18.2 million people on antiretroviral therapy, UNAIDS

By Henry Opondo

A new report by UNAIDS shows that countries are getting on the Fast-Track, with an additional one million people accessing treatment in just six months (January to June 2016).

By June 2016, around 18.2 million [16.1 million–19.0 million] people had access to the life-saving medicines, including 910 000 children, double the number five years earlier. If these efforts are sustained and increased, the world will be on track to achieve the target of 30 million people on treatment by 2020.

Get on the Fast-Track: the life-cycle approach to HIV was launched today in Windhoek, Namibia, by the President of Namibia, Hage Geingob and the Executive Director of UNAIDS, Michel Sidibé.  “Just under two years ago, 15 million people were accessing antiretroviral treatment—today more than 18 million are on treatment and new HIV infections among children continue to fall,” said President Geingob. “Now, we must ensure that the world stays on the Fast-Track to end the AIDS epidemic by 2030 in Namibia, in Africa and across the world.”

The report contains detailed data on the complexities of HIV and reveals that girls’ transition to womanhood is a very dangerous time, particularly in sub-Saharan Africa. “Young women are facing a triple threat,” said Mr Sidibé. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment. The world is failing young women and we urgently need to do more.”

HIV prevention is key to ending the AIDS epidemic among young women and the cycle of HIV infection needs to be broken. Recent data from South Africa shows that young women are acquiring HIV from adult men, while men acquire HIV much later in life after they transition into adulthood and continue the cycle of new infections.
The report also shows that the life-extending impact of treatment is working. In 2015, there were more people over the age of 50 living with HIV than ever before—5.8 million. The report highlights that if treatment targets are reached, that number is expected to soar to 8.5 million by 2020. Older people living with HIV, however, have up to five times the risk of chronic disease and a comprehensive strategy is needed to respond to increasing long-term health-care costs.

The report also warns of the risk of drug resistance and the need to reduce the costs of second- and third-line treatments. It also highlights the need for more synergies with tuberculosis (TB), human papillomavirus (HPV) and cervical cancer, and hepatitis C programmes in order to reduce the major causes of illness and death among people living with HIV. In 2015, 440 000 of the 1.1 million people who died from an AIDS-related illness died from TB, including 40 000 children.

“The progress we have made is remarkable, particularly around treatment, but it is also incredibly fragile,” said Mr Sidibé. “New threats are emerging and if we do not act now we risk resurgence and resistance. We have seen this with TB. We must not make the same mistakes again.” Get on the Fast-Track: the life-cycle approach to HIV outlines that large numbers of people at higher-risk of HIV infection and people living in high-burden areas are being left without access to HIV services at critical points in their lives, opening the door to new HIV infections and increasing the risk of dying from AIDS-related illnesses. The report examines the gaps and approaches needed in HIV programming across the life cycle and offers tailored HIV prevention and treatment solutions for every stage of life.

“Ending AIDS is possible only if we join hands—by each doing what is within our scope, creatively and aggressively embracing the 90–90–90 targets,” said Eunice Makena Henguva, Youth Economic Empowerment Project Officer for the Namibian Women’s Health Network.

From birth

Globally, access to HIV medicines to prevent mother-to-child transmission of HIV has increased to 77% in 2015 (up from 50% in 2010). As a result, new HIV infections among children have declined by 51% since 2010.

The report highlights that of the 150 000 children who were newly infected with HIV in 2015, around half were infected through breastfeeding. It stresses that infection through breastfeeding can be avoided if mothers living with HIV are supported to continue taking antiretroviral medicines, allowing them to breastfeed safely and ensure that their children receive the important protective benefits of breastmilk.

Testing also remains a major issue. The report shows that only four of 21 priority countries in Africa provided HIV testing for more than half the babies exposed to HIV within their first weeks of life. It also shows that in Nigeria, which accounts for more than a quarter of all new HIV infections among children globally, only half of pregnant women living with HIV are tested for HIV.

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