The latest Global Report on HIV/AIDS says the number of new infections continues to fall, with the sharpest declines in the Caribbean and sub-Saharan Africa.
The UNAIDS report says overall there are about 34 million people living with the disease, nearly 70 percent of them in sub-Saharan Africa. The region remains the “most severely affected with nearly one in twenty adults living with HIV.” The next hardest hit regions are the Caribbean, Eastern Europe and Central Asia.
UNAIDS also says there’s “cause for concern” over the number of newly infected people in the Middle East and North Africa. The MENA region traditionally has had very low numbers of HIV infections. But the report says there’s a trend upward. New infections have increased 35 percent since 2001.
On the positive side, the number of new infections worldwide has fallen sharply since 2001 to about two and a half million people per year.
“Today we are reporting a more than 50 percent drop in new infections across 25 countries since 2001. Thirteen of these countries are in sub-Saharan Africa, the region that’s by far the most affected by HIV – a 73 percent reduction in Malawi – and Botswana, a 71 percent drop. I mean these are very, very impressive figures,” said Bernhard Schwartlander, UNAIDS’ director of evidence, innovation and policy.
South Africa – the country with the largest number of infections – has shown a 41 percent reduction since 2001. At the same time, treatment in South Africa was scaled up by 75 percent over the last two years.
“We are really seeing a quickening in the pace of progress over the past two years. We have achieved in the past two years what took us before a whole decade. We have seen in the past two years a 60 percent increase in the number of people accessing life-saving treatment. Five countries in the region have achieved more than 80 percent coverage of HIV treatment. That is Botswana, Namibia, Rwanda, Swaziland and Zambia,” he said.
Outside of sub-Saharan Africa, UNAIDS says China has scaled up treatment by 50 percent over the past year.
Schwartlander also said great progress has been shown regarding newborns.
“In the last two years, half of all the reductions in HIV infections have been among children. In six countries – Burundi, Kenya, Namibia, South Africa, Togo and Zambia – the number of children newly infected with HIV has fallen at least 40 percent in the past two years,” he said.
Countries that had infection rates greater than 25 percent between 2001 and 2011 include Bangladesh, Georgia, Guinea-Bissau, Indonesia, Kazakhstan, Kyrgyzstan, Philippines, Republic of Moldova and Sri Lanka.
About 1.7 million people died of AIDS-related causes in 2011, showing a continued decline. The downward trend began in the mid-2000s with the increased availability of antiretroviral drugs in developing countries.
HIV/AIDS is primarily a sexually transmitted disease. Recent studies have shown that antiretroviral drug use can help prevent initial infections, and there’s very promising research regarding microbicide gels. Nevertheless, UNAIDS says that “the current pace of progress is insufficient to reach the global goal of halving sexual transmission by 2015.”
The report describes condom use as a “critical element of combination prevention.” However, it says surveys indicate declines of condom use in Uganda, Benin, Burkina Faso and Ivory Coast. Knowledge of condom use, especially among young women, remains low in several countries with high infection rates.
Male circumcision has been shown to reduce the risk of HIV infection. However, UNAIDS says there’s been limited progress in scaling up voluntary medical male circumcision.
Mitchell Warren, head of the advocacy group AVAC, reacted to the report, and said, “It’s a great report and it’s great news on the one hand. I think that it’s a question of where do we go next?”
Warren said the 50 percent reduction in new infections must be taken in perspective.
“While that 50 percent decline is terrific, it’s over a decade. All this talk about ending the epidemic or about an AIDS-free generation – we need to pick up the pace. If we’re really serious about achieving the end of the epidemic, getting a 50 percent reduction over a decade, while good news, is not the pace we need to be on to end the epidemic,” he said.
The head of AVAC said what now takes two years to achieve needs to be accomplished in one year.