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Nov 27
Global HIV Infections Down 17 Per Cent
A new report shows that global new HIV infection rates have fallen by 17 per cent and suggests that HIV prevention programmes are making a difference beyond the natural course of the HIV/AIDS epidemic.

2009 AIDS epidemic update was released on Tuesday by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) at a press conference in Shanghai.

The drop of 17 per cent reflects new data that shows in some parts of the world such as East Asia, the rate of new HIV infection has dropped by nearly 25 per cent from 2001 to 2008. In South and South East Asia it has dropped by 10 per cent, and in sub-Saharan Africa it has dropped by about 15 per cent, over the same period.

In Eastern Europe it has levelled off, while in some countries it looks like the new HIV infection rate is on the rise again.

Michel Sidibe, Executive Director of UNAIDS, spoke about the good and the bad news highlighted in the report.

"The good news is that we have evidence that the declines we are seeing are due, at least in part, to HIV prevention."

"However, the findings also show that prevention programming is often off the mark and that if we do a better job of getting resources and programmes to where they will make most impact, quicker progress can be made and more lives saved."

The report shows that globally more people are living with HIV than ever before; it has gone up from 31.1 million in 2001 to 35.8 million in 2008. And while this is partly due to increased population it is also due to life saving antiviral treatments, as suggested by the fact that AIDS-related deaths have declined by 10 per cent in the past five years as people have increasingly gained access to treatment which has saved estimated 2.9 million lives since it became available in 1996.

One area where increased availability of antiretrovirals has made a noticeable difference is in helping HIV-positive mothers not pass the infection on to their children, a move which in 2001 is thought to have prevented about 200,000 new infections in children, said the report.

Among countries highlighted as making considerable progress is Botswana, Southern Africa, where treatment coverage is now 80 per cent, AIDS-related deaths have more than halved in the last five years, and because their parents are living longer, there are fewer newly orphaned children.

However, Dr Margaret Chan, Director-General of the WHO called for significant further investment in HIV treatment.

"We cannot let this momentum wane. Now is the time to redouble our efforts, and save many more lives," she told the press.

The report also suggests that more progress is made where AIDS and HIV programmes are an integral part of social and welfare services.

Sidibe focused on this when he spoke to the press, "AIDS isolation must end," he said.

"Already research models are showing that HIV may have a significant impact on maternal mortality. Half of all maternal deaths in Botswana and South Africa are due to HIV. This tells us that we must work for a unified health approach bringing maternal and child health and HIV programmes as well as tuberculosis programmes together to work to achieve their common goal," explained Sidibe.

Among the items of not so good news is evidence that suggests the "face of the epidemic is changing" and that efforts to prevent it are not keeping pace with this shift.

The report cites the example of Eastern Europe and Central Asia, where at first the HIV/AIDS epidemic was confined to injecting drug users, but is now infecting their partners. In other parts of Asia there has been a similar shift from sex workers and injecting drug users to heterosexual couples.

Another area of increasing concern raised in the report is that HIV programmes are not designed for older people, and yet there is increasing evidence, for instance in sub-Saharan countries, that this part of the population may have a high rate of infection. It gives the example of Swaziland, where more than two thirds of HIV infections among adults are in people over the age of 25, but few prevention programmes target this group.

There also appears to be a trend in many countries toward reducing the proportion of the HIV/AIDS budget that is spent on prevention. For instance in Ghana the prevention budget was 43 per cent smaller in 2007 compared to 2005, and in Swaziland, despite 26 per cent of the population being infected with HIV, only 17 per cent of the country's total HIV/AIDS budget goes on prevention.

Some critics suggest that the amount of attention that is paid worldwide to HIV and AIDS is disproportionate to the size of the problem compared to other "silent killer" diseases such as pneumonia and diarrhoea, and perhaps another approach would be better, to improve healthcare systems overall, with HIV and AIDS as part of the package.

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