Region improves on HIV/AIDS
The UNAIDS 2006 Report on the global AIDS epidemic launched on Wednesday cites positive trends in HIV prevention and AIDS treatment in the region with caution. The positive trend seems to be sweeping across the whole world although there are few exceptions. In the region Zimbabwe has taken the lead in reducing the prevalence rate while Botswana with 85 percent patients having access to ART is at the top in the area of treatment. “HIV prevalence fell in Kenya and Zimbabwe, as well as in urban areas of Burkina Faso. Still, HIV treatment coverage varies considerably within regions . . . In sub-Saharan Africa, treatment coverage ranges from 3% in the Central African Republic, to 85 percent in Botswana,” says the report. “In the rest of sub-Saharan African, the majority of epidemics appear to be levelling off,” said UNAids. Six of 11 African countries reported declines of 25 percent or more in HIV prevalence among 15-24year-olds in capital cities. Rates of sex among young people declined in nine of 14 sub-Saharan countries. Condom use with a non-regular partner increased in eight out of 11 countries. According to UNAIDS, the overall use of condoms in the world remains below 50 percent. Use of HIV testing and counselling, an important tool for facilitating both treatment and prevention, quadrupled to 16.5 million people tested in 2005. In 58 countries 74 percent of primary schools and 81% of secondary schools now provide AIDS education. “While this progress is notable, the HIV prevention response falls short in many areas,” says the report. The Declaration of Commitment calls for 90 percent of young people to be knowledgeable about AIDS by 2005, but the UNAIDS surveys indicate that fewer than 50 percent of young people achieved comprehensive knowledge levels. Mother-to-child prevention is still lagging behind. “An area of exceptional concern is the ongoing shortfall in care to prevent mother-to-child HIV infection, in which just 9 percent of pregnant women are currently covered,” says the report. Elsewhere, there were declines in Cambodia and Thailand, but prevalence rose in China, Indonesia and Vietnam. In a major turn of events India overtook South Africa as the world’s worst-affected country in terms of the absolute number of people with HIV, although not as a proportion of the population. According UNAIDS the response to the HIV epidemic is diverse with some countries doing well on treatment but poorly on HIV prevention efforts and vice-versa. The report indicates that a number of significant challenges remain. Among these are the need for improved planning, sustained leadership and reliable long-term funding for the AIDS response. By and large the world figures are still alarming high. l An estimated 38.6 million (33.4 million ‘ 46.0 million) living with HIV worldwide l 4.1 million (3.4 million ‘ 6.2 million) newly infected in 2005 l 2.8 million (2.4 million to 3.3 million) died of AIDS in 2005 While the epidemic’s toll remains massive, experts find reasons for optimism, as well as guidance for how to improve the AIDS response. “Encouraging results in HIV prevention and treatment indicate a growing return on investments made in the AIDS response,” said UNAIDS Executive Director Dr. Peter Piot. “We are reaching a critical mass in terms of improvements in funding, political leadership and results on the ground, from which global action against AIDS can and must be greatly accelerated. The actions we take from here are particularly important, as we know with increasing certainty where and how HIV is moving, as well as how to slow the epidemic and reduce its impact,” he said. The report cites significant improvements in several elements of the global AIDS response. In the key area of financial resources, the US $8.3 billion available for the AIDS response in 2005 is more than five times the funding available in 2001, and is well within the Declaration of Commitment target range. The report also cites significant increases in global political leadership, which is key to maintaining the AIDS response at the centre of national and international development planning. Present at the launch was UNICEF Executive Director Ann Veneman, United Nations Population Fund (UNFPA) Executive Director Thoraya Obaid representing the ten co-sponsoring agencies of UNAIDS. The report shows that young people and children are increasingly affected by the epidemic, and efforts to protect them and other vulnerable groups are not keeping pace with the epidemic’s impact. “For too long, children have often been the missing face of the AIDS pandemic,” said UNICEF Executive Director Ann Veneman. “It is critical that the impact of HIV/AIDS on children be addressed through programs to prevent mother to child transmission and to treat cases of paediatric AIDS.” On HIV prevention, the report documents behaviour changes including delays in first sexual experience, increasing use of condoms by young people, and resulting decreases in HIV prevalence in young people in some sub-Saharan countries. “Prevention remains our first and most effective line of defence,” noted UNFPA Executive Director, Thoraya Ahmed Obaid. “In countries where HIV prevalence is declining among young people, there is behaviour change and comprehensive condom programming. This is encouraging proof that prevention works and saves lives. But women still remain disproportionately vulnerable and greater efforts must be made to give them methods of prevention they can control.” The report also makes clear that on many issues and in most regions of the world greater action against the epidemic is required immediately and will be required long into the future. The main emphasis at the launch was that the upcoming goals related to universal access to HIV treatment and the 2010 UN goal of halting and beginning to reverse the epidemic will require much greater action moving forward.