Major drop in new HIV cases

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Global rates of HIV infection and AIDS-related death have both fallen dramatically, the UN has today announced. According to the widely reported figures from the UN’s UNAIDS division, both have fallen by 21% since their peaks at the turn of the millennium. Measures such as improved medical treatment were estimated to have prevented 700,000 AIDS-related deaths in 2010 alone.

The global statistics have been published ahead of World AIDS day on December 1, and to mark a decade since a groundbreaking summit that led to a global strategy for tackling HIV. The report investigated the rates of new HIV infections, people living with HIV worldwide and AIDS-related deaths, to see how far we are currently from the UNAIDS’ ambitious vision: zero new HIV infections, zero discrimination and zero AIDS-related deaths.

The report also outlined strategies of what still needs to be done to prevent new infections and to support the 34 million currently living with HIV.

The news has been widely welcomed, with groups such the charity Medecins Sans Frontieres declaring the fall to be ‘a promising moment to really turn this epidemic around’. However, as the charity and UNAIDS have also highlighted, there is a need to sustain these improvements and continue fighting this worldwide problem with a truly global solution such as the UNAIDS plan.

UNAIDS is the United Nations’ programme for tackling HIV and AIDS as a global problem. Working closely with the World Health Organization its goal is to drive a long-term strategic response to tackle the world AIDS epidemic.

In 2010, the UNAIDS group set out a series of specific goals to achieve by 2015. These include:

In the wake of the UNAIDS strategy and improving national plans, new infections and AIDS deaths have both dramatically fallen in number since their peak in the late 1990s.

The UK HIV situation

Although this UNAIDS report focused on the global response to HIV, advances such as antiretroviral treatment have been  important in improving the lives of people living with HIV in the UK. One large recent study estimated that their introduction boosted the average life expectancy of HIV-positive people from 50 years in 1996 up to 66 years in 2008. Campaigns to address the needs of specific high-risk groups are also thought to have helped by raising awareness of safer sex, the importance of testing and the need to take antiretroviral drugs.

Although the number of new HIV infections each year remains high (between 2.5 and 3 million people worldwide), this is 21% lower than the number of new infections seen at the peak of the epidemic in 1997. Notably, HIV incidence has fallen in 33 countries, including 22 in the sub-Saharan African region, which has been particularly affected by the AIDS epidemic.

AIDS-related deaths have also fallen by 21% since their peak in the mid-2000’s, from 2.2 million to 1.8 million. Although this may seem like a relatively modest drop, this should also be seen in the light of the rising number of people living with HIV. Since 2001, the number of people living with HIV has risen by 17%, due to both a large number of new HIV infections but also a greater number of people having access to life-prolonging antiretroviral drugs.

UNAIDS placed this pattern into context, estimating that in 2010 alone, some 700,000 AIDS-related deaths were averted by actions such as improving access to medical treatment.

UNAIDs said that a decade ago, when the UN brought together world leaders for a global summit on AIDS, only three countries: Senegal, Thailand and Uganda, stood out as having successfully responded to HIV. Since then there has been a tremendous response to HIV as both a global and national problem, and that a number of medical, social, financial and behavioural changes have combined to drive rates down.

For example, UNAIDS said that the decline in new HIV infections is in part due to changes in sexual behaviour, especially among young people. The programme highlighted research that found:

National programmes ensuring wider access to antiretroviral treatments have also had a major impact on people living with HIV. UNAIDS estimated that approximately 2.5 million deaths have been avoided in low- and middle-income countries since 1995 due to antiretroviral therapy being introduced. Approximately 6.6 million people are now receiving treatment in low- and middle-income countries, which is nearly half of those eligible.

In turn, better access to antiretroviral drugs has also reduced rates of new HIV infection as they reduce they amount of viral particles in a person’s body and therefore the potential for transmission.

The report said that in June 2011, the UN member states agreed that by 2015 they would make US$22-24 billion available for the global HIV response each year. UNAIDS said that if all low-and middle-income countries could allocate resources in proportion to their HIV burden, the domestic public-sector allocation of medical services would double by 2017.

However, they added that countries that have the highest rates of HIV and AIDS also tend to have the least resources. Therefore, ‘international donors’ (UN Member States that directly provide development assistance to recipient countries) will also need to continue to support the poorest and worst affected countries.

UNAIDS is particularly focused on implementing a global plan to completely halt new HIV infections among children and to increase the availability of antiretroviral drugs.

The organisation also discussed emerging technologies and strategies such as a vaccine trial in Thailand that found its recipients were 31.2% less likely to become infected with HIV over 42 months than participants that did not receive the vaccine. Although this is not sufficiently effective to grant the vaccine a licence, the report said that continued investment in researching and developing a preventative vaccine is essential.