Key facts on global HIV epidemic and progress in 2010
Based on Progress report 2011: Global HIV/AIDS response
Beyond 2011: Treatment gains amid funding uncertainties
A 2011 study indicates that investments in ART programmes are having a significant impact on economic activity and labour force productivity, with gains expected to reach up to US $34 billion and 18.5 million life years in low- and middle-income countries by 2020. This more than offsets the costs of ART programmes.
As a result of new evidence that early ART initiation significantly reduces AIDS-related illness and death, as of late 2010, 88 out of 93 reporting countries were following the new WHO recommendations to initiate ART for all patients with CD4 counts of or below 350 cells/mm3.
The Treatment 2.0 initiative, launched by UNAIDS and WHO in 2010, is continuing the drive innovation and efficiency in key areas, such as simplified and more affordable diagnostics and treatment regimens, and integrated, decentralized HIV service delivery.
Examples of these efficiency gains in countries include:
- In South Africa, a new tendering strategy, aimed at increasing competition between drug manufacturers and reducing treatment costs, has resulted in a 53% reduction overall in the cost of antiretrovirals and estimated savings of US$ 685 million over a two-year period.
- In Uganda, the use of simplified fixed-dose combination ARVs for children, as opposed to costly and less convenient syrups and single-drug formulations, has risen from 17% to 100% of those in need in the past two years, and enabled savings of US$ 2 million.
- In Mozambique, after the introduction of CD4 testing devices at selected primary health care clinics, the median time taken for CD4 staging was reduced from 27.5 days to one, and the number of patients lost to follow up prior to initiation of ART fell from 64% to 33%.
- In Malawi, as a result of shifting treatment delivery from hospitals to health centres and from clinical officers to nurses, patients in Thyolo district now start treatment within 3 weeks of diagnosis as opposed to 3 months. HIV testing and counselling services have also been transferred from nurses to trained assistants.
After years of significant increases, international funding for HIV programmes fell in 2010 in the wake of the global financial crisis. Current annual funding is estimated to be US$16 billion, well below the US$22–24 billion needed annually by 2015 for a comprehensive, effective global response to HIV, according to UNAIDS' Investment Framework.
WHO is working with Member States to optimize HIV treatment, prevention and diagnostics, and improve integration and efficiencies of HIV programmes. In May of this year, the World Health Assembly adopted the new Global Health Sector Strategy on HIV/AIDS, 2011 – 2015 with a view to eliminating new infections in infants, reducing new infections in young people by 50%, reducing AIDS-related deaths by 35%, and reducing tuberculosis-related deaths by 50%.