Donors crucial to battle against HIV/Aids

More lives are being saved from HIV/Aids than ever before and eight developing countries now give drug treatment to all those who need it, according to a United Nations report published on Wednesday.

But those gains could be reversed without extra money from donors, it warns. About 5.2-million people with HIV now receive antiretroviral drugs that keep them not only alive but also 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 in the world, experienced 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 assistant director general of the WHO. “But, globally, it remains an unfulfilled commitment.”

Dr Gottfried Himschall, the WHO’s director for HIV/Aids, warned that there was a shortfall of $10-billion in the estimated $26-billion needed to keep up progress this year. Much will depend on the replenishment conference of the Global Fund to Fight Aids, TB and Malaria in Geneva in October, where donors will be asked to pledge new funds.

“It is a tipping point,” said Himschall. He said it was 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, UN secretary general Ban Ki-moon won a commitment from donors of $40-billion by 2015 for his plan to achieve the millennium development goals to tackle poor health and poverty by means of focusing 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 from passing HIV on to their babies at birth. But the latest report says the battle against HIV faces difficulties.

There is better evidence than ever before of the positive impact of HIV programmes on reducing infections and cutting deaths, it says.

“Yet 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 continued and strengthened financial and programmatic commitments, there is considerable danger that these achievements could be undone.”

The report details some considerable achievements, but very few countries are able
to treat and protect all their citizens. Data collected from 144 low and middle- income countries shows that 15, including Botswana, Guyana and Sout h Africa, were able to give 80% of women in childbirth the services they needed to prevent transmission of HIV to their babies.

Fourteen countries, including Brazil, Namibia and Ukraine, provided HIV treatment to more than 80% of the children who needed it.

Sarah Boseley is health editor of the Guardian

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