World Aids Day


AFTER NEARLY 30 years of epidemic, on this – World Aids Day – there are some 33.3 million people across the planet living with HIV, 22.5 million of them in sub-Saharan Africa. In 2009, largely due to the multinational Global Fund to Fight Aids, some 5.2 million were on successful combination antiretroviral therapy to keep them alive and well. This was nearly a third more than in 2008 although another 10 million more need it urgently.

Figures from the United Nations organisation Unaids confirm that the tide has been turned slowly although the challenge remains colossal and still significantly beyond the means we are prepared to deploy. In a report last year, Unaids estimated that for every 100 people put on treatment each year, 250 became newly infected. Now it estimates that for every 100 on treatment, 200 become infected. Last year, however, there were an estimated 1.8 million Aids-related deaths, a fall from 2.1 million in the peak year of 2004, and 2.6 million new infections, a fifth fewer than 1999. In Ireland in 2008-09, there was also a 2.2 per cent decline in new infections.

Yet despite progress many countries will not hit the commitment they have made to the sixth of the UN Millennium Development Goals – to halt by 2015, and start to reverse, the spread of HIV/Aids and other infectious diseases. Already inadequate funding is being reduced in richer countries in response both to the economic crisis and shifting priorities. In 2009 about €12.2 billion was spent on the global Aids response, while Unaids argues about €20.6 billion is needed annually to fully fund treatment, care and prevention.

The most promising signs of progress are coming from sub-Saharan Africa where the number of new infections has fallen in eight years from 2.2 million to 1.8 million in 2009, although the total infected continues to grow largely because the infected are now living longer.

There is, however, welcome clear evidence of sexual behaviour change among young people, both in terms of reduced promiscuity and increased condom use, of success in preventing mother-to-child transmission, and of the lower infectious risk of people who are successfully taking Aids drugs. The decline also reflects a normal downturn when high-risk groups become saturated and, with the accession to the presidency of Jacob Zuma, a policy shift in favour of drug treatments in South Africa which has the world’s worst epidemic. Pope Benedict’s recent acceptance of the limited use of condoms should also contribute in coming years.