Vector Issue 12 - 2011

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www.ghn.amsa.org.au
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6 MDG
Up to 2 million people die from AIDS related
illnesses every year, many of whom are in
southern Africa (38%). Increased access to
antiretroviral drugs in poorer countries means this is
decreasing; however over 5,000 people still die each
day from AIDS. Running a close second in global
mortality is tuberculosis, responsible for 1.8 million
deaths in 2008, about 500,000 of whom were HIVpositive.
90 per cent of malaria deaths also occur
in Africa, where it accounts for a fifth of childhood
mortality (equivalent to the death of one child in the
world every 45 seconds) 1-3 . [ ]
vector FEB 2011
combat HIV/AIDS, malaria and other diseases
Challenges to achieving the targets
1
Education and knowledge of HIV is unacceptably low
Knowledge about HIV and its modes of transmission
is the first step to preventing its spread. However,
less than a third of young men and one fifth of
young women in developing countries have received
education about the illness. Condom use also remains
low globally, especially among developing countries.
With many young people in Africa unaware of the
risks and modes of transmission for HIV, the UN’s
goal on comprehensive HIV knowledge of 95 per cent
of people in developing countries is still far from
being achieved 1,2,4 . []
Antiretroviral treatment has expanded but HIV
prevalence rates continue to rise
When antiretroviral therapy was launched in 2003,
only 400,000 people were able to access it. By the
end of 2009, more than five million people were
receiving treatment. However, for every two people
starting HIV treatment each year, five new people
are infected. Access to antiretroviral therapy needs
to be expanded for pregnant women, as most of
the 2 million children younger than 15 living with
HIV were infected by vertical transmission (in the
womb, at birth or via breastfeeding). In 2008 alone,
over 60,000 HIV infections among at-risk babies
were prevented because their HIV-positive mothers
received treatment. However, less than 50 per cent
of HIV-positive expectant mothers currently receive
treatment 1,2,5,6 . []
3
HIV/AIDS is becoming a chronic disease in many
countries
The survival rate of HIV/AIDS is growing in many
countries due to the increasing availability of
antiretroviral drugs in the developing world. As
a result, HIV/AIDS is being transformed into a
chronic disease, with a model of care that also needs
to transform to focus on multidisciplinary models,
continuity of care, long-term adherence support, and
social support 1,4,7 . []
4
HIV/AIDS may not just affect poorer populations
Contrary to evidence for other infectious diseases,
HIV may be more prevalent amongst higher-income
demographic populations than previously thought.
In a large study looking at eight African countries,
wealthier men and women had a higher prevalence
of HIV than poorer ones and were at least as likely
as poorer adults to be infected. If this is in fact a
common pattern, a broader approach needs to be
taken in the prevention of HIV/AIDS in developing
countries 8 . []
What is being done worldwide?
The UN is coordinating global efforts to achieve
these targets in reducing communicable and largely
preventable deaths. Several UN programs aim
to prevent these diseases and enhance access of
treatments according to the following strategies:
•Increase technical support for HIV/AIDS
• The Joint United Nations Programme on HIV/
AIDS (UNAIDS) coordinates the resources of ten
organisations assisting developing countries with
technical support in the implementation of their
national AIDS plans [1 .]
•Prevent mother-to-child transmission of HIV/AIDS
• The UN Children’s Fund (UNICEF), the World
Health Organisation (WHO), the UN Population
Fund (UNFPA) and UNAIDS have assisted countries
to develop and implement programmes aimed at
preventing vertical transmission of HIV, including
training, funding and technical expertise [1,2 .]