UN urges more funds for early HIV treatment

The United Nations AIDS agency on Friday urged increased funding for early treatment of people with HIV following a new international study showing it could dramatically reduce the number of new infections through sexual transmission.

UNAIDS Executive Director Michel Sidibe said pushing for early treatment "is at the top of the agenda" following the striking results of an international study overseen by the U.S. National Institutes of Health.

The nine-nation study offered convincing evidence of what scientists have long believed — that HIV medicines don't just benefit the patient, but may act as a preventive by making those people less infectious. Earlier treatment in the study meant patients were 96 percent less likely to spread the virus to their uninfected partners, according to preliminary results announced last month.

Sidibe told a news conference launching a new report by UNAIDS that early treatment and prevention efforts must also be accompanied by better skills for health workers and sex education for young people.

"Access to treatment will transform the AIDS response in the next decade," Sidibe said. "Anti-retroviral therapy is a bigger game-changer than ever before — it not only stops people from dying, but also prevents transmission of HIV to women, men and children."

Sidibe stressed that billions of dollars will be needed to meet the agency's vision for the future — "zero new HIV infections, zero discrimination and zero AIDS-related deaths."

The report said "universal access" to drug treatment for those with HIV is achievable.

UNAIDS released the 139-page document ahead of Sunday's 30th anniversary of the first official report of what would become the HIV epidemic by the U.S. Centers for Disease Control and Prevention. The General Assembly is holding a high-level meeting on AIDS at U.N. headquarters from June 8-10, where 20 world leaders and over 100 ministers are expected.

U.N. Deputy Secretary-General Asha-Rose Migiro said at Friday's launch that the world is "at a turning point in the AIDS response" and the meeting is an opportunity to "expand HIV services ... (and) chart a new path."

"The goal towards achieving universal access to HIV prevention, treatment, care and support must become a reality by 2015," she said.

The last decade has seen a nearly 25 percent decline in new HIV infections, a reduction in AIDS-related deaths, and "unprecedented advances" in access to treatment, prevention services and care, the report said.

In India, which has the largest number of people living with HIV in Asia, the rate of new infections fell by more than 50 percent, while in South Africa, which has the largest number of HIV cases in Africa, the rate fell by more than 35 percent, the report said.

But UNAIDS said these achievements are unevenly distributed, exceedingly fragile, and fall short of global targets.

"People in rich countries don't die from AIDS any more," former U.S. President Bill Clinton wrote in the report, "but those in poor countries still do — and that's just not acceptable."

The report said more than 34 million people were living with HIV at the end of 2010 — including 2.6 million who became newly infected with the virus that causes AIDS in 2009.

It said the proportion of countries conducting systematic surveillance of HIV among high-risk populations increased between 2008 and 2010: from 44 percent to 50 percent for sex workers, and from 30 percent to 36 percent for gay men. An estimated 20 percent of the 15.9 million people who inject drugs worldwide are living with HIV, the report said.

An estimated 6.6 million people in low- and middle-income countries were receiving antiretroviral drug treatment at the end of last year, but about 9 million eligible people in those countries were not, the report said.

According to the report, investment in the response to HIV in low-and middle-income countries rose from US$1.6 billion in 2001 to US$15.9 billion in 2009.

U.N. Secretary-General Ban Ki-moon wrote in the preface that "the number of people becoming infected and dying is decreasing, but the international resources needed to sustain this progress have declined for the first time in 10 years, despite tremendous unmet needs."

Sidibe said financial challenges are putting "unprecedented downward pressure on funding sources, internally and internationally." But he said the right approach can spur all countries "to do things better, with maximum value for money."

The Lancet, a British medical journal, published a proposal Friday developed by a study group set up by UNAIDS which outlines what the group called "a more targeted and strategic approach to investment."

Implemeting the new investment framework "would avert 12.2 million new HIV infections and 7.4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches," it said,

"The yearly cost of achievement of universal access to HIV prevention, treatment, care, and support by 2015 is estimated at no less than US$22 billion," the Lancet report said, but in the long term the cost of responding to AIDS would be reduced.