Global AIDS Detection and Treatment Sees Major Increase

Global AIDS Detection and Treatment Sees Major Increase
By CELIA W. DUGGER
Copyright by The New York Times
Published: September 30, 2009
http://www.nytimes.com/2009/10/01/world/01aids.html?_r=1&ref=global-home


JOHANNESBURG — The number of people being tested for H.I.V. more than doubled in dozens of countries last year, improving detection of AIDS and contributing to a major surge in those being treated.

The ranks of people taking antiretroviral drugs in the developing world rose by over a million to surpass 4 million people globally, the United Nations reported Wednesday in its 2009 progress report on H.I.V. and AIDS.

The vast international effort on AIDS, financed by the United States, European countries and other donors, also ensured that growing numbers of children with AIDS, who had largely been left to die quick, unheralded deaths in past years, also benefited from the life-saving drug therapies. Their number rose to 275,700 in 2008 from 198,000 just a year earlier.

And the portion of mothers who got medicines to prevent them from infecting their babies with H.I.V. also rose markedly in the parts of Africa hardest hit by the disease to more than half those in need.

“In the space of one year, you’re seeing a huge ramping up of AIDS services,” said Mark Stirling, regional director for the United Nations’ efforts against AIDS in eastern and southern Africa. “It’s unprecedented. In the acceleration and intensification of reach, 2008 was an extraordinary year.”

But the United Nations’ progress report on AIDS also contained sobering news. While over a million people were put on drugs in the past year — drugs they will need for the rest of their lives — 2.7 million people were newly infected with H.I.V. in 2007, the latest year for which there were estimates.

“We are walking backward on the treadmill,” said Prof. Salim S. Abdool Karim, who heads the Center for the AIDS Program of Research in South Africa, based in Durban. “We’re not going to treat our way out of this problem.”

The United Nations report stressed that African countries this past year laid the ground work to broadly offer men circumcisions, a surgical procedure to remove the foreskin that has been shown to cut their risk of H.I.V. infection by more than half.

But health officials, experts and advocates said that political leaders, particularly in Africa, would have to be far more outspoken about the practice of having more than one long-term sexual partner fueling the epidemic — and about circumcision cutting the risk of infection.

“I’m worried,” said Mr. Stirling. “I don’t hear the most senior political leaders talking about concurrent partners or male circumcision, not enough.”

South Africa, which has more H.I.V.-positive citizens than any other nation, exemplified both the progress on treatment and the uncertain prospects for prevention, experts said.

The number of people getting antiretroviral drugs last year grew by more than half, faster than in any other country. South Africa now has by far the largest AIDS treatment program in the world. The United Nations estimated that more than 700,000 South Africans were getting the medicines, though advocates here have said the number is actually closer to 600,000 after discounting those who have died or dropped out.

Even with the gains, however, less than half those here who need the drugs are getting them, advocates say. And South Africa lacks a policy on male circumcision. The country is still overcoming setbacks from the years when its president, Thabo Mbeki, denied the scientific consensus that H.I.V. causes AIDS and that antiretroviral drugs are essential to treat the disease.

The country’s new leaders have broken cleanly with those views but still need to act with greater urgency on H.I.V. prevention, said Mark Heywood, executive director of the AIDS Law Project and deputy chairman of the South African National AIDS Council, which advises the government.

“South Africa will get its act together, but it hasn’t at the moment,” he said.