7000 per day. The global reduction in the rate of new HIV
infections hides regional variations. According to the report,
above-average declines in new HIV infections were recorded
in sub-Saharan Africa and in South-East Asia, while Latin
America and the Caribbean experienced more modest reductions
of less than 25%. There has been an increase in the rate of
new HIV infections in Eastern Europe and in the Middle East
and North Africa.
In virtually all countries, HIV prevalence among populations
at increased risk of HIV infection -- men who have sex with
men, people who inject drugs, sex workers and their clients,
and transgender people -- is higher than among other populations.
Access to HIV prevention and treatment for populations at
higher risk of infection is generally lower due to punitive
and discriminatory laws, and stigma and discrimination. As
of April 2011, 79 countries, territories and areas criminalize
consensual same-sex relations; 116 countries, territories
and areas criminalize some aspect of sex work; and 32 countries
have laws that allow for the death penalty for drug-related
According to the report, gender inequalities remain a major
barrier to effective HIV responses. HIV is the leading cause
of death among women of reproductive age, and more than a
quarter (26%) of all new global HIV infections are among young
women aged 15-24.
AIDS resources declining
According to the report, investments in the HIV response in
low- and middle-income countries rose nearly 10-fold between
2001 and 2009, from US$ 1.6 billion to US$ 15.9 billion. However,
in 2010, international resources for HIV declined. Many low-income
countries remain heavily dependant on external financing.
In 56 countries, international donors account for at least
70% of HIV resources.
"I am worried that international investments are falling
at a time when the AIDS response is delivering results for
people," said Mr Sidibé. "If we do not invest
now, we will have to pay several times more in the future."
A 2011 investment framework proposed by UNAIDS and partners
found that an investment of at least US$ 22 billion is needed
by the year 2015, US$ 6 billion more than is available today.
When these investments are directed towards a set of priority
programs that are based on a country's epidemic type, the
impact is greatest. It is estimated that the return on such
an investment would be 12 million new HIV infections averted
and 7.4 million AIDS-related deaths averted by the year 2020.
The number of new infections would decline from about 2.5
million in 2009 to about 1 million in 2015.
Perspectives on AIDS from leaders around the world
The report features commentaries from 15 leaders in the global
AIDS response, including South Africa's President Jacob Zuma,
former United States President Bill Clinton, former President
of Brasil Luiz Inácio Lula da Silva, the President
of Mali, Amadou Toumani Touré, and Jean Ping, Chairperson
of the African Union Commission. The commentaries cover a
range of areas, such as AIDS funding, South-South cooperation,
youth leadership, the empowerment of women, key affected populations,
injecting drug use, human rights, stigma and discrimination
and systems integration.
Young people leading the HIV prevention revolution
AIDS at 30: Nations at the crossroads also includes
an article on a recent event held on Robben Island, South
Africa, where Archbishop Desmond Tutu, Co-chair of the UNAIDS
High Level Commission on HIV Prevention, passed the baton
of leadership in the AIDS response to a new generation of
According to the report, some of the most important HIV prevention
successes have been led by young people. Data indicate that
young people in many heavily affected countries are increasingly
adopting safer sexual behaviors.
Schwartlander, J Stover, T Hallett, et al. (Investment Framework
Study Group). Towards an improved investment approach for
an effective response to HIV/AIDS. The Lancet 377(9782):2031-2041
full text with registration). June 11, 2011.
AIDS at 30: Nations at the Crossroads. June 2011. http://www.unaids.org/unaids_
Global AIDS Response Continues to Show Results as a Record
Number ff People Access Treatment and Rates of New HIV Infections
Fall by Nearly 25%. Press release. June 3, 2011.