Since it was first recognised in 1981, AIDS has killed more than 25 million people, making it one of the most destructive pandemics in recorded history. Despite improved access to treatment and care, in 2007 the disease claimed 2.1 million people, among them 330,000 children. The International Red Cross and Red Crescent Movement has warned that the pandemic is so severe in some countries it should be classified as a disaster, fitting the UN definition of an event overwhelming the capacity of any single society to manage.
Over the past two decades significant progress has been made, but much more needs to be done as the pandemic continues to wreak havoc across the world. The theme for this year's World AIDS Day is Lead - Empower - Deliver, a continuation of last year's Take the Lead theme, focusing primarily on political leaders delivering on their promises – such as universal access to HIV prevention, treatment, care, and support by 2010, and the Millennium Development Goal to reverse the epidemic by 2015.
The AIDS pandemic cannot be reversed, and gains made cannot be sustained, without a reduction in the new infection rate. According to a study recently published in The Lancet, universal testing for HIV, followed by immediate treatment could cut the number of people developing full-blown AIDS by up to 95% in ten years time. While such a strategy could virtually eliminate HIV transmissions, the WHO has warned that the feasibility of universal testing is challenged by weak health care systems.
But money alone won't suffice to cure the world. Between 2001 and 2007 there was a six fold increase in financing for HIV programmes among developing countries, which has led to lower mortality and higher rate of prevention. However, the progress is uneven, and key to success in addressing the epidemic is further, immediate, worldwide reduction of the human rights violations associated with AIDS, the gender inequality, stigma, and discrimination acting as roadblocks, impeding effective, evidence- and rights-based responses to the pandemic.
Today the spread of AIDS has stabilised at an unacceptably high level. While the number of new HIV infections globally declined from 3 million in 2001 to 2.7 million in 2007 (that's still almost 7400 people a day), an estimated 33 million people were living with the disease in 2007 – more than half of them children. In sub-Saharan Africa, by far the worst-affected region, the pandemic has even begun to decline, but infections are on the rise in a number of places outside Africa.
The USA has one of the largest HIV prevalence rates in the world, with an estimated 1.2 million people living with HIV in 2005. In Canada, an estimated 58,000 people were living with the disease in 2005 – an increase of 16% since 2002 – with women's proportion of new HIV infections on the rise. AIDS continues to disproportionally affect African Americans in the USA and aboriginal people in Canada. The rate of new HIV infections in the EU has almost doubled since 1999, with particularly high prevalence in France, Italy, Spain and the UK – Estonia, Portugal and the UK having the highest rates of new HIV diagnoses. The ECDC estimates that almost one third of people living with HIV in Europe are unaware they are infected.
While globally the percentage of women living with HIV has remained at 50% for several years, women's share of infections is rising in several countries. Among children, the annual number of new HIV infections has declined since 2002, but an estimated 370,000 children under the age of 15 became infected in 2007 (over 1000 a day). Despite young people, 15 - 24 years of age, accounting for 45% of all new HIV infections, many of them still lack accurate, comprehensive information on how to avoid exposure to the virus.
Events marking the day will be held throughout the world (see here for Canada), calling for universal treatment, care and support for people living with HIV and AIDS. But the most important action remains to educate and protect yourself and your loved ones. So, spread the word and enjoy sex safely.