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An estimated 33 million people are living with HIV around the world, and every day 5,500 people die from AIDS-related illnesses.
HIV has left over 15 million orphans and deprived societies of people in their most economically productive years.
In some countries HIV has shortened life expectancy by 20 years. Many of the professionals most needed to help countries escape poverty, such as health workers and teachers, have contracted the disease.
A complicated disease
Curbing the spread of HIV is more complex than promoting the use of condoms and clean needles, important as those are. The drivers of the HIV epidemic in each country are different, and prevention and treatment strategies must take those factors into account.
Gender inequality, stigma, discrimination and poverty all play their part. Equally powerful can be the culture of silence around sex in many countries, and the role of religion in others. There are also the practical constraints of limited funds – not enough condoms, too few health workers and limited or unreliable supplies of drugs to name just a few.
Making inroads
International efforts to increase access to treatment have started to pay off. Nearly three million people were receiving antiretroviral treatment in low- and middle-income countries at the end of 2007. This still represents only 31% of those who need it, but is a 45% improvement over 2006.
Some countries have made amazing progress. For example, Namibia has increased access to treatment from 1% in 2003 to 88% in 2007, and Rwanda, from 3% to 71% in the same period.
More pregnant mothers are also getting treatment to prevent HIV transmission to their children - up from 9% in 2004 to 33% in 2007.
After decades of rising deaths, the number of people dying from AIDS-related illnesses has declined in the past two years – partly a result of greater access to treatment. But the cost of providing HIV treatment will continue to increase as more people access treatment, and as some of those already on treatment need more expensive second and third line drugs.
Prevention is key
Prevention efforts have been less successful – the number of new HIV infections is rising faster than people accessing treatment.
- For every two people put on antiretroviral drugs, another five become newly infected.
- UN data collected from 64 countries also indicates that fewer than 40% of young people have basic information about HIV.
- And the failure of many countries to really tackle the stigma and discrimination around HIV means prevention programmes aren’t reaching the populations who are most at risk.
High profile but more funding needed
HIV has become the highest profile disease affecting the development of poorer countries. In 2005 world leaders promised access to HIV prevention, care and treatment for all by 2010 following a global campaign. Funding to reach that aim has increased considerably, but is still far less than what is needed. The UN calculates that three to five times the level of current financing is needed to meet the 2010 promise.
Health Poverty Action says:
- National governments must show greater commitment to tackling poverty and the discrimination against women and other marginalised groups that perpetuates vulnerability to HIV.
- Governments must work harder to reach marginalised groups with condoms and prevention messages, HIV testing and treatment, and care and support. Community organisations and peer groups can be an effective way of reaching sex workers, drug users, men who have sex with men and others.
- Preventing the spread of HIV must be as high a priority as providing access to treatment. More work is needed to change the beliefs and behaviours that put people at risk and to increase access to sexual and reproductive health advice, especially for young people.
- Significantly more money must come from wealthy countries to match the commitments they have given and to plug the funding gap for both prevention and treatment.
- Funding for HIV must also support the strengthening of national health systems. This includes more clinics and hospitals, more trained health workers, and more mobile staff and health outposts in remote areas, in order to deliver comprehensive prevention and treatment programmes.
What is Health Poverty Action doing to help?
- Health Poverty Action is helping marginalised young people in remote regions of Namibia combat the spread of HIV/AIDS.
- In Ethiopia we are running a pilot HIV/AIDS counselling and testing service with pastoralist communities.
- Health Poverty Action is working via a network of youth organisations to reduce HIV and AIDS amongst young people in Nicaragua to spread the word about the dangers of unprotected sex and sharing needles.
