A new United Nations report says that a radically simplified approach to ensuring access to HIV treatment for everyone who needs it could prevent 10 million deaths by 2025 and 1 million new infections annually.
The so-called Treatment 2.0, says the Joint UN Programme on HIV/AIDS (UNAIDS), could lower the cost of treatment, simplify treatment regimens, ease the burden on health systems, and improve the quality of life for people living with HIV and their families.
“We can bring down costs so investments can reach more people,” Michel Sidibé, UNAIDS Executive Director, said at the report’s launch in Geneva today. “This means doing things better – knowing what to do, channelling resources in the right direction and not wasting them, bringing down prices and containing costs. We must do more with less.”
The agency estimates that there were 33.4 million people living with HIV worldwide at the end of 2008, as well as nearly 2.7 million new infections and 2 million AIDS-related deaths.
It adds that only one third of the world’s 15 million people in need of HIV treatment are accessing life-saving medicines.
For the new plan to succeed, the agency’s Outlook report calls for action to be taken across five key areas.
Firstly, it calls for the creation of a better pill that is less toxic and for a simple diagnostic tool to monitor treatment.
Secondly, evidence suggests that people living with HIV who have reduced the level of virus in their bodies, through antiretroviral therapy, are less likely to transmit it. As a result, UNAIDS says that if everyone in need has access to treatment, this could reduce the number of new HIV infections by one third annually.
The report also urges slashing the cost of antiretroviral treatment, especially for hospitalization and monitoring treatment, which can cost twice as much as drugs.
Fourth, UNAIDS stresses the need to improve voluntary HIV testing and counselling, since starting treatment at the right time, optimally when their CD4 count – a measure of immune system strength – is around 350, boosts the efficacy of treatment and increases life expectancy.
Lastly, Treatment 2.0 will be fully successful if communities are mobilized and involved in managing treatment programmes and access.
“Not only could Treatment 2.0 save lives, it has the potential to give us a significant prevention dividend,” said Mr. Sidibé.
The report also shows that young people are leading the prevention revolution, with 15 of the most severely affected countries reporting a 25 per cent drop in HIV prevalence among this key population.
In eight countries – Côte d’Ivoire, Ethiopia, Kenya, Malawi, Namibia, Tanzania, Zambia and Zimbabwe – significant HIV prevalence declines have been accompanied by positive changes in sexual behaviour among young people.
Mr. Sidibé cautioned that flatlining or reductions in investments in HIV will only hurt the AIDS response, with nearly $27 billion required this year to meet country-set targets for universal access to HIV prevention, treatment, care and support.
“The AIDS response needs a stimulus package now,” the official underlined. “Donors must not turn back on investments at a time when the AIDS response is showing results.”
His agency recommends that nations invest between 0.5 and 3 per cent of government revenue into their AIDS response programmes, but warned that for the majority of countries severely affected by the epidemic, national investments, even at optimal levels, are insufficient.
Also included in the report released today are the results of a public opinion poll that shows that nearly three decades into the epidemic, countries continue to rank AIDS high on the list of the most important challenges the world faces.
Overall in the survey, AIDS is perceived to be the top healthcare issue in the world, followed by safe drinking water.
The publication wraps up with a “Last Word” from UNAIDS Goodwill Ambassador Annie Lennox, who said that “as a woman and mother, I feel compelled to speak out, and try to raise awareness in the best way I can, to try to use my platform to do so.”