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'Aids is not over': lack of funding hampers progress

Anne Gulland
The number of AIDs cases and deaths has fallen over the last year but progress is too slow - REUTERS

The number of people newly infected with HIV is falling but a drop in funding and mixed progress around the world are hampering efforts to wipe out the disease. 

UNAIDS’ annual report on the global fight to stop the Aids and HIV epidemics shows that there were 1.7 million new HIV infections in 2018, a 16 per cent decline since 2010. 

However, the report shows a mixed picture with some countries making great strides in the fight against the disease while others lag behind.

In southern and eastern Africa the number of new infections dropped by 28 per cent between 2010 and 2018. 

But in eastern Europe and central Asia there was a 29 per cent rise in the number of new diagnoses. There were also increases in the Middle East and North Africa (10 per cent) and Latin America (seven per cent).

The report shows that key populations - including sex workers, people who inject drugs, men who have sex with men and transgender women - account for more than half (54 per cent) of new HIV infections globally.

And in eastern Europe and central Asia and the Middle East and north Africa these groups accounted for around 95 per cent of new HIV infections.

However, less than half of people in these groups have access to HIV prevention services - a sign that they are marginalised and stigmatised, the report warns.

Progress against the disease in low and middle income countries is being hampered by a drop in funding of around $900,000 between 2017 and 2018.

Peter Ghys, UNAIDS strategic information director, said some donors, including the UK, had reduced contributions over the previous year to the Global Fund to Fight Aids, Malaria and Tuberculosis - the main funder of Aids programmes in many low and middle income countries. Although the UK has announced a boost to the fund's coffers over the next three years. 

Dr Ghys added that domestic funding was down too.

“Countries which are affected by HIV and do not have a lot of resources have increased their domestic contributions but in many cases these have not kept up with inflation.

"Aids is not over and it will continue to require a lot of resources," he said.

In 2018, 770,000 people died from Aids - a fall of 33 per cent since 2010, largely due to getting more people on life-saving treatment. 

The report shows that 79 per cent of people globally who have HIV/Aids are aware of their status. And of these, 78 per cent are on treatment and 86 per cent are virally suppressed - that means the level of virus in their blood is so low it is undetectable.

The target is for 90 per cent of people to know their status and for 90 per cent of that number to be on treatment and virally suppressed. Some 15 countries around the world have reached this milestone - the UK hit this target at the end of last year and joined countries such as Botswana, Cambodia, Namibia and the Netherlands. 

Globally many targets are off track - some 23.3 million people are on HIV treatment, short of the 30 million target by 2020. And some 940,000 children are on treatment, a long way short of the target of 1.6 million. 

Gunilla Carlsson, UNAIDS executive director, said political leadership was crucial to ending the epidemics. 

“This starts with investing adequately and smartly and by looking at what’s making some countries so successful. Ending Aids is possible if we focus on people not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reaching people most affected by HIV," she said. 

Christine Stegling, executive director of Frontline AIDS, said: “Marginalised people face a daily toll of stigma, discrimination and criminalisation. They are often denied access to HIV prevention, treatment and care simply because of who they are.

"This report is a wakeup call to invest more in marginalised people and adolescent girls and young women if we want to avoid sleepwalking into a further crisis fuelled by the denial of human rights and gender justice.”

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