We’re not there yet, but the fight against AIDS is reaching a tipping point.
The number of new cases of HIV are falling while the number of people receiving life-saving treatment is going up. If current trends holds, the two trends will meet by 2015, says a new report.
That is the tipping point for beating AIDS.
The 2.3 million new HIV infections recorded in 2012 is the lowest number since the 1990s, says the Joint United Nations Programme on HIV/AIDS (UNAIDS). The cost of treatment for AIDS is down dramatically from roughly $10,000 per person per year in the 1990s to $140 today.
However, Attention and financing for AIDS is wavering as the world nears this crucial moment. UNAIDS estimates that as much as $24 billion will be needed each year by 2015.
It is expected that The Global Fund to Fight AIDS, Tuberculosis and Malaria will not reach its goal of raising $15 billion next month. It should have more money than its last replenishment of $10 billion and Global Fund reforms will ensure it is better spent.
The inflection point, called “the beginning of the end of AIDS” by advocates, could very well be the tipping point that will accelerate the world towards the defeat of AIDS. Reaching it will be a landmark moment.
“The disease is beating us essentially. Every year we have been outpaced by it,” said Erin Hohlfelder, Global Health Policy Director for ONE. “This will be the first time we will will get ahead of it.”
A report released ahead of World AIDS day by ONE uses updated data on infections and treatment to show that the estimated inflection point has moved up from 2022 to 2015.
The improvement is the result of new data that shows things were better than previously reported and the acceleration of progress by countries beset by AIDS, explained Hohlfelder.
Prevention has been a key part of why things are getting better. Male circumcision has proven to help reduce the spread of HIV, but it is only now starting to be pushed as a key intervention.
Using HIV treatment medicines are prevention tools is another area of promise. Studies in recent years showed that anti-retrovirals can help prevent the spread of HIV from an infected partner to an uninfected one.
Gaps in the response still exist. Marginalized groups, such as sex-workers, men who have sex with men and injecting drug-users, are unable to access life-saving medicines in some parts of the world. UNAIDS recently called attention to the problem arguing that leaving people on the sidelines is in part why HIV infections have risen by 13% in Eastern Europe and Central Asia since 2006.
“Every person counts,” said Michel Sidibé, Executive Director of UNAIDS. “If we are going to keep our pledge of leaving no one behind—we have to make sure HIV services reach everyone in need.”
Neglect goes beyond marginalized groups. The elderly and children are also often not on treatment for HIV. Adults are twice as likely to be treated for HIV than children under the age of 15, says UNAIDS. All of these problems illuminate why more money is vital to maintaining global advances.
“It is difficult to argue that we can accelerate progress without increases in funding,” she said.
Low and middle-income countries are doing more to spend on HIV and AIDS. Domestic spending now accounts for 53% of global spending on AIDS, but more is needed from both donors and countries, says ONE. The plateaued spending by donor countries and its reason is a bigger worry for advocates.
“The thing we are more concerned about is more about flailing political will about this issue,” said Hohlfelder. “A few years ago this was a consistently high ranking issue. In recent years we have seen that falter a bit.”
The Congressional re-authorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) was a rare show of bi-partisanship. The ten year old program will continue forward, but the funding remains up in the air. An ongoing battle over the federal budget likely kept financing commitments out of the PEPFAR re-authorization bill.
“At a time when so much partisanship is happening, it is promising that such an issue can bring people together,” said Hohlfelder.
Getting to the tipping point against AIDS is within site, but it could remain as close as the horizon if the funding situation does not improve.