Despite a plateau in funding by international donors, the United Nations AIDS agency reports striking progress in curbing new HIV infections and deaths from AIDS.
That progress — apparently due in large part to increases in affected countries' own anti-HIV spending — is fueled by a steady increase in the number of people getting antiviral drugs. Treatment not only prevents their death but can sharply reduce their risk of passing HIV to their sexual partners and children. It's "Treatment As Prevention," as the slogan goes.
UNAIDS says nearly 10 million people in low- and middle-income countries were getting anti-HIV drugs at the end of 2012 — almost a 20 percent increase in just one year.
Another report out Monday notes that funding from international donors has remained flat since 2008. Donor governments currently contribute $7.9 billion toward the pandemic response in low- and middle-income countries, with the United States accounting for $5 billion of that amount.
But self-funding by HIV/AIDS-affected countries has increased, and now accounts for more than half of the $19 billion in total global spending on the pandemic.
In its update of the HIV/AIDS global situation, UNAIDS says 2.3 million people are infected with the AIDS virus each year — a 33 percent reduction from the annual spread of HIV in 2001. New infections among children are down by a heartening 52 percent.
The UNAIDS report's release was timed in advance of a U.N. meeting this week that will review progress toward meeting 2015 targets for eight Millennium Development Goals set back in 2000. Curbing the HIV/AIDS pandemic is one of the eight big goals.
The U.N. meeting will begin to lay out new goals stretching beyond 2015. The process has sparked considerable lobbying by various groups to make sure their causes get due consideration on the agenda, a key tool in international fundraising.
"Hundreds of civil society groups, aid agencies, academics and representatives from the private sector are expected to be in New York to lobby [UN member states]," writes Liz Ford of The Guardian.
But Michel Sidibe, the executive director of UNAIDS, bravely asserts that the 2015 target of 15 million people on HIV treatment is within reach — even though current global resources on HIV/AIDS are billions of dollars short of what's needed.
"Not only can we meet the 2015 target ... we must also go on beyond and have the vision and commitment to ensure no one is left behind," Sibide says in a UNAIDS statement about the latest report.
The 2015 target is to get 15 million on antiretroviral treatment. That will cost about $23 billion a year — almost $3.5 billion more than current spending.
Meanwhile, the number of people needing HIV treatment has jumped to 28.3 million as the result of revised guidelines by the World Health Organization. That's 80 percent of the people in the world that UNAIDS estimates are infected with HIV. The new guidelines reflect research showing treatment can reduce new infections by up to 96 percent.
The new UNAIDS report says expanded HIV treatment has produced "dramatic acceleration towards reaching 2015 global targets on HIV." Not only are new infections sharply down, but AIDS-related deaths dropped by 30 percent since mortality peaked in 2005. Deaths of people dually infected with HIV and tuberculosis have declined even more – by 36 percent.
Further expansion of HIV treatment is hindered by more than just funding limits. UNAIDS says persistent problems such as punitive laws, discrimination against people with HIV and users of addictive drugs, and gender inequality are obstacles against scaling up treatment.
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