HIV/AIDS is the biggest infectious disease threat facing the world and the fourth-leading cause of death. But there are signs that the pandemic has peaked and prevention and treatment programs are working.
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Cases Worldwide: 33 million
Main Causes: unprotected sex, infected needle use, transmission from mother to baby
Distribution: worldwide; highest prevalence in sub-Saharan Africa and South Asia
HIV weakens the body’s immune system, leading not only to AIDS but other deadly infectious diseases like tuberculosis. Mortality is high due to the lack of access to health services and antiretroviral drugs. The virus is transmitted through unprotected sex with an infected person, sharing of infected needles, from infected mother to her baby, and through infected blood products.
Every day, over 6800 people become infected with HIV and over 5700 die of AIDS. In 2007, an estimated 33 million people were living with HIV—2.7 million of them newly infected—and about 2 million people died of AIDS, three quarters of them in sub-Saharan Africa where it is the leading cause of adult death.
The HIV/AIDS pandemic has formed two patterns: in sub-Saharan Africa there is an epidemic among the general populations; elsewhere there are epidemics concentrated in high-risk populations; sex workers, injecting drug users, and men having sex with men.
In sub-Saharan Africa, HIV/AIDS has decimated the working-age population. In countries like Botswana, South Africa, and Zimbabwe rates of adult HIV infections range from 15 to 28 percent. The hardest hit are young women, who are three or four times more likely to be HIV positive than men.
The epidemic is reducing life expectancy, lowering fertility, creating an excess of men over women, and leaving millions of orphans behind. Schools are closing because so many teachers are dying.
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Those most at risk usually lack access to basic health education and resources; they do not know where to get an HIV test, condoms, and sterile needles and syringes. UNAIDS estimates that less than 40 percent of young people aged 15 to 24 have a “comprehensive knowledge of HIV”.
This is changing. The international community has united to fight HIV/AIDS like no other infectious disease, developing emergency programs, reducing drug prices, and setting up The Global Fund To Fight AIDS, Tuberculosis and Malaria. The fund now backs the majority of antiretroviral treatments worldwide as well as tens of millions of HIV counseling and testing sessions and services for over three million orphans.
“The response to AIDS changed the face of public health in profound ways, opening new options for dealing with multiple other health problems,” commented World Health Organization Director-General Margaret Chan on World AIDS Day in 2008. In Cambodia for example, the health system has been transformed as a result of the work done on HIV with new health centers opening up across the country.
In 2002, only about 300,000 people were receiving antiretroviral treatment. By the end of 2007, over 3 million HIV-infected people in low and middle-income countries—10 percent of patients—were getting the drugs they needed to survive.
The percentage of pregnant women living with HIV who received antiretroviral treatment to prevent mother-to-child transmission increased from 9 percent in 2004 to 33 percent in 2007.
As a result, the global prevalence of HIV infection has leveled off, with significant reductions in countries like Kenya, Cambodia, and Thailand. New infections among children are decreasing since peaking in 2001, and both adult and child deaths from AIDS are also decreasing.
If prevention remains paramount, mankind could contain yet another disease that, just like the bubonic plague, was once viewed as an instant death sentence. HIV/AIDS will not disappear, but it is increasingly recognized as a preventable and treatable illness.
editor: James Tulloch
publishing date: February 24, 2009
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