The 2024 UNAids Global Aids report has revealed that globally, approximately 39% fewer persons contracted HIV in 2023 compared with 2010, with sub-Saharan Africa seeing the highest decline (-56%).
The report also states that in 2023, an estimated 1.3 million people acquired HIV, exceeding the target of 370 000 or fewer new infections set in 2025.
The HIV pandemic is experiencing a significant increase in new infections outside sub-Saharan Africa for the first time in its history.
Three regions are experiencing rising numbers of new HIV infections: eastern Europe and central Asia, Latin America, and the Middle East and North Africa.
According to the report, people from key populations include sex workers, gay men and other men who have sex with men, people who inject drugs, transgender people, and people in prisons and other closed settings.
“World leaders can fulfil their promise to end Aids as a public health threat by 2030, and in so doing prevent millions of Aids-related deaths, prevent millions of new HIV infections, and ensure the almost 40 million people living with HIV have healthy, full lives. Through powerful case studies and new data, the report shows how some countries are already on the right path — and how all countries can get on it.”
Insufficient effort to address the disparities fuelling the HIV epidemic was identified as the reason for the global set-back.
The report found that the number of new HIV infections worldwide was not dropping quickly due to lack of progress in prevention; and that the number of HIV infections was actually increasing in three regions of the world.
Around 25% of HIV-positive individuals lacked life-saving care, leading to one person dying every minute due to Aids-related causes.
The report said: “We know what enables success. For the first time in the history of the HIV pandemic, more new infections are occurring outside sub-Saharan Africa than in sub-Saharan Africa. This reflects both the prevention achievements in much of sub-Saharan Africa and the lack of comparable progress in the rest of the world, where people from key populations and their sex partners continue to be neglected in most HIV programmes.
“There is inadequate political will to fund and provide prevention programmes for people from key populations, and hostile legal and social conditions further limit their access to lifesaving services.”
The report also highlighted persistent stigma and discrimination against HIV status, gender, behaviours, and sexuality, hindering the provision of HIV-related services by non-governmental organisations, often under-recognised and underfunded.
In some regions of sub-Saharan Africa, the incidence of HIV among teenage girls and young women between the ages of 15 and 24 is exceptionally high, despite being on the decline.
The impact of prevention programmes and initiatives to lessen harmful gender norms, violence against women, and gender inequality were found to be insufficient.
The report showed that far fewer children aged 0–14 years were acquiring HIV, a trend that was due largely to successes in eastern and southern Africa, where the annual number of new HIV infections in children fell by 73% between 2010 and 2023.
The overall decline in vertical HIV infections, however, had slowed markedly in recent years, particularly in western and central Africa.
A total of 1.4 million (1.1 million–1.7 million) children worldwide, 86% of whom are in sub-Saharan Africa, are predicted to have contracted HIV in 2023 after an estimated 120 000 (83 000–170 000) children were infected.
Increased availability to antiretroviral medication, much of it through public health systems and at no cost, has more than halved the annual number of fatalities attributable to Aids, from 1.3 million (1.0 million–1.7 million) in 2010 to 630 000 [500 000–820 000] in 2023.
In 2023, an estimated 30.7 million people were receiving HIV treatment, indicating that treatment programmes were effectively reducing the number of new HIV infections.
“The world can reduce the number of Aids-related deaths to fewer than the 2025 target of 250 000 if it achieves further rapid increases in diagnosing and providing HIV treatment to people living with HIV. 3 Vertical transmission of HIV occurs during the pregnancy and breastfeeding period.”
The Star
anita.nkonki@inl.co.za