10
Million Deaths and 1 Million New HIV Infections Could Be Averted
if Countries Meet HIV Treatment Targets, Says New UNAIDS Report
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SUMMARY:
A
new United Nations AIDS (UNAIDS) report proposes "Treatment
2.0" as a new approach to simplify the way HIV
treatment is currently provided and recommends a scaling
up of access to life-saving medicines. Modeling suggests
that compared with current treatment approaches, Treatment
2.0 could avert an additional 10 million deaths by 2025.
In addition, the new approach could also reduce new
HIV infections by up to 1 million annually if countries
provide antiretroviral therapy to all people in need,
according to the report. |
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GENEVA,
July 13, 2010 - The new UNAIDS Outlook report outlines a radically
simplified HIV treatment platform called Treatment 2.0 that could
decrease the number of AIDS-related deaths drastically and could
also greatly reduce the number of new HIV infections. Evidence shows
that new HIV infections among young people, in the 15 countries
most affected by HIV, are dropping significantly as young people
embrace safer sexual behaviors.
Also
in the report, a sweeping new UNAIDS and Zogby International public
opinion poll shows that nearly 30 years into the AIDS epidemic,
region by region, countries continue to rank AIDS high on the
list of the most important issues facing the world. And an economic
analysis makes the case for making health a necessity, not a luxury,
outlining the critical need for donor countries to sustain AIDS
investments and calling on richer developing countries to invest
more in HIV and health.
The
report was launched in Geneva ahead of the XVIII International
AIDS (AIDS 2010) Conference in Vienna. The UNAIDS Executive Director,
Mr. Michel Sidibé, stressed that innovation in the AIDS
response can save more lives. "For countries to reach their
universal access targets and commitments, we must reshape the
AIDS response. Through innovation we can bring down costs so investments
can reach more people."
According
to UNAIDS' estimates there were 33.4 million people living with
HIV worldwide at the end of 2008. In the same year there were
nearly 2.7 million new HIV infections and 2 million AIDS-related
deaths.
Treatment
2.0 saves lives
Treatment 2.0 is a new approach to simplify the way HIV treatment
is currently provided and to scale up access to life saving medicines.
Using a combination of efforts it could bring down treatment costs,
make treatment regimens simpler and smarter, reduce the burden
on health systems and improve the quality of life for people living
with HIV and their families. Modeling suggests that compared with
current treatment approaches, Treatment 2.0 could avert an additional
10 million deaths by 2025.
In
addition, the new approach could also reduce new HIV infections
by up to 1 million annually if countries provide antiretroviral
therapy to all people in need, following revised WHO treatment
guidelines. Today, 5 million of the 15 million people in need
are accessing these life-saving medicines.
To achieve the full benefits of Treatment 2.0 progress has to
be made across five areas:
1.
Create a better pill and diagnostics: UNAIDS calls for the
innovation of a smarter, better pill that is less toxic and for
diagnostics that are easier to use. Monitoring treatment requires
complex equipment and specialized laboratory technicians. A simple
diagnostic tool could help to reduce the burden on health systems.
Such a simplified treatment platform could defray costs and increase
people's access to treatment.
2. Treatment as prevention:
antiretroviral therapy reduces the level of the virus in the body.
Evidence shows that when people living with HIV have lowered their
viral load they are less likely to transmit HIV. It is estimated
that ensuring everyone in need has access to treatment, according
to the current treatment guidelines, could result in up to a one
third reduction in new HIV infections annually. Optimizing HIV
treatment coverage will also result in other health prevention
benefits, including much lower rates of tuberculosis and malaria
among people living with HIV.
3. Stop cost being an obstacle:
despite drastic reductions in drug pricing over the past ten years,
the costs of antiretroviral therapy programs continue to rise.
Drugs can be even more affordable-however, potential gains are
highest in the area of reducing the non-drug-related costs of
providing treatment, such as hospitalization, monitoring treatment,
and out-of-pocket expenses. Currently these costs are twice the
cost of the drugs themselves. Treatment 2.0 is expected to reduce
the cost per AIDS-related death averted by half.
4. Improve uptake of voluntary
HIV testing and counseling and linkages to care: when people
know their HIV status they can start treatment when their CD4
count is around 350, rather than waiting until they are feeling
sick. Starting treatment at the right time increases the efficacy
of current treatment regimens and increases life expectancy.
5. Strengthen community mobilization:
by involving the community in managing treatment programs, treatment
access and adherence can be improved. Demand creation will also
help bring down costs for extensive outreach and help reduce
the burden on health care systems.
Young
people leading the prevention revolution
The new UNAIDS study shows that young people are leading the HIV
prevention revolution. HIV prevalence among young people has declined
by more than 25% in 15 of the 21 countries most affected by AIDS.
These declines are largely due to falling new HIV infections among
young people. In eight countries-Côte d'Ivoire, Ethiopia,
Kenya, Malawi, Namibia, the United Republic of Tanzania, Zambia
and Zimbabwe-significant HIV prevalence declines have been accompanied
by positive changes in sexual behavior among young people.
For
example, in Kenya there was a 60% decline in HIV prevalence between
2000 and 2005. HIV prevalence dropped from 14.2% to 5.4% in urban
areas and from 9.2% to 3.6% in rural areas in the same period.
Similarly in Ethiopia there was a 47% reduction in HIV prevalence
among pregnant young women in urban areas and a 29% change in
rural areas.
Young
people in 13 countries, including Cameroon, Ethiopia, and Malawi,
are waiting longer before they become sexually active. Young people
were also having fewer multiple partners in 13 countries. And
condom use by young people during last sex act increased in 13
countries.
There
are 5 million young people living with HIV worldwide, making up
about 40% of new infections.
The
Benchmark survey
An
international public poll on HIV commissioned for the first time
by UNAIDS shows that nearly 30 years into the AIDS epidemic, region
by region, countries continue to rank AIDS high on the list of
the most important issues facing world. For example, in India
about two thirds report that the AIDS epidemic is more important
than other issues the world is currently facing.
Overall,
respondents put AIDS as the top health-care issue in the world.
Furthermore, about half of the respondents are optimistic that
the spread of HIV can be stopped by 2015.
There
is recognition of efforts to raise public awareness about HIV
over the course of the AIDS response, with one in three respondents
considering it the greatest achievement of the response so far.
This was followed by implementation of HIV prevention programs
and the development of new antiretroviral drugs.
When
asked about how their country was doing against the epidemic,
about 41% of respondents said that their country was dealing effectively
with the problem. Only one in three people believe the world is
responding effectively to AIDS.
For
62% of people surveyed in Sweden, the availability of funding/resources
or the availability of affordable health care is keeping the world
from effectively responding to HIV. Some 60% of people in the
United Kingdom also felt that the lack of funding was the main
obstacle. Other challenges cited by the people surveyed mirror
on the ground experience, with more than half of respondents saying
the availability of prevention services was the most important
obstacle-stigma and discrimination were cited as another barrier.
When
it came to HIV treatment, nearly six in ten believe it is the
duty of the state to provide for free or subsidized treatment
for people living with HIV.
The
poll surveyed adults in 25 countries representing all regions
with nearly 12,000 respondents.
Investments
in HIV must be sustained, efficient and predictable
Investment
in HIV is smart and proven. At this turning point, flat-lining
or reductions in investments will hurt the AIDS response. In 2010
an estimated US$ 26.8 billion is required to meet country-set
targets for universal access to HIV prevention, treatment, care
and support.
"The
AIDS response needs a stimulus package now. Donors must not turn
back on investments at a time when the AIDS response is showing
results," said Mr. Sidibé. "The 0.7% target on
international aid and the Abuja target of 15% for health cannot
be buried."
UNAIDS
recommends that national HIV programs invest between 0.5% and
3% of government revenue in the AIDS response. In recent years
many countries have increased their domestic investments in the
AIDS response. For example, the South African Government increased
its budget for AIDS by 30% to US$ 1 billion in 2010. However,
for the majority of the countries severely affected by AIDS, domestic
investments alone, even when raised to optimal levels, will not
suffice to meet all their resource needs.
UNAIDS
calls on richer developing countries to meet a substantial proportion
of their resource needs from domestic sources. Currently, 50%
of the global resources requirement for low- and middle-income
countries is in 68 countries where the national need is less than
0.5% of their gross national income. These countries have 26%
of the people living with HIV and receive 17% of international
assistance for AIDS.
According
to the report, current investments in HIV can become more efficient,
effective and predictable. "We can bring down costs so investments
can reach more people," said Mr. Sidibé. "This
means doing things better-knowing what to do, channeling resources
in the right direction and not wasting them, bringing down prices
and containing costs. We must do more with less."
7/16/10
Source
UNAIDS. 10 Million Deaths and 1 Million New HIV Infections Could
Be Averted if Countries Meet HIV Treatment Targets. Press Release.
July 13, 2010.