30 Years of HIV
Last week, the United Nations Programme on HIV/AIDS released a report called AIDS at 30: Nations at the crossroads. There have been around 30 million deaths from AIDS-related causes since the beginning of the HIV epidemic three decades ago. In 2010, there were around 34 million people living with HIV worldwide. While contracting HIV is no longer an automatic death sentence, there is still a lot to be done in prevention and treatment.
In 1981, the Centers for Disease Control (CDC) issued the first official report on HIV. However, the seriousness of the epidemic was not yet fully understood and, according to the UN report, it took more than two decades before the global community mounted a real response to the problem. As a result, HIV spread like wildfire.
The report highlights several lessons learned from the first two decades of the AIDS crisis:
- Political leadership is critically important (and was lacking).
- Communities and people affected with HIV played a powerful transformative role despite the political leadership vacuum.
- Scientific knowledge must be leveraged effectively when charting a course of action for dealing with an epidemic.
- Stigma and discrimination gets in the way of effective treatment. The countries that had the strongest measures to protect and promote the rights of people with HIV were also the most successful in fighting the disease.
Y2K and Beyond = Significant Increase in Investment, Access to Treatment and Prevention
After the year 2000, the investment in the HIV response in developing countries increased significantly. In low- and middle-income countries, the annual investment was ten times higher in 2009 than it was in 2001, rising from US$1.6 billion to US$15.9 billion annually. However, in the past five years, questions have come up about the efficiency of expenditures on HIV, which has, in turn, resulted in a flattening of donations.
The number of people receiving antiretroviral therapy in low- and middle-income countries increased almost 22-fold from 2001 to 2010, with the vast majority of recipients being in Sub-Saharan Africa.
On the prevention side, the UN reports that the safe sex message is starting to sink in, young people are more knowledgeable about HIV transmission and a greater percentage of people know their own HIV status. However, there is still work to be done, as “only 49% of young females know that using a condom helps to prevent HIV infection, compared to 74% of young males.”
The transmission of HIV from mother to child has also begun to decline. Although targets were not reached on this particular factor, at least the trend is moving in the right direction.
There continue to be numerous important issues that need to be addressed in the battle against the spread of HIV. This includes:
- Gender issues, such as the need for special attention for young girls born HIV positive, for pregnant women and mothers, and for sex workers. Currently women and girls make up 60% of Africans living with HIV.
- Continued discrimination and hate crimes against people with AIDS/HIV.
- Controversy around the use of male circumcision as an HIV prevention tool.
- The issues that are important vary from one country to the next. For example, in some countries transmission of HIV via drug-use is a significant factor, whearas in others it is not.
Hope for the Future?
A great deal of progress has been made recently in the fight against AIDS. Some of the findings and goals cited in the UN report include:
- According to the result of the HPTN052 trial that was released in May 2011, the risk of an HIV positive person transmitting the virus to an uninfected sexual partner can be reduced by 96% if they adhere to an effective antiretroviral therapy regimen.
- This year, South Africa has plans to cut the rate of new HIV infections in half, provide HIV testing to 15 million people and provide lifesaving drugs to 80% of South Africans who need them.
- By 2010, 182 countries had implemented the Declaration of Committment on HIV/AIDS.
There is still a lot of work to be done. Greater efficiency and a larger investment is still needed to tackle the HIV epidemic effectively. The UN Report provides many more details on what needs to be done for those who are interested. However, despite all the work that is still ahead of us, for the first time in 30 years it is beginning to look like we are starting to reverse some of the negative trends. Perhaps there is a light at the end of this dark tunnel.
Note: Unless otherwise stated, all data presented in this post is from the UN report.
Image credit: John Rawlinson on flickr