The global state of AIDS: The good, the goodish and the not-so good

HIV positive Monica and her granddaughter. (Credit: UNICEF)

With the start of December, World AIDS Day returns, and this year we are met with a flurry of reports and new information about AIDS around the world. The well-coordinated AIDS community makes it tough to stay on top of AIDS-related news. Fortunately for you, we are going to quickly catch you up on three notable reports that describe the promising progress toward ending AIDS and one emerging obstacle.

The Good: The tipping point against AIDS has been reached

CaptureWe have officially reached “the beginning of the end of AIDS,” according to the ONE Campaign. Setting aside the clunky phrasing, it is actually a big deal. The pronouncement is based on the fact that in 2013 the number of people being treated for AIDS outpaced new infections. ONE and others say this matters because it means that people who are infected are getting tested and treated right away, which reduces the likelihood that they will spread HIV/AIDS to a partner. It is great news for the world as a whole, but it does not mean every country is on the right track.

“This is a significant milestone, but it does not mean that we are close to ‘ending AIDS,’” said Erin Hohlfelder, ONE’s policy director for global health, in an email to Humanosphere. “The report highlights the fragility of this milestone at country level.”

Four countries in sub-Saharan Africa are falling behind in terms of the number of new cases and new people put on treatment for 2013. They are: Mali, Burkina Faso, Senegal and Benin. Another seven countries did not have sufficient data to be analyzed by the ONE Campaign. What information was made available is far from perfect. That lack of data about HIV/AIDS makes it all the more difficult to enact an appropriate response.

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“With insufficient data to allow for comparison and analysis, tracking overall progress made by individual countries in the fight against AIDS remains extremely difficult,” according to the report.

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To continue the global progress at the national level, the report makes three recommendations:

  1. Respond to HIV based on where it is a problem, not just where it is easy to reach.
  2. Spend more money from more places.
  3. Strengthen health systems so they can address all health problems, including HIV/AIDS.

The Goodish: Some 1.1 million children were not infected with HIV

The steps to prevent HIV-positive mothers from transmitting the disease to their babies are well documented. The effort to reach more mothers with prevention of mother-to-child transmission services – known as PMTCT services – is crucial to slowing down the spread of AIDS. Overall the number of new HIV cases fell by more than 50 percent from 2005 to 2013, said UNICEF late last week. The biggest gains since 2013 were made in Africa with major declines in Malawi, 67 percent; Ethiopia, 57 percent; Zimbabwe, 57 percent; Botswana, 57 percent; Namibia, 57 percent; Mozambique, 57 percent; South Africa, 52 percent; and Ghana, 50 percent. Not only are fewer children getting HIV from their mothers, the mothers are receiving treatment that will prolong their lives and help reduce their chances of spreading HIV to their husbands and partners.

That is all good, here comes the -ish part. Despite all those cases averted, the goal of reducing new child HIV infections by 90 percent from 2009 to 2015 will not happen. The problem is a lack of access to PMTCT services. Knowing how to stop transmission does not mean every mother with HIV is covered. Roughly two out of three pregnant HIV-positive women in low- and middle-income countries received the top PMTCT drugs. That needs to change, said UNICEF Executive Director Anthony Lake.

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“If we can avert 1.1 million new HIV infections in children, we can protect every child from HIV – but only if we reach every child,” said Lake. “We must close the gap, and invest more in reaching every mother, every newborn, every child and every adolescent with HIV prevention and treatment programs that can save and improve their lives.”

The Not-so Good: AIDS is getting worse among adolescents

So, the news about children and AIDS is good. That is not the case for teens. The number of AIDS-related deaths among adolescents (ages 10 to 19) rose by 50 percent from 2005 to 2012. The estimated 110,000 deaths make AIDS the leading killer of adolescents. A major gap between access to treatment for adults and children illustrates the gravity and reason for the problem.

A girl laughs during a skit on the prevention of HIV, at a youth centre in Moundou, the capital of Logone. (UNICEF)

A girl laughs during a skit on the prevention of HIV, at a youth center in Moundou, the capital of Logone. (UNICEF)

UNICEF says about 64 percent of adults in low and middle income countries living with HIV are receiving antiretroviral treatment. The rate of children with HIV receiving antiretroviral treatment is nearly half, at 34 percent. With the majority of the 2.1 million adolescents living with HIV not getting the drugs that will save their lives, the inability to reduce the deadly impact of HIV/AIDS is apparent.

“The world now has the experience and the tools to achieve an AIDS-free generation. Children should be the first to benefit from our successes in defeating HIV, and the last to suffer when we fall short,” said Lake.

In simpler terms, that means we must immediately recognize and address the specific problem of HIV among teens. The reduction in the number of children born with HIV is a promising trend, but those who are infected are slipping through the cracks, putting their lives and others at risk.

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About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.