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UNAIDS report highlights progress towards reaching MDG 6
UNAIDS has today released their annual update report on the HIV and AIDS epidemic, which details new statistics on the global epidemic. It also highlights progress made towards achieving the ten specific targets outlined in the 2011 Political Declaration on HIV and AIDS. The Global Report 2013 reveals significant improvements in the global response, such as increased access to antiretroviral treatment (ART). In low and middle-income countries, treatment access increased by 20 percent between 2011 and 2012. Many challenges remain, however, such as coverage of services for at-risk groups (e.g. injecting drug users - IDUs).
The reports estimates that there are now 35.3 million people living with HIV (PLHIV) globally. This is an increase on last year, due in part to higher numbers of people testing for HIV and accessing treatment. New HIV infections have declined globally - 2.3 million people became newly infected in 2012, down one third from 2001. AIDS-related deaths have also decreased markedly - last year 1.6 million people died of an AIDS-related cause, down from a peak of 2.3 million in 2005.
In 2012, 70 percent of new HIV infections were in sub-Saharan Africa, however, since 2001 the annual number of new HIV infections has declined by 34 percent in this region. The Caribbean has also seen a considerable decline in new infections since 2001 (down 49 percent), the greatest of any region. However, new HIV infections have been on the rise in Eastern Europe and the Middle East and North Africa (MENA) regions. Despite improvements in decreasing sexual transmission of HIV by 50 percent or more across 26 countries, there are also worrying signs of increased risky behaviour in certain countries. For example, there have been reports of increased numbers of sexual partners and decreased condom use in Uganda and Côte d’Ivoire.
Many low- and middle-income countries are now witnessing rates of mother-to-child transmission closer to that of high-income countries, thanks to increased coverage of HIV prevention services for pregnant woman. Between 2001 and 2012, there was a 52 percent decline in new HIV infections among children.
Much effort has been made to increase access to treatment for PLHIV in low and middle-income countries. Under 2010 WHO Guidelines, 61 percent of people who were eligible were on treatment in 2012. However, under revised 2013 World Health Organisation (WHO) Guidelines, which make more people eligible for treatment, only 34 percent of those eligible in these countries are receiving it. While treatment scale-up has been a clear success story, with the number of people receiving ART tripling over the last five years alone, it was noted that there are significant variations between countries, and among key population groups. For example, Eastern Europe, Central Asia and MENA are the only regions to not see a sharp increase in treatment access. Stigma and discrimination still also signify a key barrier to reaching people with treatment services among key populations, such as men who have sex with men (MSM), IDUs, transgender people and sex workers.
The report indicates that major obstacles remain with regard to human rights and repealing punitive laws, to ensure that key populations groups, who are particularly vulnerable to HIV, are reached with effective prevention and treatment services. Combatting violence against woman and girls and reducing stigma and discrimination against both PLHIV and vulnerable groups also remain challenges.
There has been significant progress in meeting targets to reduce tuberculosis (TB) related deaths among PLHIV – since 2004 there has been a 36 percent reduction globally. However, greater integration of HIV-TB services is needed to maintain progress and improve coverage. For example, a ‘mere fraction’ of the number of PLHIV who would have benefited received isoniazid preventive therapy (to reduce TB incidence).
Funding to respond to the global HIV and AIDS epidemic is still inadequate, with an estimated US$ 3-5 billion extra needed annually. However, despite international donor funding flatlining since 2008, domestic spending on HIV and AIDS accounted for 53 percent of global HIV resources in 2012, and should be applauded.
To find out more, you can access the full report in the link below.