An HIV/Aids ribbon Photo: Reuters/Jason Lee

A new report by UNAids has shown that HIV infections around the world are being reversed - having dropped by a whopping 40% drop compared to the late 1990s, while in Africa this number has almost halved - thanks to the successful roll-out of antiretroviral therapy in many countries. 

In a new report, Right to Health, that's been released by the world organisation in Khayelitsha, Cape Town, on Monday - ahead World Aids Day that is commemorated on December 1 - last year around 1.8 million people were newly infected with HIV, a 39% decrease from the 3 million who became newly infected at the peak of the epidemic in the late 1990s. In sub-Saharan Africa, new HIV infections have fallen by 48% since 2000.

However, new HIV infections are rising at a rapid pace in countries that have not expanded health and HIV services. In eastern Europe and central Asia, for example, new HIV infections have risen by 60% since 2010 and AIDS-related deaths by 27%.

According to the report, access to treatment has increased significantly in recent years. In 2000, just 685 000 people living with HIV had access to antiretroviral therapy. By June 2017, around 20.9 million people had access to the life-saving medicines. The report says such a dramatic scale-up could not have happened without the courage and determination of people living with HIV demanding and claiming their rights, and strong leadership and financial commitment.

Speaking during the launch of the report, Michel Sidibé, executive director of UNAIDS, said: “Many people do not remember that in 2000 there were only 90 people in South Africa on treatment. Today, South Africa has the biggest life-saving treatment programme in the world, with more than 4 million people on treatment. This is the kind of acceleration we need to encourage, sustain and replicate.”

The rise in the number of people on treatment is keeping more people living with HIV alive and well. Scientific research has also shown that a person living with HIV who is adhering to an effective regime of antiretroviral therapy is up to 97% less likely to transmit HIV. As treatment access has been scaled up for pregnant women living with HIV, new HIV infections among children have rapidly been reduced. From 2010 to 2016, new HIV infections among children were reduced by 56% in eastern and southern Africa, the region most affected by HIV, and by 47% globally.

“In 2001, the first person in Khayelitsha started HIV treatment. Today there are almost 42 000 people on treatment here. The success of Khayelitsha’s treatment programme is a microcosm of the massive success of South Africa’s HIV programme,” said Aaron Motsoaledi, Minister of Health, South Africa.

The challenges now are to ensure that the 17.1 million people in need of treatment, including 919 000 children, can access the medicines and to put HIV prevention back at the top of public health programming, particularly in the countries in which new HIV infections are rising.

The new report highlights that the most marginalised people and most affected by HIV in society are still facing major challenges in accessing the health and social services they urgently need. However, the report also gives innovative examples of how marginalized communities are responding.

In India, for example, a collective of sex workers has trained sex workers to work as nursing assistants, providing stigma-free health services to sex workers and the wider community. In Uganda, groups of grandmothers are weaving and selling traditional baskets to allow them to pay for schooling for the grandchildren in their care who lost their parents to AIDS.

The report gives voice to the communities most affected by HIV—including people living with HIV, sex workers, people who use drugs, gay men and other men who have sex with men and young people—on what the right to health means to them.

Cindy Mguye, a civil society representative said: “Almost twenty years ago, the struggle was about access to treatment. Now, my struggle is not only about access but about ensuring that I have the support that I need to live a healthy and positive life. That is my right to health,” 

The report underscores that to reduce new HIV infections and AIDS-related deaths and ensure access to essential health services, funding for health needs to increase.