An annual report released Monday by UNAIDS, the United Nations agency fighting AIDS has revealed that the world’s AIDS epidemic has hit a plateau, with 2.7 million people becoming newly infected each year for the last five years.
The report adds that nearly seven million people are receiving treatment and the number has been steadily rising. However there is still a lag. Last year, 1.35 million got on treatment for the first time, meaning 200 people were newly infected for each 100 newly treated.The treatment figure falls far short of reaching the ambitious new “test and treat” goal adopted last year by U.N.AIDS and endorsed this month by Secretary of State Hillary Rodham Clinton in her speech calling for an “AIDS-free generation.” To reach that, all 34 million infected people in the world would have to be found and then put on antiretroviral drugs immediately so they would stop passing the virus on.
Additionally donor funds dropped about 10 percent last year as the worldwide economic crisis made some countries cut their donations. Global AIDS leaders, including Michel Sidibé, the executive director of UNAIDS, are urging countries to rely less on donors. He regularly praises South Africa, which pays 80 percent of its own costs.
Dr. Bernhard Schwartländer, the agency’s chief of strategy, said AIDS had seen a “game-changing year in science,” noting especially a study showing that people on drugs lowered by 96 percent their chances of passing on the infection. And he highlighted areas where progress had been made.
- Almost half the world’s pregnant women with HIV get at least one drug to help prevent passing the virus to their children.
- Eleven poor or middle-income countries now treat more than 80 percent of their infected citizens. The Centers for Disease Control and Prevention estimates that 20 percent of infected Americans do not know they are infected. The 11 countries are: Botswana, Cambodia, Chile, Comoros, Croatia, Cuba, Guyana, Namibia, Nicaragua, Rwanda and Slovakia.
- In 22 countries new infections have declined. Epidemiologists credit several factors: Fear of death stems some reckless behavior; safe-sex education is slowly growing; and the surging number of people on AIDS drugs, especially in southern Africa, means more people with lower viral loads who are thus less likely to infect others.
The report directly compares countries with one another. Cambodia, for example, has lowered infections far faster than its richer neighbor Vietnam because it targeted its sex tourism industry while Vietnam has shied away from helping the drug users and gay men who drive its epidemic. Brazil and Russia both have economies of similar size and both spend about $700 million a year on AIDS, but Brazil does far better because it concentrates on high-risk groups like gay prostitutes. Russia made “largely a political decision” not to help its drug injectors, Dr. Schwartländer said. “That’s not cost-efficient.” Countries where homosexuals face jail or execution will never address their epidemics, he said, because gay men will stay hidden.
In Egypt, Iran, Pakistan and Ukraine, for example, less than 20 percent of those needing treatment are getting it. In Bangladesh, China, India, Indonesia, Nigeria and Russia, less than 40 percent are.
Up to half the children infected at birth, the report said, get infected because their mothers avoid testing for fear that the nurses or their neighbors will sneer at them. The report endorsed HIV home-testing kits, which use a cheek swab or a finger prick, cost pennies and give results in minutes.
Dr. Paul De Lay, deputy executive director of UNAIDS, acknowledged the idea of eliminating AIDS infections and deaths is “more of a vision for the future,” and would likely not be accomplished without new tools like a vaccine, which could take several decades. De Lay said U.N. strategies will focus on more aggressive prevention and treatment policies, like treating people with HIV earlier.