UNAIDS: AIDS epidemic ebbs, problems remain
 

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posted Friday, November 26, 2010 - Volume 38 Issue 48

UNAIDS: AIDS epidemic ebbs, problems remain
by Mike Andrew - SGN Staff Writer

The number of new HIV infections is declining globally, but millions of people living with HIV/AIDS urgently need treatment if they are going to survive, according to a new report by UNAIDS.

UNAIDS - an agency of the United Nations and the World Bank based in Geneva - issues an annual report on the global HIV/AIDS epidemic. The report, released on November 23, includes data through the end of 2009.

'We can say with confidence and conviction that we have broken the trajectory of the HIV/AIDS epidemic,' said UNAIDS deputy director Paul De Lay. 'There are fewer people infected, and there are fewer people dying.'

The downward trend is the consequence of many factors, UNAIDS says, including changes in sexual behavior among young people, success in preventing mother-to-child transmission of the virus, and lowered infectiousness of people who are successfully taking AIDS medications.

It also reflects the epidemic's natural history, in which the annual number of new infections peaks and then declines as the disease 'saturates' high-risk groups in the population.

In 2009 there were 33.3 million people living with HIV infection, compared with 26.2 million in 1999.

However, the number of new infections in 2009 was down 16% from a decade ago - 2.6 million versus 3.1 million.

The number of AIDS-related deaths peaked in 2004 at 2.1 million, and has declined annually since then. In 2009, it was down to 1.8 million.

The UNAIDS report says the number of people using anti-retroviral drugs has increased from 700,000 in 2004 to 5.2 million people in 2009.

The number of children infected at birth has fallen nearly 25% in five years.

The number of pregnant women with HIV who get medicines to prevent passing the virus to their babies is now just over 50%, up from 35% in 2007.

But only 15% of the women are then put on a permanent course of antiretroviral therapy, which is a big problem, according to UNAIDS executive director Michel Sidibe said.

'We need to make sure that when we save the baby that we don't abandon the mother. That is a major challenge that I am fighting to make sure we change,' he said.

The report also described some discouraging developments.

Some 10 million people need treatment but are not getting it.

In more than a half-dozen countries, HIV infection rates went up more than 25% in the past decade.

In the U.S. and Western Europe, new infections among Gay and Bisexual men continue to increase.

In 2009, about $15.9 billion was spent on the global AIDS response, with slightly more than half the money provided by low- and middle-income countries.

However, much more money - about $26.8 billion - is needed every year to fully fund treatment, care and prevention, the report said.

Equally troubling, according to the report, was that in 2009 the $7.6 billion provided by wealthy countries to treat and prevent AIDS was somewhat lower than in the previous year.

'This is coming at the wrong moment, just as we are seeing the investment pay off,' Sidibe said. 'For me, it will be immoral to bring more than 5 million people on treatment and to possibly then say, 'We do not have the means to pay for that treatment.'

According to the report, treatment of about 2.5 million people is paid for by the U.S. government.

Sub-Saharan Africa continues to be the region most affected by the epidemic, with around 70% of all new HIV infections occurring there.

Africa's total number of people living with HIV/AIDS - about 22.5 million - continues to grow, in part because of the longer survival of people who have started taking antiretroviral drugs.

In 22 African countries, the annual number of new infections has dropped by more than 25% since the peak of the epidemic in 1999, however.

New infection rates are falling particularly sharply in South Africa, Zambia, Zimbabwe and Ethiopia.

There is a mixed picture in other parts of the world.

Eastern Europe and Central Asia show sharp rises in both new infections and AIDS-related deaths.

UNAIDS says that discriminatory laws, particularly in respect to drug users and LGBT people, continue to hamper the fight against AIDS.

'Investments in the AIDS response are paying off, but gains are fragile - the challenge now is how we can all work to accelerate progress,' Sidibe said.



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