Since 2005, the number of new HIV/AIDS cases around the world has been relatively constant, according to a study published in the Lancet journal.
India had 1.96 lakh new human immunodeficiency virus (HIV) infections in 2015, a recent study has shown. This number is in addition to the existing 28.81 lakh people who were already living with HIV as of last year.
The number of people living with HIV/AIDS has been steadily increasing across the world and reached 388 lakh (ranging between 376-404 lakh) in 2015. At the same time, HIV/AIDS mortality has been declining over the years – from a peak of 18 lakh deaths in 2005 to 12 lakh deaths in 2015, a new report in the journal The Lancet HIV has said.
The number of deaths due to the deadly disease in India was 1.3 lakh (ranging from 1.24 lakh to 1.38 lakh) and the percentage of patients receiving antiretroviral therapy (ART) treatment stood at 25.82% as against the global percentage of 41%, the study said. However, the Indian government’s official figures put the number of people living with HIV as 21.17 lakh and the number of new infections at 86,000 in 2015.
The report, ‘Estimates of global, regional, and national incidence, prevalence, and mortality of IV, 1980-2015: the Global Burden of Disease Study 2015’, released at the ongoing AIDS Conference 2016 in Durban, South Africa, also says that the global HIV incidence (new cases), which reached its peak in 1997 at 33 lakh new infections, has stayed relatively constant at about 26 lakh per year since 2005, after a period of rapid decline between 1997 and 2005.
“We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections,” say the authors of the study, which has undertaken by the Global Burden of Disease, 2015.
A scaling up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV as enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030, the study says.
The UNAIDS 90-90-90 targets aim to have 90% of people living with HIV know their status, 90% of those detected treated with ART, and 90% of those receiving treatment achieving viral load suppression (reducing the load of HIV in blood).
The study credits introduction of antiretroviral therapy (ART) in 1996 for the greatly reduced HIV-related mortality; the creation of the joint United Nations Programme on HIV/AIDS (UNAIDS) in 1996; the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002; and the US President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 for combating the epidemic.
In the last 15 years, the global community has provided $109.8 billion in development assistance to curb the HIV/AIDS epidemic. As a result, HIV mortality has declined overall in low-income and middle-income countries since 2004.
Further, according to the study in 2015, 1.8 million new HIV infections (75.4% of new cases) were in sub-Saharan Africa, with large proportions in western, southern, and eastern sub-Saharan Africa. Outside sub-Saharan Africa, south Asia accounted for 2,06,830 (range 1,71,790–2,49,700), or 8.5% of new infections per year. Southeast Asia accounted for 4.7% of global infections in 2015, and East Asia accounted for 2.3%, the study suggests.
Distributions of new infections by sex were broadly similar. The prevalence and mortality have also been greatest in sub-Saharan Africa. HIV infection rates varied tremendously across countries in 2015 for incidence for 1990 and 2005. The highest rates of infection were in southern Africa, with more than 1% of the population per year becoming infected in Botswana, Lesotho and Swaziland. Within sub-Saharan Africa, rates in excess of 150 per 100,000 people occurred in a cluster of countries from Nigeria to Tanzania – with the notable exceptions of the Democratic Republic of the Congo (42 per 100,000 and Ethiopia (39.4 per 1,00,000). The highest estimated incidence rates in Europe were recorded in Russia, and in Asia in Cambodia. In the Americas, only Belize, Guyana and Haiti had rates of more than 50 per 100,000 people.
Due to improved access to treatment, the prevalence compared with incidence was higher in countries with a high socio-demographic index. Six countries (Botswana, Lesotho, Namibia, Swaziland, South Africa and Zimbabwe) had a HIV prevalence of more than 10% of the entire population. Nine countries in sub-Saharan Africa (Central African Republic, Cameroon, Equatorial Guinea, Kenya, Mozambique, Malawi, Tanzania, Uganda and Zambia) had a prevalence of more than 2.5% of the entire population. Outside sub-Saharan Africa, a further 11 countries (the Bahamas, Belize, Bermuda, Dominican Republic, Guyana, Haiti, Cambodia, Portugal, Suriname, Trinidad and Tobago, and Saint Vincent and the Grenadines) had prevalence rates between 0.5% and 2.5%.
For estimates of annual new infections, UNAIDS 2014 has estimated a much faster rate of decline than did GBD 2015. Globally, GBD 2015 estimates about 2.5 million new infections in 2014, whereas UNAIDS estimates about 2 million for the same year. UNAIDS 2016 has slightly higher estimates of incidence than the 2014 publication, at 2.1 million for 2015. In terms of annualised rate of decline in new infections between 2005 and 2014, GBD 2015 estimates about a 0.4% decline per year, whereas the UNAIDS estimates from 2014 show a 3.3% decline per year.
In only seven countries (Madagascar, Democratic Republic of the Congo, Burkina Faso, Guinea-Bissau, Chad, Rwanda and the Gambia) in sub-Saharan Africa, annualised rates of decline in new infections are faster in GBD 2015 than in UNAIDS 2014. In Côte d’Ivoire, Burundi, Eritrea, Zimbabwe, Lesotho, Nigeria, Botswana and Kenya, GBD 2015 estimates an increase in numbers of new infections, whereas UNAIDS 2014 predicts a decline. The biggest difference is in Kenya, where results from GBD 2015 show an increase in annual new infections from 60,000 in 2005 to 146,700 in 2014, whereas UNAIDS shows a decrease from 73,000 to 56,000 during the same period.