New UN Report: Improvements in HIV/AIDS Treatment

A new United Nations report published by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) evaluates HIV/AIDS treatment in 144 low- to middle-income countries.  It appears that progress has been made in improving access to HIV/AIDS medication and services in over thirty developing nations.  

Fifteen of these countries had an 80% or better rate of treatment for HIV-positive pregnant women in order to prevent mother-to-child transmission; fourteen had an 80% treatment rate or better for HIV-positive children.  Perhaps of greatest significance, the report found that eight countries--Botswana, Cambodia, Croatia, Cuba, Guyana, Oman, Romania and Rwanda--have achieved universal access (defined as coverage of at least 80% of the population in need and based on the 2010 WHO guidelines) of antiretroviral treatment of adults.  

Like the Report, the Economist also highlighted some positives in the movement toward global access to HIV/AIDS treatment.  However, in finding positives, the Economist also evaluated several countries illustrating the stark differences in coverage based on the nation in which a patient resides.  Rwanda and Botswana both boast an impressive treatment coverage rate of over 80%; other African nations such as South Africa, Uganda, Zimbabwe and Mozambique cover less than 40% of their HIV/AIDS population.  Significantly, India--one of the world's largest manufacturers of generic medicines--fared poorly in comparison with many other low- to middle-income countries; less than 30% of those who need HIV/AIDS treatment received it in 2009.  Russia's treatment percentage rated just under 20%.

Ultimately, the UN report found that in 2009 5.25 million people had access to HIV/AIDS treatments in low- to middle-income countries, an increase of 1.2 million people (or 36%) from 2008.  In particular, significant progress appeared in Eastern and Southern Africa--the area of the world most in need of HIV treatment.  In this region, HIV treatment coverage increased over 10% and up to 41% of individuals there received necessary treatment in the past year.  

In sub-Saharan Africa, another area heavily afflicted by the HIV/AIDS crisis saw an increase of nearly one million additional people beginning treatment with ARV medications.  Thus, in 2009, the treatment rate in sub-Saharan Africa rose to 37% coverage.  Amongst other regions with developing nations: Latin America and the Caribbean managed a treatment rate of 50%; South-East Asia/East/South Asia averaged 31%; Europe and Central Asia at 19%; and North Africa/Middle East at 11%.

Although the report found an overall improvement in HIV/AIDS treatment from 2008 to 2009, it also notes the significant challenges in achieving universal access to ARVs and testing.  These challenges include, for example, lack of adequate funding, limited human resources, and weak procurement and supply systems for ARVs and diagnostic tools.  Furthermore, better prevention efforts are needed, particularly those aimed at the most-at-risk populations (which include sex workers and drug users, among others) as well as efforts to ensure the availability and safety of blood products (such as for transfusions).  Currently, the quality assured screening of blood covered less than 50% of donations in low-income countries, in stark contrast with the 85% in middle-income countries and 99% assured safety of high-income countries.

The report calls for the the international community to address these concerns, among others, in order to promote better global health for HIV/AIDS.  The WHO is developing a strategy intended to guide the health sector response to HIV/AIDS through 2015 which is expected to be ratified at next year's World Health Assembly.  The full UN report, entitled "Towards Universal Access," is available here.

Although the report demonstrates progress, we are still a long way away from true universal treatment access.  The previous Millennium Development Goal for universal access by 2010 will clearly not be achieved.  Increased funding can greatly improve the movement for universal access.  You can help by asking President Obama to keep his campaign promises to increase funding for global AIDS to $50 billion over five years and to expand funding by $1 billion per year by signing on here.