Making Inroads

More has been achieved in the past two years in the fight against AIDS than in the preceding 20 years

BETWA SHARMA

The latest report on the global AIDS epidemic, released at the United Nations, found big improvements in preventing new HIV infections and a decline in AIDS-related deaths, in the past year. But experts said that more funding was essential to keep up the fight against the epidemic.

"There have been significant gains in preventing new HIV infections in a number of heavily affected countries," the report said. However, the decline in the rate of new infections in several countries has been diminished by an increase in other countries.

The data showed that an estimated 33 million people were living with AIDS in 2007. There were 2.7 million new HIV infections and two million AIDS related deaths last year.

The study is done by UNAIDS, the United Nations Programme on HIV/AIDS, every two years. “We have achieved more in the fight against AIDS in the last two years than the preceding twenty years,” said Peter Piot, head of the programme, at a press conference.

“We have seen a substantial increase in the HIV prevention efforts and treatment and these are producing results in a number of heavily affected countries,” he added.

Young people have exhibited several positive developments like the increased use of condoms, according to the report. Further, the youth in seven of the most affected countries including Burkina Faso, Cameroon, Ethiopia, Ghana, Malawi, Uganda and Zambia are waiting longer to have sexual intercourse. For instance, the percentage of young people having sex before the age of 15 has gone down from 35 percent to 14 percent in Cameroon.

Thoraya Ahmed Obaid, head of the United Nations Population Fund (UNFPA) pointed out that young people remained the most vulnerable to HIV infections. “Forty five percent of the all the new adult infections occurred last year in young people aged 15 to 24,” she said. “That is the target group and prevention there is quite important.”

However, the latest statistics collected from about 64 countries indicated that fewer than 40 percent of young people had basic information about HIV, which makes them vulnerable to the epidemic.

Obaid told the press that it was important to make sure that “sex education is integrated in the formal and informal education system” and should be “grounded on real social-cultural context to be realistic.”

UNAIDS also had good news for children. The percentage of HIV positive pregnant women receiving antiretroviral drugs to prevent mother-to-child transmission rose from nine percent in 2004 to 33 percent in 2007. Countries such as Botswana, Namibia, Swaziland and South Africa experienced increases in coverage of prevention of mother-to-child transmission services. “I think that is an achievement that is remarkable,” said Piot.

During this period the number of new infections among children fell from 410,000 to 370,000. However, the total number of children living with HIV increased from 1.6 million in 2001 to two million in 2007. Almost 90 percent of these children live in sub- Saharan Africa.

On the treatment front, the report pointed out that nearly three million people were receiving antiretroviral treatment in the developing world in 2007. This represents 31 percent of estimated global needs and 45 percent improvement over 2006.

Treatment of HIV patients reached new records in some countries. Namibia scaled up treatment from one percent in 2003 to 88 percent in 2007. Rwanda went from three percent to 71 percent in the same period. Botswana delivered HIV treatment to more than 90 percent of people in need.

However, the advances made in treatment numbers continue to fall behind the number of new HIV infections -for every two people put on antiretroviral drugs, another five become newly infected.

“The gap between those who are in need of treatment and those who have access to treatment is widening,” Piot said. “Ultimately we’ll have to intensify our interventions, our prevention efforts to stop this epidemic.”

For people most at risk—sex workers, men who have sex with men and people who inject drugs—there has been a tripling of HIV prevention efforts since 2005.

The report said that discrimination continued to be an obstacle to access most-at-risk people. “Countries with less discrimination has made better progress towards prevention,” stressed Obaid.

While addressing the opening at the 17th International AIDS Conference in Mexico City, this week, the U.N. Secretary-General, Ban Ki-moon, called on politicians all over the world to speak out against discrimination.

He asked, “schools to teach respect, religious leaders to preach tolerance, and for media to confirm prejudice in all its forms.”

In Asia an estimated 5 million people had HIV last year and 380,000 people died from the AIDS related illness. The survey showed that South East Asia saw the highest levels of HIV.

Injecting drug use was highlighted as the major risk factor in several Asian countries. The report estimated that in China almost half the people living with HIV were infected through use of contaminated injecting equipment in 2006. Data indicated that India, Pakistan and Vietnam were on the same trajectory.

In India, the report found high HIV prevalence among sex workers and “possibly rising prevalence among people who inject drugs and men who have sex with men.” It pointed out that sex between men was a “significant yet under-researched aspect of India’s HIV epidemic.”

Afghanistan is the latest prey of HIV in Asia, according to the survey. It found that in Kabul, the three percent of the people who injected drugs was HIV positive. They also shared needles and syringes.

Kemal Dervis, administrator of the United Nations Development Program (UNDP) stressed that the AIDS epidemic continued to take a toll on development particularly in the low and middle-income nations.

“In the high prevalence country we lose half to one and half percentage points of economic growth due to HIV-AIDS,” he said. “That is huge.”

Obaid emphasised that the fight against AIDS was entering a new phase and that more funding was needed to meet the “whole target of universal access for prevention, treatment, care and support.”

The experts stressed that the present level of funding was insufficient to sustain long-term efforts. Last year, the 10 billion dollars spent on AIDS programs in developing countries, came from a combination of domestic funding, private and donor money.

Piot warned that while developing countries could draw from their domestic budget, the poorest regions, Africa in particular, would continue to require external support.

The UNAIDS chief welcomed the “Tom Lantos and Henry J. Hyde United States Global Leadership against HIV/AIDS, Tuberculosis and Malaria Reauthorisation Act,” signed into law by President George Bush in July, which gives 48 billion in a response against fighting the epidemic.

Ban reiterated this point in Mexico City. “In the most affected countries, donors will have to provide the majority of the funding,” he said.

The UN chief also called for long term and sustained financing. “As more people go on treatment and live longer, budgets will have to increase considerably over the next few decades,” he said.