HIV/AIDS

The Challenge

In 2010, HIV/AIDS killed 1.8 million people, 1.2 million of whom were living in sub-Saharan Africa. Major progress has been made in delivering life-saving treatment for people living with HIV/AIDS - there are now 6.6 million people globally on treatment of which more than 5 million are in Africa. However, nearly 8 million more people are in need of treatment and HIV infection rates are far outpacing the number of people added to treatment each day.

Because individuals in their most productive years (15-49 years old) are most commonly infected with HIV/AIDS, the disease has a wide socioeconomic impact that threatens development progress in many poor countries, especially those in sub-Saharan Africa. 14.8 million children in the region have already lost one or more parents to the disease. In South Africa alone, nearly one in five children are projected to be orphans by 2010, exacerbating a social dynamic that is already deeply challenged by crime, violence and unemployment. HIV/AIDS targets people during their most productive years, making economic progress in many sub-Saharan African countries even more of a challenge. Some estimates suggest that annual GDP growth in highly affected countries can be 2-4% lower than in countries with the absence of AIDS. HIV/AIDS is also a major constraint on the provision of quality education. For example, Tanzania needs around 45,000 additional teachers to make up for those who have died or left the system because of AIDS - many were their most experienced teachers.

In 2005, world leaders at the G8 summit in Gleneagles and at the U.N. World Summit in New York pledged to reach near universal access to prevention, care and treatment by 2010. UNAIDS estimates that $25.1 billion will be required for the global AIDS response in 2010 to achieve universal access - treatment that reaches at least 80% of patients in need - for HIV prevention, treatment care and support in low and middle-income countries, a figure $9.2 billion higher than what was invested in the AIDS response in 2009. Delivering these essential services will require a strengthening of health systems, especially in Africa, which is home to two-thirds of those requiring antiretroviral (ARV) treatment, but only 3% of the global health care workers to provide it. Progress must also continue in expanding prevention efforts, making treatment less expensive and more available, and including resources for second-line regimens, pediatric formulations and diagnostic tests and equipment.

The Opportunity

Dramatic increases in global resources have helped many countries make significant progress in combating HIV/AIDS in recent years. HIV/AIDS medication per patient now costs as little as $140 per year, down from nearly $10,000 less than ten years ago. Lower prices have helped support a rapid scale-up of access to life-saving antiretroviral (ARV) treatment, especially in sub-Saharan Africa. More than 5 million Africans are receiving antiretroviral treatment, up from only 50,000 in 2002. Some countries have achieved even more dramatic results. Botswana, Rwanda, and Namibia have achieved universal access and Benin, Ethiopia, Mali, Senegal, Swaziland, and Zambia had coverage rates between 50 to 80% and are making progress toward universal access. These results demonstrate that expansion of vital services can be rapidly scaled up even in developing countries.

Donors such as the United States, the United Kingdom and France have taken a leading role in increasing their commitments to funding for HIV/AIDS. The Global Fund to Fight AIDS, Tuberculosis and Malaria has helped 3.3 million people receive antiretroviral treatment and conducted 190 million HIV counseling and testing sessions, while the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has supported 3.2 million people on antiretroviral treatment and reached more than 11 million people with care services, including 3.8 million orphans, in FY2010.

Future efforts to combat HIV/AIDS should include an increased focus on prevention, in tandem with expanded ARV access and continued research towards finding a vaccine. Prevention must be a central component of the fight against AIDS, and there are many strategies available to reduce HIV transmission. These approaches include prevention of mother-to-child transmission (use of antiretroviral drugs and adherence to breastfeeding guidelines), the ABC strategy to prevent sexual transmission (Abstain, Be Faithful, correct and consistent use of Condoms), male circumcision, and reducing unsafe blood and medical injections. These strategies should be accompanied by increased knowledge about how HIV is transmitted, access to education, strengthened legal protection for women, and action to end violence against women and girls, as these are all barriers to HIV prevention.