An estimated 34 million people are living with HIV around the world, and every day over 6,800 people are newly infected.
HIV has left over 15 million orphans and deprived societies of people in their most economically productive years.
In some countries HIV has shortened life expectancy by 20 years. Many of the professionals most needed to help countries escape poverty, such as health workers and teachers, have contracted the disease.
A complicated disease
Curbing the spread of HIV is more complex than promoting the use of condoms and clean needles, important as those are. The drivers of the HIV epidemic in each country are different, and prevention and treatment strategies must take those factors into account.
Gender inequality, stigma, discrimination and poverty all play their part. Equally powerful can be the culture of silence around sex in many countries, and the role of religion in others. There are also the practical constraints of limited funds – not enough condoms, too few health workers and limited or unreliable supplies of drugs to name just a few.
International efforts to increase access to treatment have started to pay off. Over eight million people were receiving antiretroviral treatment in low- and middle-income countries at the end of 2011, an increase of 20% from 2010.
Sub-Saharan Africa has seen great improvements with nearly 6.2 million people receiving antiretroviral therapy in 2011, up from just 100 000 in 2003. However, more than 90% of children living with HIV globally live in sub-Saharan Africa.
To combat this, more pregnant mothers are receiving treatment to prevent HIV transmission to their children – up from 9% in 2004 to 57% in 2011.
The number of people dying from AIDS-related illnesses has declined by almost a quarter since 2005 when the death rate was at its peak – partly a result of greater access to treatment. But the cost of providing HIV treatment will continue to increase as more people access treatment, and as some of those already on treatment need more expensive second and third line drugs.
Prevention is key
Prevention efforts have been less successful – the number of new HIV infections is rising faster than people accessing treatment.
- The global response to HIV appears likely to fail to meet internationally agreed targets for HIV prevention.
- Knowledge about HIV and HIV transmission amongst young men and women remains low
- The failure of many countries to really tackle the stigma and discrimination around HIV means prevention programmes aren’t reaching the populations who are most at risk.
Health Poverty Action says:
- National governments must show greater commitment to tackling poverty and the discrimination against women and other marginalised groups that perpetuates vulnerability to HIV.
- Governments must work harder to reach marginalised groups with condoms and prevention messages, HIV testing and treatment, and care and support. Community organisations and peer groups can be an effective way of reaching sex workers, drug users, men who have sex with men and others.
- Preventing the spread of HIV must be as high a priority as providing access to treatment. More work is needed to change the beliefs and behaviours that put people at risk and to increase access to sexual and reproductive health advice, especially for young people.
- Significantly more money must come from wealthy countries to match the commitments they have given and to plug the funding gap for both prevention and treatment. Funding for HIV must also support the strengthening of national health systems. This includes more clinics and hospitals, more trained health workers, and more mobile staff and health outposts in remote areas, in order to deliver comprehensive prevention and treatment programmes.