For the first time since the global onset of the HIV/AIDS epidemic, the scales have tipped in favour of patients. The latest UNAIDS report, released on Thursday, reveals that more than half of all People Living with HIV (PLHIV) now have access to HIV treatment.
Further, globally AIDS-related deaths have almost halved since 2005.
“We met the 2015 target of 15 million people on treatment, and we are on track to double that number to 30 million and meet the 2020 target,” said Michel Sidibé, Executive Director of UNAIDS. “We will continue to scale up to reach everyone in need and honour our commitment of leaving no one behind.”
As of last year, 19.5 million of the 36.7 million HIV+ patients had access to treatment. Deaths caused by AIDS have fallen from 1.9 million in 2005 to 1 million in 2016.
New infections in India
The bad news is that the majority of the cases — nearly 95 per cent of the cases in 2016 — were concentrated in just 10 countries, India being one of them. India has 2.1 million people living with HIV, with 80,000 new infections annually, as of 2016. In 2005, the annual incidence was 1,50,000 people.
“India is the country where most new HIV infections are occurring in the Asia-Pacific region. While India has made big progress with new infections dropping significantly, the emergence of HIV in some locations that were earlier considered ‘not high-burden’ areas is a cause for concern.,” said Eamonn Murphy, Director, UNAIDS Regional Support Team for Asia-Pacific.
While the world seems to be on track to reach the global target of 30 million people on treatment by 2020, access to medicines remains a major barrier and India plays a special role. The report states that “although important progress has been made in improving access to medicines for people living with HIV, insufficient availability and poor affordability of essential medicines in low- and middle-income countries remain major barriers.
Averting market failures
Actions focused on the intersections between intellectual property rights, innovation, and public health are vitally important for resolving market failures in medicine development and manufacture, unmet needs for research and development, and pricing.
This is especially true in light of the concentration of the generic pharmaceutical industry in India, and the global AIDS response’s continued reliance on the Indian industry, which supplied nearly 90% of antiretroviral medicines in low- and middle-income countries in 2015”.
The report, Ending AIDS: Progress towards the 90–90–90 target, is the annual scorecard for progress.
In 2016, 1.8 million people became infected with HIV. While this is a drastic decline from the peak of the epidemic in 1997 when 3.2 million got infected, experts maintain that since 2010, the decline in new infections has only been 16%.
Going by this trend, the global target of reducing the figure to 500,000 a year by 2020 — adopted as a global target by UNAIDS in 2013 — seems unattainable.
The idea behind the 90-90-90 target is to diagnose 90% of people who are HIV positive; get 90% of the diagnosed HIV+ people on antiretroviral treatment, and 90% of those on antiretrovirals should be virally suppressed. This is attained when an HIV+ patient’s viral load reaches an undetectable level, curbing transmission.
