A message from Alyson, our HIV and AIDS advisor

Dear Colleagues,

Today, 1 December 2008 marks the 20th anniversary of World AIDS Day. In a report by UNAIDS it is clear that since 1988, efforts made to respond to the epidemic have produced positive results. However, there are still huge outstanding needs and consequent efforts required by all of us to reduce HIV. Please take the time to read through this message today and consider what we can do to make a difference.

This year’s theme is “Lead – Empower – Deliver”. Designating leadership as the World AIDS Day theme for 2007 – 2008 highlights both the political leadership needed to fulfill commitments that have been made in the response to AIDS – particularly the promise of universal access to HIV prevention, treatment, care and support by 2010 – and celebrating the leadership that has been witnessed at all levels of society.

This year WAD activities are being held across the Territories, for example:

• South East Territory are holding a conference to launch their HIV project where workshops will be held on Anti stigma, HIV awareness and Sexual health .The conference will also include personal statements from young people.
• Northern Territory is running a number of events up to and during WAD week. This includes a Universal Children’s day conference where peer educators raised awareness of their work throughout the year, through displays and discussions. The Mayor of Liverpool and Hollyoaks stars, will join young British Red Cross volunteers and Liverpool school children to celebrate Universal Children’s Day and gain awareness of HIV and AIDS

Many of the National Societies that we are working with are holding different events with their volunteers, staff and partners across their countries. This aims to demonstrate their commitment to increase awareness of HIV and reduce discrimination.

Some key facts on the AIDS epidemic which we should consider in planning and implementing our work:

• An estimated 33 million people were living with HIV in 2007. There were 2.7 million new HIV infections and 2 million AIDS-related deaths last year.
• The rate of new HIV infections has fallen in several countries, but globally these favourable trends are at least partially offset by increases in new infections in other countries.
• Globally, women account for half of all HIV infections—this percentage has remained stable for the past several years.
• The global percentage of adults living with HIV has levelled off since 2000. In virtually all regions outside sub-Saharan Africa, HIV disproportionately affects people who inject drugs, men who have sex with men and sex workers.
• Prevention
• In the last two years, good progress has been made in the prevention of mother-to-child transmission of HIV, but more work is urgently required with only 33% of pregnant women living with HIV receiving antiretroviral treatment to prevent mother-to-child transmission in 2007.
• The scaling up of HIV prevention programmes globally is paramount.
• For people most at risk, since 2005 we have seen a tripling of HIV prevention efforts focused on sex workers, men who have sex with men and people who inject drugs.
• The number of new HIV infections continues to outstrip the advances made in treatment numbers—for every two people put on antiretroviral drugs, another five become newly infected.

Treatment

• Nearly 3 million people were receiving antiretroviral treatment in low- and middle-income countries at the end of 2007. This represents 31% of estimated global need and a 45% improvement over 2006.
• Globally, treatment coverage is higher for women than men.
• But children are not benefiting equally as adults. In sub-Saharan Africa, children living with HIV are about one third as likely to receive antiretroviral therapy as adults.
• Increases in treatment have been extraordinary in many countries.
• After decades of increasing mortality, the annual number of AIDS deaths globally has declined in the past two years, in part as a result of greater access to treatment.
• The cost of providing HIV treatment will continue to increase – as some of those on treatment currently need to access second and third line treatment regimens, and as delayed access makes disease management more complex for the estimated 30 million HIV-positive people worldwide who have never been on treatment.
• Most countries have policies providing free antiretroviral drugs—however many patients have to pay ‘out-of-pocket’ costs such as diagnostic tests, treatments for opportunistic infections and transportation, items which can be quite considerable depending on local contexts.

Tuberculosis and HIV

• Tuberculosis remains a leading cause of death for people living with HIV in low- and middle-income countries.
• While tuberculosis incidence has declined globally in recent years, the number of cases continues to increase in areas heavily affected by HIV or drug-resistant TB.
• Despite the availability of affordable treatments for tuberculosis, only 32% of TB cases in people living with HIV received both antiretroviral and anti-tuberculosis drugs—the greatest need for dual treatment is in sub-Saharan Africa.
• Efforts to prevent, diagnose and treat tuberculosis must be scaled up in HIV care settings

Source: Report on the global AIDS epidemic 2008, August 2008 (UNAIDS/WHO next plan to publish an AIDS Epidemic Update in 2009).

Many regards,
Alyson