In the 30 years since HIV/AIDS was first discovered, the disease has taken the lives of more than 35 million people around the world. In 2012 alone, HIV/AIDS killed 1.6 million people, 1.2 million of whom were living in sub-Saharan Africa. Though life-saving antiretroviral treatment is available, millions of people cannot access it. Of the estimated 28 million HIV-positive people who are eligible for treatment, more than 18 million are missing out.
New HIV infections continue to outpace the number of people newly accessing treatment. More than 260,000 babies and children were infected with HIV in 2012, just part of 2.3 million new HIV infections in total that year. This number is down from half a million in 2006.
Because people in their most productive years (15-49 years old) are most commonly infected with HIV/AIDS, the disease threatens broader development progress in many low-income countries, especially in those in sub-Saharan Africa. In 2010, UNAIDS reported that 14.8 million children in that region have already lost one or more parents to the disease, and economic growth is held back as a result.
In 2005, world leaders at the G8 summit in Gleneagles and at the UN World Summit in New York pledged to reach universal access to prevention, care and treatment by 2010. This target was missed, and is still far from being met as of 2013. But leaders recommitted to the fight against AIDS in 2011 by agreeing to work toward achieving universal access to HIV prevention, treatment, care and support by 2015.
We are at a critical moment in the fight against HIV/AIDS. The world has made incredible progress in its efforts to understand, prevent and treat this disease, and progress has been particularly rapid during the last ten years.
Today 9.7 million people are on life-saving antiretroviral treatment, up from just 300,000 in 2002. Of that 9.7 million, more than 7.5 million are living in sub-Saharan Africa.
Botswana, Namibia, Rwanda, Swaziland, and Zambia have achieved universal access to antiretroviral therapy by providing treatment to at least 80% of patients in need. In Benin, Kenya, Malawi, South Africa, and Zimbabwe, access to treatment is more than 60% of people in need, and heading steadily towards the 80% target.
Though progress on the prevention of HIV has been slow, we now have impactful new data and technologies to help us better prevent new infections in years to come. It is now possible to prevent the transmission of HIV from mother-to-child in 95% or more of cases. New research has also provided ground-breaking data on two fronts: the impact of treatment as prevention and the role of male circumcision in prevention strategies. Clinical trials have shown that treatment acts as prevention, reducing the likelihood of an HIV-positive individual on treatment passing HIV on to others by up to 96%. Voluntary medical male circumcision, another powerful tool, was shown to reduce the likelihood of HIV infection by up to 60%.
Combination prevention, the ABC strategy to prevent sexual transmission (Abstain, Be faithful, and correct and consistent use of Condoms), male circumcision, and reduction of unsafe blood and medical injections, will play a central role in moving us towards ending the pandemic.
During a time of economic crisis in many parts of the world, both rich and poor countries need to keep their spending promises on HIV/AIDS. From 2002 to 2008, international government financing of HIV programs increased dramatically from $1.6 billion to $7.7 billion annually, and these international investments are paying off. The Global Fund to Fight AIDS, Tuberculosis, and Malaria has helped 6.1 million people get treatment and provided 250 million HIV counselling and testing sessions. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has directly supported 6.7 million people with treatment as of September 2013. It also reached 17 million people with care services, including 5 million orphans, in FY2013.
However international funding has largely plateaued since 2009, with governments giving $7.9 billion in 2012 – just barely up from $7.7 billion in 2009. Most spending increases in recent years have come from low- and middle-income countries, which now make up 53% of HIV/AIDS program funding.
Now, for the first time in history, the world can look ahead to the beginning of the end of the AIDS pandemic.
We need to focus our efforts on three milestones: virtual elimination of mother-to-child transmission by 2015, antiretroviral treatment for 15 million people by 2015, and putting new prevention techniques into practice. To be effective, these goals cannot be achieved in isolation from one another, or be the sole responsibility of a small number of donor countries. Only when donors, African governments, international organisations and the private sector work together will the beginning of the end of AIDS become a reality.