HIV/AIDS is becoming a manageable chronic disease: WHO

Thirty years after the first reported case of human infection with the HIV virus, the profile of HIV/AIDS is undergoing a transformation from a life-threatening emergency to a manageable chronic disease. New strategies and initiatives have ensured that fewer people are getting infected with the virus, and more infected people are getting treatment and living longer. On World AIDS Day 2011, WHO urges countries in South-East Asia to focus on eliminating the disease, particularly in children, by 2015.

Between 2001 and 2010, the number of people newly infected with HIV declined sharply by 34% in WHO’s South-East Asia Region. The number of people living with HIV and receiving anti-retroviral treatment (ART) also increased 10-fold. This indicates that more people are getting access to treatment. With the expansion of facilities providing testing and counseling services, approximately 16 million people have been tested for HIV across the Region.

“We are coming out of a transformative decade for the HIV/AIDS epidemic. With innovative treatment regimens, improved health services as well as political commitment, HIV- positive people who are on treatment are living longer and better lives,” said Dr Samlee Plianbangchang, WHO Regional Director for South-East Asia. He added, “We must learn from our experiences, and work to ensure that no child born gets infected with HIV.”

To achieve this, WHO along with UNICEF, UNFPA, UNAIDS and countries in the Asia-PacificRegion launched an initiative in 2011 with the goal of eliminating new paediatric HIV infections and congenital syphilis by 2015.

Also making this possible is the new treatment initiative recommended by WHO and UNAIDS, “Treatment 2.0”. It works on the principle that high quality drugs that are easy to take, easy to monitor, and affordable are needed to achieve universal, sustainable access to treatment.

However, major challenges remain. According to the WHO Progress Report on HIV/AIDS in South-East Asia 2011, an estimated 3.5 million people were living with HIV/AIDS in 2010, including 140 000 children. Women accounted for 37% of this population. The epidemic continues to be on the rise in Indonesia, although the number of new infections is showing a downward trend in India, Myanmar, Nepal and Thailand. Annually, there are an estimated 210 000 new HIV infections and 230 000 AIDS deaths in the South-East Asia Region, mainly transmitted through sexual intercourse, followed by injecting drug use (IDU).

The overall prevalence of HIV is low in the Region (0.3%), but sex workers and their clients, men who have sex with men (MSM), transgender individuals and people who inject drugs are disproportionately affected. Protective behaviour such as consistent condom use is increasing among sex workers, but not in MSM and IDUs.

The majority of people living with HIV are unaware of their HIV status. Less than one out of five pregnant women have access to HIV testing and counselling; two out of three HIV-infected pregnant women do not receive anti-viral prophylaxis. Only a third of all people with advanced HIV infection are receiving anti-retroviral treatment as per the latest WHO criteria. However, more than four out of five people who have started treatment are alive and on treatment 12 months after the start of therapy.

Access to HIV testing for all pregnant women, and ART for those who have tested positive, are essential to prevent children from being infected in the womb or through breastfeeding. In order to achieve this, WHO recommends HIV services be integrated into related health services, such as maternal and child health services. Reducing HIV-associated stigma and discrimination in community and healthcare settings is also vital. WHO continues to advocate for reducing prices of anti-retroviral drugs, and investing in building health systems and human resources so that countries can scale up HIV interventions.

The Regional Health Sector Strategy on HIV, 2011-2015, which has been endorsed by all Member States of the WHO South-East Asia Region, envisions “zero new HIV infections, zero AIDS-related deaths and zero discrimination in a world where people living with HIV are able tolive long, healthy lives.