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Fight against AIDS: Important but uneven progress

Fight against AIDS has achieved important but uneven global progress – UN

In the most comprehensive report so far on the world’s progress in combating the HIV/AIDS epidemic, the main United Nations agency combating the disease says most countries have built a strong foundation on which to mount an effective response but new infections are continuing to increase in certain areas.

The study, called “Report on the Global AIDS Epidemic: A UNAIDS 10th Anniversary Special Edition” comes out on the eve of the 2006 High-Level Meeting on AIDS. A dozen heads of State, more than 100 cabinet ministers and about 1,000 representatives of civil society and the private sector are expected to gather in the General Assembly at UN Headquarters in New York from 31 May to 2 June to discuss its findings.

“After a tragically late and slow start, the world’s response has gathered strength – as we saw at the United Nations General Assembly Special Session on HIV/AIDS five years ago,” Secretary-General Kofi Annan says in the preface to the 630-page report, which was produced by the Joint United Nations Programme on HIV/AIDS.

“Since then, there has been remarkable progress in rallying political leadership, mobilizing financial and technical resources, bringing antiretroviral treatment to people the world over and even reversing the spread in some of the world’s poorest nations.”

UNAIDS Executive Director Peter Piot says in his introduction: “Even though the pandemic and its toll are outstripping the worst predictions, for the first time ever we have the will, means and knowledge needed to make real headway.

“Goals that seemed impossible to achieve just five years ago have been realized. There is robust political commitment today. In 40 developing countries, the national AIDS response is now personally led by heads of government or their deputies. Total financing for the response in developing countries rose fivefold between 2001 and 2005, reaching $8.3 billion in the last year.”

In more and more countries on every continent, AIDS epidemics are declining, proving concretely that “AIDS is a problem with a solution,” Dr. Piot says. “Thus, today the foundations exist for the world to mount a response commensurate with the challenge of stopping and reversing the pandemic.”

Noting that precise figures are impossible to collect, the report points out that, with 126 of the 191 UN member countries submitting data, an estimated 33.4 million to 46 million people were living with AIDS at the end of last year. An estimated 3.2 million to 6.2 million became newly infected and between 2.2 million and 3.3 million died of AIDS.

The proportion of people infected with HIV, or the prevalence rate, is believed to have peaked in the late 1990s and to have stabilized globally, even though several countries have been showing increases. But “the world’s failure to make proven prevention methods available to those who need them represents a remarkable missed opportunity.”

Some 25 years after the epidemic was first recognized, most people at risk of HIV infection have yet to be reached with HIV prevention methods, “as many policy-makers refrain from implementing approaches that have been shown to work,” the report says.

Globally, treatment alone would avert 9 million new HIV infections by the end of 2020, whereas simultaneous treatment and prevention would head off an estimated 29 million new HIV infections in the same time, it notes.

Courageous political leadership and strong prevention efforts have been successful in reversing the pandemic in Brazil, Thailand and Uganda and are now reducing the HIV prevalence rate in Cambodia, Zimbabwe, parts of Burkina Faso, Haiti, Kenya and Tanzania, the report says.

Building on the experience in Botswana, where the Government recommended in 2004 that diagnostic HIV testing become a routine part of medical checkups, UNAIDS advises offering the tests in clinics treating sexually transmitted infections (STIs), maternal health clinics, and at community-based health service settings where there is access to antiretroviral drugs (ARVs).

Among the geographical regions, Sub-Saharan Africa is still the worst affected, with an HIV prevalence rate of 6.1 per cent. Of that figure, Botswana’s rate is estimated at 24.1, Lesotho’s 23.2 per cent and South Africa’s 18.8 per cent, compared to 0.9 in Senegal. Among young people, the female to male rate of infection is 3:1, and the report calls for several empowering measures for young women and girls, including an older minimum age for marriage.

The Caribbean, the world’s second most affected region, has a rate of 1.6 per cent, with Haiti coming in at about 3.8 per cent. Cuba’s rate, “an anomaly in the region,” is 0.1 per cent, with mother-to-child transmission found in only 100 babies. Other regions’ rates range from 0.3 per cent in Oceania to 0.8 per cent in Eastern Europe and Central Asia.

At the launch of the report at UN Headquarters, Dr. Piot was joined by the heads of the UN Population Fund (UNFPA) and the UN Children’s Fund (UNICEF) representing the 10 co-sponsoring agencies of UNAIDS.

UNFPA Executive Director Thoraya Ahmed Obaid noted that prevention remained the most effective line of defence, but situations in which women in some countries were powerless to refuse the demands of infected husbands had to be changed.

Saying that children were too often the missing face of the pandemic, UNICEF Executive Director Ann Veneman called for programmes to reduce mother-to-child transmission, as well as better treatment of paediatric AIDS.

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