The world will not achieve universal access to HIV care, treatment, and prevention by the end of this year, though the goal is within "clear reach" in a number of countries, according to a new joint report by the World Health Organization, the Joint United Nations Programme on HIV/AIDS, and the United Nations Children’s Fund.
U.N. member states pledged four years ago to reach universal access targets of 80% coverage for the global HIV population, which in 2008 stood at more than 33 million people.
Worldwide, just one third of those in need of antiretroviral therapy have access to it, the report says. In low- and middle-income countries, 5.2 million people received antiretroviral treatment last year, 30% more than in 2008 and a 13-fold increase from six years ago. However, an estimated 10 million people still lack treatment access. Just eight low- and middle-income countries achieved universal access by 2009, including Cambodia, Cuba, and Rwanda.
The scale of prevention measures is still inadequate, the report noted. Population surveys in 10 low- and middle-income countries found that 60% of those infected did not know it, says Yves Souteyrand, WHO's HIV/AIDS coordinator. Stigma and discrimination against at-risk populations — sex workers, drug users, migrants, and men who have sex with men — add to their marginalization from treatment and care, the report states.
In 15 sub-Saharan countries, more than 80% of HIV-positive pregnant women received services and anti-HIV meds to prevent mother-to-child transmission, according to the report. Botswana and South Africa were among them. Fourteen low- and middle-income countries provide pediatric ARVs for children with HIV.
"At the same time, the financial crisis and resulting economic recession have prompted some countries to reassess their commitments to HIV programs," notes the report, which urges nations to come through with pledges and funding. Otherwise, the world "risks undoing the gains of the past years," agency heads say.
