Global AIDS response - what progress?

On Wednesday, in the run up to World AIDS Day, UNAIDS released its 2013 report on the global epidemic.The report says an estimated 35.3 million people worldwide were living with HIV last year, a slight increase on previous years (34 million in 2012).

The report tells the story of the significant gains that have been made towards many of the 2015 targets in the Millennium Development Goals. For example, AIDS-related deaths among people living with HIV have decreased by 30 percent since the peak in 2005 as access to antiretroviral treatment (ART) has expanded.

However, two specific aspects of the report are of immense concern to the Alliance and reflect the priorities we have in our work:

Access to life-saving treatment

The report says that the world is within reach of providing antiretroviral therapy (ART) to 15 million people by 2015. However, with the publication this year of new guidance by WHO, this statement does not reflect the numbers of people who are now eligible for treatment in low- and middle-income countries.

Before the new guidelines, close to 17 million people living with HIV in low- and middle-income countries were eligible for ART. With the change in threshold, an estimated 26 million will now be eligible.

The latest UNAIDS data shows that in 2012 9.7million people were able to access ART treatment. This represents just 34% of the people who are eligible for treatment. Prior to the new guidance, this figure would have been 61%. We still have a long way to go to ensure that all those in need have access to life-saving treatment. It is vital that the health goal and targets in the post-2015 development agenda reflect this ongoing challenge.

Funding and under spending on key populations

We know that much HIV funding continues to be directed to low-impact interventions for low-risk populations. The new report sadly confirms this is still the case with key populations still unable to access appropriate health services.

The report says that efforts to reduce transmission related to sex work and men who have sex with men remain ‘insufficient’, as evidenced by recent trends in prevalence among these groups. It also reports that HIV prevention coverage for people who inject drugs remains low, with only two of 32 reporting countries providing the recommended minimum of at least 200 sterile syringes per year for each person who injects drugs.

The good news is that UNAIDS estimates that in 2012, $18.9 billion was available for HIV programmes in low- and middle-income countries - up by 10 percent from 2011. The report also notes that although international HIV funding has remained flat, many low- and middle-income countries have increased funding for HIV, with domestic sources accounting for over half of all HIV-related spending in 2012. Whilst the increased funding provided by governments for their national response is welcomed, many continue to neglect the most marginalized communities who consistently bear the greatest burden of HIV.

UNAIDS estimates that by 2015, the annual cost of fighting HIV will be between $22 billion and $24 billion. Anton Ofield-Kerr, Head of Policy said "In this scenario it is even more vital that international donors meet their commitments on the 3rd December when they meet in Washington DC for the replenishment conference for the Global Fund to Fight AIDS, TB and Malaria." At this meeting, the Global Fund is aiming to secure the $15 billion financing needed for their programs in more than 140 countries for the period 2014-2016.

“These latest figures only serve to intensify our work to influence and shape the global HIV response, informed by the knowledge of the local contexts through our alliance of national, independent Linking Organisations” continued Ofield-Kerr.