2006 Report on the Global AIDS Epidemic

30 May 2006

Progress Seen in Fighting AIDS, but Epidemic Outpaces Response, May 30, 2006

(U.N. report cites positive trends in global HIV prevention, treatment)

By Cheryl Pellerin
Washington File Staff Writer

Washington -- According to new data in the Joint United Nations Programme on HIV/AIDS (UNAIDS) 2006 Report on the Global AIDS Epidemic, released May 30, the epidemic seems to be slowing down globally, but new infections continue to increase in some regions and countries.

The report shows that progress has been made in country AIDS responses, including increases in funding and access to treatment, and decreases in HIV prevalence among young people in some countries over the past five years.

At a May 30 press briefing in New York, UNAIDS Executive Director Dr. Peter Piot called the report “the most comprehensive analysis of both the global epidemic and of the response.”

UNAIDS brings the efforts and resources of 10 U.N. system organizations to the global AIDS response. The UNAIDS secretariat works on the ground in more than 75 countries.

An estimated 38.6 million people live with HIV worldwide. In 2005, some 4.1 million became infected with HIV and 2.8 million died of AIDS-related illnesses, according to the report.

PROGRESS, CHALLENGES

The report is a five-year assessment of progress in AIDS using indicators developed by UNAIDS, individual nations and a range of partners. It arose from the 2001 Declaration of Commitment on HIV/AIDS, adopted at a special session of the U.N. General Assembly.

At that meeting, 189 U.N. member states committed to targets for delivering the HIV prevention, treatment, care and support needed to halt and begin to reverse the global epidemic by 2015.

“On the AIDS response side,” Piot said, “there is good news.” Many countries have made important progress over the past five years, with increased funding; a decrease in the number of new infections, especially among young people; and more people being treated.

“This signals that we’re beginning to see a return on the investment for AIDS funding,” Piot said, “and we could say it’s about time.”

But AIDS is still an exceptional threat, the report says. Some countries are doing well on treatment but poorly on HIV prevention efforts, and significant challenges remain, including the need for better planning, sustained leadership and reliable long-term funding for the AIDS response, according to the report.

The report was released in advance of the U.N. General Assembly 2006 High Level Meeting on AIDS, which is bringing world leaders to New York from May 31 to June 2 to review progress made since 2001.

SIGNIFICANT IMPROVEMENTS IN AIDS RESPONSE

The report cites significant improvements in several elements of the global AIDS response.

In the key area of financial resources, the $8.3 billion available for the AIDS response in 2005 is more than five times the funding available in 2001, and is well within the Declaration of Commitment target range.

The report also cites significant increases in global political leadership, which is key to maintaining the AIDS response at the center of national and international development planning.

The report shows that young people and children increasingly are affected by the epidemic, and efforts to protect these and other vulnerable groups are not keeping pace with the epidemic’s impact.

“For too long,” said Ann Veneman, executive director of the U.N. Children’s Fund, who attended the press conference, “children have often been the missing face of the AIDS pandemic.”

It is critical, she added, “that the impact of HIV/AIDS on children be addressed through programs to prevent mother-to-child transmission and to treat cases of pediatric AIDS.”

On HIV prevention, the report documents behavior changes, including delays in first sexual experience, increasing use of condoms by young people, and resulting decreases in HIV prevalence in young people in some sub-Saharan countries.

The report also makes clear that on many issues and in most regions of the world, greater action against the epidemic is required now and will be required long into the future.

PREVENTION

In terms of prevention, six of 11 African countries reported declines of 25 percent or more in HIV prevalence among 15- to 24-year-olds in capital cities. Rates of sexual activity among young people declined in nine of 14 sub-Saharan countries.

Use of HIV testing and counseling, an important tool for treatment and prevention, quadrupled from 2001 levels to 16.5 million people tested in 2005. In 58 countries reporting, 74 percent of primary schools and 81 percent of secondary schools now provide AIDS education.

The Declaration of Commitment called for 90 percent of young people to be knowledgeable about AIDS by 2005, yet surveys indicate that fewer than 50 percent of young people achieved comprehensive knowledge levels.

An area of exceptional concern is the ongoing shortfall in care to prevent mother-to-child HIV infection, in which just 9 percent of pregnant women now are covered.

TREATMENT, LEADERSHIP

Access to anti-retroviral treatment has expanded significantly, from 240,000 people in 2001 to 1.3 million people in low- and middle-income countries in 2005.

Prices for anti-retroviral therapy dropped significantly and procurement systems have improved, as has generic drug availability.

Still, HIV treatment coverage varies considerably within regions. In sub-Saharan Africa, treatment coverage ranges from 3 percent in the Central African Republic to 85 percent in Botswana.

AIDS leadership and political action also increased significantly since 2001.  Ninety percent of reporting countries have a national AIDS strategy, 85 percent have a single national body to coordinate AIDS efforts and 50 percent have a national monitoring and evaluation framework and plan.

But systems for implementing such plans are inconsistent, as are civil society involvement and the involvement of people living with HIV.

“We must move to build upon an increasingly strong foundation,” Piot said, “by transforming the AIDS response from a year-to-year crisis management approach to one of long-term strategic planning that includes sustained leadership and funding to reduce the epidemic and its impact.”

The 2006 Report on the Global AIDS Epidemic is the most comprehensive report on the response to AIDS ever compiled, using data from 126 countries and more than 30 civil society organizations.  The report is available at the UNAIDS Web site.

For information on U.S. policy, see AIDS and Other Infectious Diseases.