Sub-Saharan Africa ‘turning HIV tide’

21 September 2010

Twenty-two of the most affected countries in sub-Saharan Africa have reduced new HIV infections by more than 25%, according to new data from UNAids which cites South Africa as a country making “good progress” in its Aids response.

The data shows that countries with the largest epidemics in Africa – Cote d’Ivoire, Ethiopia, Nigeria, South Africa, Zambia and Zimbabwe – are leading the drop in new HIV infections, UNAids said on the eve of a United Nations summit on the Millennium Development Goals, taking place in New York from 20 to 22 September.

“Between 2001 and 2009, 22 countries in sub-Saharan Africa have seen a decline of more than 25% in new HIV infections,” UNAids said in a statement on Friday.

According to the organisation, there are now 5.2-million people on HIV treatment globally – a 12-fold increase in six years. With the widening availability of treatment, Aids deaths have dropped significantly – there were 200 000 fewer deaths worldwide in 2008 than in 2004.

“We are seeing real progress towards Millennium Development Goal 6 [to halt and begin to reverse the spread of HIV by 2015],” said UNAids executive director Michel Sidibe. “For the first time, change is happening at the heart of the epidemic.”

South Africa, for example

Citing South Africa as one of many countries showing good progress in their Aids response, UNAids noted that SA was “rapidly accelerating efforts to achieve universal access to HIV prevention, treatment, care and support.

“New HIV infections among adults and young people have dropped by more than 25%, and record numbers of women are accessing treatment to prevent mother-to-child transmission of HIV from previous years,” the organisation said.

South Africa had also “significantly increased its domestic investments for the Aids response in the current fiscal year”.

Young people ‘leading the revolution’

UNAids said that young people were leading the global “prevention revolution by choosing to have sex later, having fewer multiple partners, and using condoms,” while condom use among adults had doubled globally over the past five years.

At the same time, communities worldwide were embracing male circumcision, which has the potential to reduce HIV infection among men by nearly 60%.

And new HIV prevention research had “reported efficacy in a microbicide controlled and initiated by women,” UNAids said, referring to a vaginal gel, developed through South African research, that had the potential to reduce sexually transmitted HIV infection by as much as 54%.

Challenges

However, challenges remained, UNAids warned, noting that Eastern Europe and Central Asia continued to have expanding HIV epidemics, and that there had been a resurgence of HIV infections among men who had sex with men in several high-income countries.

There was also a US$10-billion shortfall for the global Aids response in 2009, as international investments for Aids fell from the previous year to an estimated $15.9-billion.

“At this turning point, flat-lining or reductions in investments will set-back the Aids response and threaten the world’s ability to reach MDG 6,” Sidibe said.

UNAids recommends that national governments allocate between 0.5% and 3% of total government revenue on HIV, depending on the HIV prevalence of the country.

While domestic investments for Aids had increased over the past decade, for most countries severely affected by Aids, domestic investments alone would not be enough.

“On the other hand, Aids programmes can be made sustainable and affordable by increasing the efficiency and effectiveness of HIV programmes,” UNAids said.

Take Aids response ‘out of isolation’

The most important weakness in the global Aids response, however, was a strategic one: Aids programmes had to be taken out of isolation, Sidibe said.

“By situating the Aids response within the broader development agenda and integrating Aids with other health, development and human rights efforts, the world can accelerate progress across the array of MDGs, optimize efficiency in the use of resources, and save and improve more lives.”

For example, new UN estimates show that there were 42 000 deaths due to HIV among pregnant women in 2008. About half of these deaths were estimated to be maternal.

“Integrating HIV investments for maternal health, sexual and reproductive health, as well as child health will leverage better results for millions of people most in need,” Sidibe said. “As we move ahead, the HIV response can help accelerate progress across all eight development goals.”

SAinfo reporter

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