HIV numbers rise to 40 million

Posted: 22 November 2005

Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean, according to the AIDS Epidemic Update2005 report published on 21 November by UNAIDS and WHO.

There were an additional five million new infections in 2005. The number of people living with HIV globally has reached its highest level with an estimated 40.3 million people, up from an estimated 37.5 million in 2003. More than three million people died of AIDS-related illnesses in 2005; of these, more than 500,000 were children. According to the report, the steepest increases in HIV infections have occurred in Eastern Europe and Central Asia (25 per cent increase to 1.6 million) and East Asia. But sub-Saharan Africa continues to be the most affected globally - with 64 per cent of new infections occurring here (over three million people).

Ethiopian soldier
Ethiopian soldier
A soldier in Humera, Ethiopia. Infection rates for sexually transmitted diseases are up to five times higher in the military than among civilians, according to the United Nations. Credit: ┬ęPep Bonet/Panos Pictures
Kenya, Zimbabwe and some countries in the Caribbean region all show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya from a peak of 10 per cent in the late 1990s to 7 per cent in 2003 and evidence of drops in HIV rates among pregnant women in Zimbabwe from 26 per cent in 2003 to 21 per cent in 2004. In urban areas of Burkina Faso prevalence among young pregnant women declined from around 4 per cent in 2001 to just under 2 per cent in 2003.

The report recognizes that access to HIV treatment has improved markedly over the past two years. More than one million people in low-and middle-income countries are now living longer and better lives because they are on antiretroviral treatment and an estimated 250,000 - 350,000 deaths were averted this year because of expanded access to HIV treatment. More could be averted if access to treatment was extended.

But WHO's 3 by 5 initiative - which aimed to provide antiretroviral therapy to 3 million people with HIV/AIDS in developing countries by the end of 2005 - has failed to meet its target. WHO admits that there may not be even 1.5 million - half the target - on treatment by the end of the year.

Commenting on the potential enhanced impact of integrating prevention and treatment, the 2005 report emphasizes that a comprehensive response to HIV and AIDS requires the simultaneous acceleration of treatment and prevention efforts with the ultimate goal of universal access to prevention, treatment and care. Dr Andrew Ball, of WHO's HIV/AIDS Department, stressed that prevention and treatment were mutually reinforcing, pointing out that the offer of treatment was a strong incentive for voluntary testing.

New data show that in Latin America, Eastern Europe and particularly Asia, the combination of injecting drug use and sex work is fuelling epidemics, and prevention programmes are falling short of addressing this overlap. The report also shows how sustained, intensive programmes in diverse settings have helped bring about decreases in HIV incidence - among young people in Uganda and Tanzania, among sex workers and their clients in Thailand and India, and among injecting drug users in Spain and Brazil.

The report notes that, without HIV prevention measures, about 35 per cent of children born to HIV-positive women will contract the virus. While mother-to-child transmission has been virtually eliminated from industrialized countries and service coverage is improving in many other places, it still falls far short in most of sub-Saharan Africa. An accelerated scale-up of services is urgently needed to reduce this unacceptable toll.