The Current State of the Global HIVAIDS Epidemic

1
The Current State of the Global HIV/AIDS
Epidemic
Alicia L. Carbaugh Senior Policy Analyst, HIV
Policy Kaiser Family Foundation for KaiserEDU.or
g Tutorial December 2008
Return to KaiserEDU.org
2
Key Points
Slide 2

• Although HIV/AIDS is found throughout the world,
  most people living with HIV/AIDS reside in low-
  and middle-income countries
• More people are living with HIV/AIDS than ever
  before and millions of people are infected each
  year
• HIV/AIDS is multiple epidemics. Communities,
  regions and populations are affected differently

3
Current Global HIV Estimates
Slide 3
33 Million
80
31
2.7 Million
2.0 Million
Percent on ARTs (as of December
2007)
Percent w/ HIV Who Dont Know Theyre Infected
New Infections (in 2007)
Deaths (in 2007)
People Living with HIV/AIDS (end 2007)
Of those needing antiretroviral (ART) therapy in
low and middle-income countries. Sources UNAIDS,
2008 Report on the Global AIDS Epidemic, 2008
WHO/UNAIDS/UNICEF Towards Universal Access
Scaling Up Priority HIV/AIDS Interventions in the
Health Sector, Progress Report, June 2008.
4
Slide 4
Global Estimates of People Living with HIV/AIDS,
19802007
In Millions
Number of People
End 2007 33 million
Sources UNAIDS, 2008 Report on the Global AIDS
Epidemic, 2008 and Special Data Request.
5
People Living with HIV/AIDS by Region, as
Percent of Global Total, 2007
Slide 5
Total 33 million
Source UNAIDS, 2008 Report on the Global AIDS
Epidemic, 2008.
6
Estimated Adult HIV/AIDS Prevalence Rate
by Region, 2007
Slide 6
Note Prevalence rates are among adults aged
15-49. Source UNAIDS, 2008 Report on the Global
AIDS Epidemic, 2008.
7
Women as Share of Adults Living with HIV/AIDS by
Region, 2007
Slide 7
Source UNAIDS, 2008 Report on the Global AIDS
Epidemic, 2008.
8
Young People as a Percent of New HIV Infections,
2007
Slide 8
Under 15 14
Aged 25 47
Aged 15-24 38
New Infections 2.7 million
Source Calculations based on UNAIDS/WHO, Core
Slides Global Summary of the HIV and AIDS
Epidemic, 2007, 2008.
9
Slide 9
Sub-Saharan Africa is the Worlds Hardest Hit
Region
Sources UNAIDS, 2008 Report on the Global AIDS
Epidemic, 2008 UNAIDS/WHO, Core Slides Global
Summary of the HIV and AIDS Epidemic, 2007, 2008
Population Reference Bureau, 2007 World
Population Data Sheet, 2007.
10
Top 15 Countries by Number of People Living with
HIV/AIDS, 2007
Slide 10
Source UNAIDS, 2008 Report on the Global AIDS
Epidemic, 2008 www.globalhealthfacts.org.
11
Top 15 Countries by Adult HIV/AIDS Prevalence
Rate, 2007
Slide 11
Note Prevalence rates are among adults aged
15-49. Source UNAIDS, 2008 Report on the Global
AIDS Epidemic, 2008 www.globalhealthfacts.org.
12
Top 15 Countries by Number of Women Living with
HIV/AIDS, 2007
Slide 12
Source UNAIDS, 2008 Report on the Global AIDS
Epidemic, 2008 www.globalhealthfacts.org.
13
Access to Antiretroviral (ARV) Treatment by
Region, December 2007
Slide 13
Percent on ARVs as of end of 2007 (of those who
need them in low and middle-income countries)
All
Sub-Saharan Africa
Latin America/Caribbean
East/South/South-East Asia
Europe/Central Asia
North Africa/Middle East
Source WHO/UNAIDS/UNICEF, Towards Universal
Access Scaling Up Priority HIV/AIDS
Interventions in the Health Sector, Progress
Report June 2008.
14
Access to Prevention Services
Slide 14

• Access to prevention services is limited as well.
  Recent data has shown that
• 33 of pregnant women with HIV received
  antiretroviral therapy to prevent transmission of
  HIV to their babies
• 10-11 of people in low and middle-income
  countries have been tested for HIV and received
  results
• 10 of injection drug users in Eastern Europe and
  Central Asia have access to prevention programs
• Despite these challenges, there have been
  successful prevention efforts in different parts
  of the world.

Source WHO/UNAIDS/UNICEF, Towards Universal
Access Scaling Up Priority HIV/AIDS
Interventions in the Health Sector, Progress
Report June 2008.
15
Critical Challenges to Addressing the Epidemic
Slide 15

• Many lack basic information about HIV/AIDS and
  HIV-related stigma remains

• Limited access to key prevention and care
  services and system capacity issues
• Need for more training, quality monitoring
  systems, facilities
• Need to address healthcare workforce shortages
• Other barriers to access may include price,
  patent laws and other regulatory issues

• Poverty and collateral effects (epidemic
  exacerbates existing problems in other sectors)

• Research and development continue but a vaccine
  is still years away

• Meeting needs with available resources and
  sustaining the response

16
Resource Needs, Funding Key Initiatives
Slide 16

• NEED AVAILABLE FUNDING

• UNAIDS estimates that approximately 18.1 billion
  was needed to effectively respond in low and
  middle-income countries in 2007

• Estimate of available funding in 2007 10 billion

• KEY INITIATIVES/ORGANIZATIONS

• The Global Fund to Fight AIDS, Tuberculosis and
  Malaria

• U.S. Presidents Emergency Plan for AIDS Relief
  (PEPFAR)

• World Banks MAP Initiative

• United Nations Universal Access Initiative
• United Nations Millennium Development Goals
  (MDGs)

• Private sector foundations, businesses,
  pharmaceutical industry

Sources UNAIDS Kaiser Family Foundation,
Financing the Response to AIDS in Low- and
Middle- Income Countries International
Assistance from the G8, European Commission and
Other Donor Governments, 2007, July 2008 UNAIDS,
2008 Report on the Global AIDS Epidemic, 2008.
17
The U.S. Government Response to the Global
Epidemic
Slide 17

• U.S. funding began in 1986 has increased
  significantly since 1999
• PEPFAR (The U.S. Presidents Emergency Plan for
  AIDS Relief)
• Originally authorized at 15 billion over 5 years
  (starting in FY 2004) actual spending higher
• Most supports 15 focus countries, remainder
  for bilateral efforts in 100 other countries and
  support for The Global Fund
• Legislation reauthorized in 2008 at 48 billion
  over 5 years (starting FY 2009)
• Concrete goals for next 5 years prevent 12
  million infections, treat at least 3 million,
  provide care for 12 million

Sources White House, 2004 Kaiser Family
Foundation, Reauthorization of PEPFAR, The United
States Leadership Against HIV/AIDS, Tuberculosis
and Malaria Act A Side-by-Side Comparison to
Current Law, July 2008 www.pepfar.gov.
18
Successes
Slide 18

• Despite the challenges, there have been some
  important successes and promising signs
• Care and treatment have reduced morbidity and
  mortality among people with HIV/AIDS in those
  countries with access.
• Prevention works evidence from a number of
  different countries worldwide.
• The global prevalence rate has leveled off, and
  there are signs of stable or declining rates in
  certain areas/among certain populations annual
  new infections and deaths have declined in recent
  years.

• Yet, the epidemic is far from over and the
  continued response to HIV/AIDS will be a global,
  multi-sector, long-term endeavor.

19
Key Resources
Slide 19

• UNAIDS, 2008 Report on the Global AIDS Epidemic,
  2008 http//www.unaids.org/en/KnowledgeCentre/HIV
  Data/GlobalReport/2008/
• WHO/UNAIDS/UNICEF, Towards Universal Access
  Scaling Up Priority HIV/AIDS Interventions in the
  Health Sector, Progress Report, June 2008
  http//www.who.int/hiv/pub/2008progressreport/en/i
  ndex.html
• Kaiser Family Foundation, The Global HIV/AIDS
  Epidemic, Fact Sheet, July 2008
  http//www.kff.org/hivaids/3030.cfm
• Kaiser Family Foundation/UNAIDS, Financing the
  Response to AIDS in Low- and Middle-Income
  Countries International Assistance from the G8,
  European Commission and Other Donor Governments,
  2007, July 2008 http//www.kff.org/hivaids/7347.c
  fm
• Kaiser Family Foundation, Reauthorization of
  PEPFAR, The United States Global Leadership
  Against HIV/AIDS, Tuberculosis and Malaria Act
  A Side-by-Side Comparison to Prior Law, July
  2008 http//www.kff.org/hivaids/7799.cfm
• Kaiser Family Foundation, Globalhealthfacts.org
  www.globalhealthfacts.org
• Kaiser Family Foundation, Global HIV/AIDS
  Timeline www.kff.org/hivaids/timeline/hivtimelin
  e.cfm
• Kaiseredu Reference Libraries on HIV/AIDS
  www.kaiseredu.org/reference_index.asp
• Global HIV Prevention Working Group
  www.globalhivprevention.org