Young Africans are leading are leading the AIDS prevention revolution, says a new report by the UNAIDS. As many as 15 of the most severely affected countries in the continent are reporting a 25% drop in HIV prevalence in the younger generation.
The report was launched in Geneva ahead of the XVIII International AIDS Conference in Vienna. The UNAIDS Executive Director, Mr Michel Sidibé, stressed that innovation in the AIDS response can save more lives.
"For countries to reach their universal access targets and commitments, we must reshape the AIDS response. Through innovation we can bring down costs so investments can reach more people."
According to UNAIDS' estimates there were 33.4 million people living with HIV worldwide at the end of 2008. In the same year there were nearly 2.7 million new HIV infections and 2 million AIDS-related deaths.
Treatment 2.0 is a new approach to simplify the way HIV treatment is currently provided and to scale up access to life saving medicines. Using a combination of efforts it could bring down treatment costs, make treatment regimens simpler and smarter, reduce the burden on health systems and improve the quality of life for people living with HIV and their families. Modelling suggests that compared with current treatment approaches, Treatment 2.0 could avert an additional 10 million deaths by 2025.
In addition, the new approach could also reduce new HIV infections by up to 1 million annually if countries provide antiretroviral therapy to all people in need, following revised WHO treatment guidelines. Today, 5 million of the 15 million people in need are accessing these life-saving medicines.
"Not only could Treatment 2.0 save lives, it has the potential to give us a significant prevention dividend," said Mr Sidibé, speaking at the launch of the report.
On the gratifying development of decline in HIV among the youth, the report says that In eight countries—Côte d'Ivoire, Ethiopia, Kenya, Malawi, Namibia, the United Republic of Tanzania, Zambia and Zimbabwe—significant HIV prevalence declines have been accompanied by positive changes in sexual behaviour among young people.
For example, in Kenya there was a 60% decline in HIV prevalence between 2000 and 2005. HIV prevalence dropped from 14.2% to 5.4% in urban areas and from 9.2% to 3.6% in rural areas in the same period. Similarly in Ethiopia there was a 47% reduction in HIV prevalence among pregnant young women in urban areas and a 29% change in rural areas.
Young people in 13 countries, including Cameroon, Ethiopia, and Malawi, are waiting longer before they become sexually active. Young people were also having fewer multiple partners in 13 countries. And condom use by young people during last sex act increased in 13 countries.
There are 5 million young people living with HIV worldwide, making up about 40% of new infections.
An international public poll on HIV commissioned for the first time by UNAIDS shows that nearly 30 years into the AIDS epidemic, region by region, countries continue to rank AIDS high on the list of the most important issues facing world. For example, in India about two thirds report that the AIDS epidemic is more important than other issues the world is currently facing.
Overall, respondents put AIDS as the top health-care issue in the world. Furthermore, about half of the respondents are optimistic that the spread of HIV can be stopped by 2015.
There is recognition of efforts to raise public awareness about HIV over the course of the AIDS response, with one in three respondents considering it the greatest achievement of the response so far. This was followed by implementation of HIV prevention programmes and the development of new antiretroviral drugs.
When asked about how their country was doing against the epidemic, about 41% of respondents said that their country was dealing effectively with the problem. Only one in three people believe the world is responding effectively to AIDS.
For 62% of people surveyed in Sweden, the availability of funding/resources or the availability of affordable health care is keeping the world from effectively responding to HIV. Some 60% of people in the United Kingdom also felt that the lack of funding was the main obstacle. Other challenges cited by the people surveyed mirror on the ground experience, with more than half of respondents saying the availability of prevention services was the most important obstacle—stigma and discrimination were cited as another barrier.
When it came to HIV treatment, nearly six in ten believe it is the duty of the state to provide for free or subsidized treatment for people living with HIV.
The poll surveyed adults in 25 countries representing all regions with nearly 12,000 respondents.
UNAIDS recommends that national HIV programmes invest between 0.5% and 3% of government revenue in the AIDS response. In recent years many countries have increased their domestic investments in the AIDS response. For example, the South African Government increased its budget for AIDS by 30% to US$ 1 billion in 2010. However, for the majority of the countries severely affected by AIDS, domestic investments alone, even when raised to optimal levels, will not suffice to meet all their resource needs.
UNAIDS calls on richer developing countries to meet a substantial proportion of their resource needs from domestic sources. Currently, 50% of the global resources requirement for low- and middle-income countries is in 68 countries where the national need is less than 0.5% of their gross national income. These countries have 26% of the people living with HIV and receive 17% of international assistance for AIDS.
According to the report, current investments in HIV can become more efficient, effective and predictable. "We can bring down costs so investments can reach more people," said Mr Sidibé. "This means doing things better—knowing what to do, channelling resources in the right direction and not wasting them, bringing down prices and containing costs. We must do more with less."