Getting the upper hand in the fight against the spread of HIV/AIDS requires a much faster expansion in HIV prevention efforts, says a joint UNAIDS/World Health Organization report on the epidemic. In sub-Saharan Africa alone, a comprehensive prevention and treatment package “would avert 55% of new infections that otherwise would be expected to occur until 2020,” it says.
“It is clear that a rapid increase in the scale and scope of HIV prevention programmes is urgently needed,” said Peter Piot, the executive director of UNAIDS, when he launched the report in Delhi, India, this week. “The reality is that the AIDS epidemic continues to outstrip national efforts to contain it,” he said. But the UNAIDS chief pointed out that sustained HIV prevention programmes have also “played a key part in bringing down infections” in some countries. Prevention, treatment, care, and impact mitigation goals need to be pursued simultaneously, the report recommends.
Countries also need to pour more human and institutional resources on the scale required, it says. In 2005, there were an estimated 4.9 million new infections bringing the total number of people living with HIV worldwide to a record 40.3 million, up from 37.5 million in 2003.
Despite decreases in the rate of infections in some countries, overall the number of people living with HIV increased in all regions, with the exception of the Caribbean, with the steepest increases reported in Eastern Europe and central Asia. Also, about 3.1 million people, including 570 000 children, died of AIDS related illnesses this year, says the report.
Sub-Saharan Africa remains the hardest hit, accounting for two thirds of all people living with HIV, the largest number of new infections (3.2 million), and the largest number of AIDS related deaths (2.4 million).
On a more hopeful note, the report says that evidence shows that HIV “does yield to determined and sustained interventions,” and cites reductions in HIV prevalence in Kenya, Uganda, Zimbabwe, and other nations.
In Kenya, HIV prevalence in adults declined from 10% in the late 1990s down to 7% in 2003, and included a dramatic drop in prevalence among pregnant women from 28% in 1999 to 9% in 2003.
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Longer versions of these articles are on bmj.com
AIDS Epidemic Update, December 2005 is available at www.unaids.org/epi2005/index.html.
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