A new joint report shows that more than four million people in low and middle income coutries were receiving life-saving treatment for HIV at the end of 2008, representing over one third more than the year before and a ten-fold increase on the number five years earlier.

The new report was released on Wednesday and is titled “Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector Progress report, September 2009”. It is the result of collaboration among the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The report also highlights other gains in scaling up universal access, such as expansion of HIV testing and counselling, and improved access to services to stop HIV being passed from mother to child.

WHO Director-General Margaret Chan told the media that:

“This report shows tremendous progress in the global HIV/AIDS response.”

However, we still need to do more, she urged.

“At least 5 million people living with HIV still do not have access to life-prolonging treatment and care,” said Chan, explaining that many people in need of prevention still can’t access services either.

“Governments and international partners must accelerate their efforts to achieve universal access to treatment,” added Chan.

One area that is expanding very fast is access to antiretroviral therapy (ART). The authors reported that of the 9.5 million people in low and middle income countries who need ART, 33 per cent were receiving it in 2007 and only one year later, this figures went up to 42 per cent. The biggest expansion of ART access was in sub-Saharan Africa, where two-thirds of all HIV infections occur.

One of the reasons is that prices of the most commonly used ARTs have come down quite a lot in recent years: the cost of most first line treatments went down by 10 to 40 per cent between 2006 and 2008.

But second-line drugs are still expensive, said the report authors.

And although this recent progress is signficant, access to treatment is still far from meeting need, and many are worried that the current global economic crisis may undermine attempts to hold on to the gains. Many patients are still only being diagnosed too late to give ART a chance of success and many die in their first year of treatment.

The report’s highlights show that:

  • Among 66 countries covered, data on testing and counselling services shows that the number of health facilities offering them has gone up by 35 per cent between 2007 to 2008.
  • The number of people using testing and counselling services has also gone up: 39 countries report a doubling in HIV tests between 2007 to 2008, and 93 per cent of all countries that reported data across all regions offered free HIV tests through public health outlets in 2008.
  • But despite this progress the majority of people living with HIV don’t know they have it.
  • Part of the reason for the low uptake of HIV testing could be poor awareness of how one can become infected with HIV, together with fear of stigma and discrimination, said the report authors.
  • Access to HIV services for women and children increased in 2008, with about 45 per cent of HIV-positive pregnant women receiving ART to prevent their babies being born with the virus. This is up from 35 per cent in 2007.
  • In 2007 only 15 per cent of pregnant women in low and middle income countries received an HIV test. This figure went up to 21 per cent in 2008.
  • 198,000 children needing ART received it in 2007: this figure went up to 275,700 in 2008, representing 38 per cent of the children who needed it.
  • In 2008 more information became available about the groups that are most at risk of HIV infection, such as sex workers, men who have sex with men and injected drug users.
  • While HIV programs are expanding as a whole, there are considerable technical, legal and sociocultural barriers to accessing HIV healthcare in the high risk groups.

Globally, AIDS is the leading cause of death among women of reproductive age.

Executive Director of UNICEF, Ann M Veneman said:

“Although there is increasing emphasis on women and children in the global HIV/AIDS response, the disease continues to have a devastating impact on their health, livelihood and survival.”

Executive Director of UNAIDS, Michel Sidibé said all the evidence points to the number of people who will need HIV treatment rising dramatically in the next few years:

“Ensuring equitable access will be one of our primary concerns and UNAIDS will continue to act as a voice for the voiceless, ensuring that marginalized groups and people most vulnerable to HIV infection have access to the services that are so vital to their wellbeing and to that of their families and communities.”

— more info on the report

Source: WHO.

Written by: Catharine Paddock, PhD