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Progress in Containing HIV/AIDS, But No Cause for Complacency

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By Somar Wijayadasa* | IDN-InDepthNews Analyis


NEW YORK (IDN) - Almost all countries of the world commemorated the World AIDS Day on December 1 with statements that exhibit optimism that the HIV/AIDS epidemic is finally on its last leg.

Despite tremendous progress in containing the pandemic, the Joint United Nations Program on HIV/AIDS (UNAIDS) estimates that, in 2014, there were “over 2 million new HIV infections”.

Contrary to perceptions, 6,000 new HIV infections a day is an unacceptably high level that is nothing to be complacent about.

UNAIDS estimates that “there were 36.9 million people living with HIV in 2014, up from 29.8 million in 2001” – perhaps due to continuing new infections, people living longer with HIV medications, and general population growth.

What keeps the AIDS virus growing, perhaps, is the fact that 19 million of them even do not know that they have the virus. That is frightening.

Ending the AIDS epidemic by 2030

At the United Nations General Assembly in September 2015, world leaders committed to ending the AIDS pandemic by 2030 as part of the UN’s Sustainable Development Goals (SDGs).

To achieve that ambitious goal, the UNAIDS leads and inspires the world to scale up treatment targets by 2020 to ensure that, in the coming five years, 90% of people living with HIV will know their HIV status; 90% of people with HIV infection will receive antiretroviral treatment; and 90% of people receiving antiretroviral therapy will have viral suppression.

UNAIDS unites the efforts of 11 UN organizations – UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank – and works closely with global and national partners towards ending the AIDS epidemic.

Status of global HIV pandemic

United Nations data show 25 countries have cut their new HIV infections at least in half. That is progress thanks to an increased investment by the international community and local governments in education, testing and treatment.

But the data provided by governmental authorities reveal that there is still no light at the end of the tunnel. Figures for any country are questionable as there is a wide gap in data collection and dissemination.

SUB-SAHARAN AFRICA is the most affected part of the world. UNAIDS estimates that “out of the 36.9 million people living with HIV in 2014, around 25.8 million live in sub-Saharan Africa”.  It also estimates that from 1981 to 2014, over 26 million Africans died of AIDS related deaths, and that it has over 40 million children orphaned by AIDS.

South Africa has about 6.3 million and Nigeria about 3.2 million people living with HIV. Africa has the biggest antiretroviral programs in the world, and “by mid-2015, 11.4 million people living with HIV in sub-Saharan Africa had access to treatment”.

According to UNAIDS, ASIA AND PACIFIC have the second largest population of people living with HIV, at an estimated 4.8 million people.

SRI LANKA, has an HIV infection rate of 0.1% of the general population. Sounds great but according to the National STD/AIDS Control Program of Sri Lanka, approximately four people are diagnosed with HIV every week in Sri Lanka, with an estimated 5 more going undetected.

INDIA, with a population of 1.3 billion has 2.1 million people living with HIV – an HIV prevalence rate of 0.3%. Among its most affected populations are sex workers, men who have sex with men, injecting drug users, transgender people, migrant workers, and truck drivers.

India has made enormous progress in containing the disease and it has been providing free antiretroviral treatment to all known HIV patients.

CHINA, with a population of almost 1.4 billion, has a low HIV prevalence rate of 0.03% with about 575,000 people living with HIV/AIDS. However, according to the Chinese Center for Disease Control and Prevention, “the rate is up from the 437,700 reported in 2013”.

The Chinese government has methadone treatment programs to treat heroin addicts, and has closed down commercial blood centers for the safety of blood transfusions and blood products.

While transmission of HIV through blood transfusion and mother-to-child transmission in China is down, the rate of contracting the disease through sexual transmission is on the rise.

WESTERN AND CENTRAL EUROPE, according to UNAIDS, has an HIV infection rate of 0.1%. It estimates that, in 2013, “there were 860,000 adults living with HIV in this area” and “in 2012, there were 27,315 newly diagnosed cases of HIV”.

As in all other regions, HIV infection is mainly concentrated among men who have sex with men, heterosexuals, and in people who inject drugs.

EASTERN EUROPE AND CENTRAL ASIA has an estimated 1.1 million people living with HIV that accounts for 3% of the global total.

According to UNAIDS, the HIV epidemic in this region continues to grow, particularly in Russia, Ukraine, Latvia and Uzbekistan. Russia accounts for eight out of ten new HIV infections.

In 2013, Russia passed a federal law banning “gay propaganda" to enshrine deeply conservative values. Russia also prohibits the use of methadone to treat drug addicts. HIV rates remain high due to injecting drug use, and spread via heterosexual transmission.

LATIN AMERICA has about 1.7 million people living with HIV – a prevalence rate of 0.4%. However, according to UNAIDS, in 2013, there were an estimated 94,000 new HIV infections and 47,000 deaths from AIDS-related illnesses.

The vast majority of people living with HIV in Latin America (75%) live in four countries: Brazil, Colombia, Mexico and Venezuela. The main route of transmission is sexual contact with transgender women, gays and other men who have sex with men, and female sex workers.

CUBA became the first country to be certified by the World Health Organization as having eliminated new HIV infections among children. Its HIV infection rate of 0.01% is low whereas the Caribbean region has a high HIV prevalence rate.

UNITED STATES OF AMERICA (USA), where HIV/AIDS was first identified in 1981, currently has around 1.2 million people living with HIV.

According to the Center for Disease Control (CDC), “HIV prevalence has dropped dramatically since the 1980s but has around 50,000 new infections per year”. In the USA, HIV is spread mainly through having unprotected sex or by sharing contaminated drug injecting needles. Gay and bisexual men account for the majority of new infections, and 12.8 percent of people with HIV do not know they are infected.

Even in the USA, stigma and discrimination continue to hamper people's access to HIV prevention, testing and treatment services, fueling the cycle of new infections.

Antiretroviral therapy

HIV is treated using a combination of medicines called antiretroviral therapy (ART). It is not a cure but it reduces the amount of HIV virus in the body to undetectable levels – thus, reducing the chance of transmitting HIV to sexual partners. ART’s have turned what was once a death sentence into a manageable disease.

Now, thanks to the low-cost availability of ART’s, people have become complacent. They gamble by having unprotected sex, don't care to take the HIV test, fail to inform their partners that they have the deadly virus – thus spreading HIV.

According to UNAIDS, “1.2 million people died of AIDS in 2014, a 42% decrease since 2004” – perhaps, thanks to ART treatments. Today, about 15.8 million people are on ART therapy. Yet, 22 million HIV patients have no access to these life saving medications.

Between 2000 and 2014, the percentage of pregnant women living with HIV with access to ART therapy rose to 73%, and new HIV infections among children dropped by 58%.

Finally, almost all countries admit that HIV prevalence is on the rise, and that there are millions who have not yet been diagnosed. Young people, ages 15-24, account for approximately 30% of new HIV infections.

Even with the awareness of the deadly AIDS virus for 35 years, stigma and discrimination against those with the virus still remain an issue at schools, hospitals, workplaces and other establishments all over the world.

That undermines prevention, care and support, and fuel the spread of HIV. For many, the brutally inhumane approach to the sick and dying remains unconscionable.

*Somar Wijayadasa was a delegate of UNESCO to the UN General Assembly for ten consecutive years from 1985-1995, and was Representative of UNAIDS at the United Nations from 1995-2000. [IDN-InDepthNews – 08 December 2015]

For Somar Wijayadasa’s previous IDN articles, please click here.

Photo: The United Nations Secretariat Building is lit with the Red AIDS ribbon, demonstrating the Organization's commitment to the battle against HIV/AIDS, and to spotlight the General Assembly Special Session on HIV/AIDS on June 25-27, 2001. | Credit: UN Photo # 123470

2015 IDN-InDepthNews | Analysis That Matters

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