World AIDS Day

On the right road to zero

November 29 was World AIDS Day with the theme: Getting to Zero: Zero new HIV infections. Zero deaths from AIDS-related illness. Zero discrimination.

Although the disease continues to spread – there were 2.5 million new infections in 2011 and an estimated 1.7 million people died from the disease – there is hope that we could get to zero infections as we are now headed on the right track. Infections are decreasing – the number of infections in 2011 is 700,000 less than 10 years ago, according to the WHO.

Much of the progress is attributed to the life-saving antiretrovirals to treat those infected with HIV. These medicines reduce the amount of virus in the blood, which increases the chance they will stay healthy and decreases the risk they can pass the virus to someone else. In 2011, at the UN General Assembly, governments agreed to set the goal of getting 15 million HIVinfected people worldwide on the lifesaving antiretroviral medicines by 2015. The latest global statistics suggest that, provided countries are able to sustain current efforts, this target is within reach.

Dr Gottfried Hirnschall, Director of the World Health Organization’s HIV Department, said: “Many countries are facing economic difficulties, yet most are managing to continue expansion of access to antiretroviral medicines.”

Currently 8 million people in low- and middle-income countries are accessing the treatment they need, up from only 0.4 million in 2003.

“The challenge now is to ensure that global progress is mirrored at all levels and in all places so that people, whoever they are and wherever they live, can obtain antiretroviral therapy when they need it,” adds Dr Hirnschall.

In all regions of the world, some groups of people are still not able to access HIV prevention and treatment. There are many reasons for this. Sometimes geographical factors make it more difficult to deliver services. Stigma, discrimination and legal issues are often significant barriers to accessing effective care. Adolescent girls, sex workers, men who have sex with men and people who use drugs often remain vulnerable and marginalized. Migrants frequently have only limited access to health services.

As a result, they often struggle to obtain the health services they need, including the provision of antiretroviral therapy.

Children, for example, are lagging badly behind: only 28% of children who need antiretrovirals can obtain them.

“About 3.3 million children are living with HIV today,” said Dr Philippe Douste- Blazy, Chairman of the UNITAID Executive Board. “The international community must commit to providing them with the best treatment, and avoid childhood HIV becoming a neglected disease.”

Children are rarely born with HIV in wealthy countries because mothers living with HIV are treated during pregnancy to ensure that their babies are born HIV-free. It is very different elsewhere: there were 300,000 new infections in children in sub-Saharan Africa in 2011, the majority infected in the womb. Nevertheless, programmes to stop mother-to-child transmission of the disease in Africa are working – between 2009 and 2011 antiretroviral prophylaxis prevented 409,000 children from acquiring HIV infection in low- and middle-income countries, according to UNAIDS.

Eastern Mediterranean region

The WHO Regional Office for the Eastern Mediterranean estimates that there are 561,000 living with AIDS in the region.

WHO EMRO warns that the region is experiencing the fastest rate of increase of the HIV epidemic in the world, but providing the lowest coverage of HIV prevention, treatment and care services.

More than 85% of people living with HIV in the region who need life-saving antiretroviral therapy do not receive it.

On the occasion of World AIDS Day, Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean, reiterated that without ending the treatment gap in the Region and without scaling up HIV testing and counselling and other prevention interventions, the Region is far from getting to zero.

The main contributor to this treatment gap is the low uptake of HIV testing and counselling services. In particular, people at higher risk of HIV, that is, people who inject drugs, men who have sex with men and sex workers, are still not being reached by available testing and counselling services.

Less than 15% of those who need treatment are actually receiving it. The main bottleneck is that less than 5% of the population of the Region knows its HIV status. Lack of awareness, fear of stigma and discrimination and inadequate service delivery prevent people from taking an HIV test.

 Date of upload: 22nd Jan 2013


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