More lives are being saved from HIV/Aids than ever and eight developing countries now give drug treatment to all those who need it, according to a United Nations report published tomorrow. However, those gains could be reversed without extra money from donors, the report warns.
About 5.2 million people with HIV now receive antiretroviral drugs that keep them not only alive, but fit and well – an increase of more than 1.2 million people in a year, says the report from the World Health Organisation, Unicef and UNAids. More than a third of those who need the drugs (36%) are now taking them.
Sub-Saharan Africa, the worst-affected region, saw the biggest increase, from 2.9 million in December 2008 to 3.9 million at the end of last year. Botswana, Cambodia, Croatia, Cuba, Guyana, Oman, Romania and Rwanda now provide universal access to antiretrovirals – defined as giving the drugs to at least 80% of those who need them. The goal was worldwide universal access by the end of this year.
"Countries in all parts of the world are demonstrating that universal access is achievable," said Dr Hiroki Nakatani, the WHO assistant director-general. "But, globally, it remains an unfulfilled commitment. And we must join forces to make it a worldwide reality in the coming years."
Dr Gottfried Himschall, the WHO's director for HIV/Aids, warned that there was a shortfall of $10bn (£6.3bn) from the estimated $26bn needed to keep up progress this year. Much will depend on the conference of the Global Fund to Fight Aids, TB and Malaria next month, where donors will be asked to pledge funds.
"It is a tipping point – it is an important moment," said Himschall. He said it was also a time to demonstrate clearly that the fight against HIV was part of the wider fight to which the world signed up last week – to save the lives of women in childbirth and their children.
At the summit in New York last week, the UN secretary general, Ban Ki-moon, won commitments of $40bn by 2015 for his plan to achieve the Millennium Development Goals – to tackle poor health and poverty – through a new focus on women and children. Some of that money will be channelled through the Global Fund. It is accepted that 9% of deaths in childbirth are HIV-related, and there is a need for more funding to prevent women passing HIV on to their babies at birth.
But the report says the battle against HIV faces difficulties, despite more evidence of the impact of HIV programmes on cutting deaths. "This evidence becomes available at a time when the global economic crisis of 2008-2009 has put the sustainability of many HIV programmes at risk. It is clear that without strengthened financial and programmatic commitments, there is considerable danger that these achievements could be undone."
The report details some achievements but few countries protect all citizens. Data collected from 144 low- and middle-income countries shows that 15, including Botswana, Guyana and South Africa, were able to give 80% of women in childbirth the services they needed to prevent transmission of HIV to babies. Fourteen, including Brazil, Namibia and Ukraine, provided HIV treatment to 80% of children who needed it.