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The beginning of the end? The HIV/AIDS pandemic in the 21 st Century Professor Hazel Barrett BA (Hons), MA, PhD, C Geog. Associate Dean for Applied Research,

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Presentation on theme: "The beginning of the end? The HIV/AIDS pandemic in the 21 st Century Professor Hazel Barrett BA (Hons), MA, PhD, C Geog. Associate Dean for Applied Research,"— Presentation transcript:

1 The beginning of the end? The HIV/AIDS pandemic in the 21 st Century Professor Hazel Barrett BA (Hons), MA, PhD, C Geog. Associate Dean for Applied Research, Faculty of Business, Environment and Society, Coventry University, CV1 5FB

2 Regional HIV/AIDS statistics, 2009 Global RegionAdults and children living with HIV Adults and children newly infected with HIV %adult prevalence rate (15-49 years) Adults and children AIDS-related deaths Sub-Saharan Africa 22.5m1.8m5%1.3m Middle East & N. Africa 460,00075,0000.2%24,000 S & SE Asia4.1m270,0000.3%260,000 E Asia770,00082,0000.1%36,000 Oceania57,0004,5000.3%1,400 Central & S America 1.4m92,0000.5%58,000 Caribbean240,00017,0001%12,000 E Europe & Central Asia 1.4m130,0000.8%76,000 W & Central Europe 820,00031,0000.2%8,500 N America1.5m70,0000.5%26,000 Global Total33.3m2.6m0.8%1.8m

3 Global Prevalence of HIV, 2009


5 Trends in HIV prevalence rates :sub-Saharan Africa and global total

6 ...the world has turned the corner – it has halted and begun to reverse the spread of HIV. (UNAIDS, 2010, 7) The overall growth of the global AIDS epidemic appears to have stabilized. (UNAIDS, 2010, 16.)

7 Let us unpick this statement What is the data telling us? What are the explanations? Are we at the beginning of the end of the HIV/AIDS pandemic?

8 The Data 1999 was the year that annual new infections peaked. Since 1999 the number of new infections has decreased by 19%. In 2009 2.6 m people became newly infected with HIV, compared to 3.1m in 1999.

9 Number of people newly infected with HIV

10 Between 2001 and 2009 HIV incidence has fallen by more than 25% in 33 countries. Of these 22 are in sub-Saharan Africa the region most severely affected by the pandemic. Countries with the most acute epidemics in sub-Saharan Africa now have stable or declining HIV epidemics.

11 However in 7 countries, mainly in Eastern Europe and Central Asia, HIV incidence increased by more than 25% between 2001 and 2009. It is a complex situation where there is no room for complacency.

12 Changes in the incidence rate of HIV infection, 2001 to 2009, selected countries

13 How has this happened? –Virtual elimination of mother-to-child transmission –Behavioural change, especially by young people

14 Major advances in prevention of MTC HIV transmission over last 10 years, involving ARV treatment. In 2009 370,000 children contracted HIV from their mothers during pregnancy, childbirth and breastfeeding. Down from 500,000 in 2001. A decline of 26%.

15 UNAIDS calling for virtual elimination of MTC transmission by 2015. Eg in South Africa 90% of HIV+ mothers to be receive ARVs has resulted in dramatic decrease in MTD transmission 15 countries have achieved 80%+ coverage (inc Botswana, Namibia, Swaziland) Shows value of appropriate and timely treatment.

16 Behavioural change is the most important factor in accounting for the decline in HIV infections. This includes increased use of condoms, delayed sexual debut and reductions in multiple sexual partnerships.

17 In Namibia prevention programmes aimed at young people have resulted in HIV prevalence among 15-24 year olds dropped from 10% in 2007 to 5% in 2009

18 But some way to go. Globally only 34% of 15-24 year olds had comprehensive knowledge about HIV/AIDS. In the worst affected countries the proportion is less than 50%.

19 AIDS deaths decline AIDS deaths decline from a peak of 2.1m in 2004 to 1.8m in 2009. In sub-Saharan Africa AIDS deaths declined by 20% between 2004 and 2009.


21 AIDS deaths decline. Why? Images of antiretroviral drugs removed for copyright reasons

22 Numbers of people receiving and needing ARV therapy in December 2005, by WHO region. (Source: WHO, 2006) WHO RegionEstimated no. of people receiving ARV December 2005 Estimated no of people under 49 years needing ARV 2005 ARV coverage, December 2005 African Region810,0004,700,00017% Region of the Americas 315,000465,00068% European Region21,000160,00013% Eastern Mediterranean Region 4,00075,0005% South-East Asia Region Western Pacific region 140,000 40,000 970,000 150,000 14% 27% TOTAL1,330,0006,500,00020%

23 In 2009 5.2m people had access to ARVs, reaching 36% of those in need. 8 countries have achieved over 80% coverage. A further 21 countries have coverage rates of 50-80%. Worldwide estimated that 14.4m life years have been saved due to ARV.

24 Summary Number of HIV infections are declining AIDS deaths are declining Scale up of ARV Numbers of infections are still high and the number of people living with HIV is increasing There is geographical variability


26 Is this the beginning of the end of HIV/AIDS pandemic?

27 Model of an epidemic

28 Certainly investments in prevention and treatment have resulted in a stabilisation of the pandemic. For the pandemic to be beaten these investments must be sustained. Whilst the pandemic has stabilised, HIV still affects many millions of people and will continue to do so for many years to come. Let us hope we are seeing the beginning of the end......

29 Reading List Barnett, T & Whiteside, A, 2003, AIDS in the twenty-first century: disease and globalisation. Palgrave Macmillan, Basingstoke. Barrett, H. R, 2007, Too little too late: responses to the HIV/AIDS epidemics in sub- Saharan Africa. Geography, 92(2), 87-96. Barrett, H. R, 2007, As`easy as ABC…? Ugandas fight against HIV/AIDS. Geography, 92(2),154-157. Basu, S, 2004, AIDS, empire and public health behaviourism. International Journal of Health Services, 34 (1), 155-167. Campbell, C, 2003, Letting them die: why HIV/AIDS prevention programmes fail. International African Institute, Oxford. Hemrich, G & Topouzis, D, 2000, Multi-sectoral responses to HIV/AIDS: constraints and opportunities for technical cooperation. Journal of International Development, 12, 85- 99. Iliffe, J, 2006, The History of the African AIDS Epidemic. J Currey. Parker, R.G, Easton, D & Klein, C.H, 2000, Structural barriers and facilitators in HIV prevention: a review of international research. AIDS, 14 (1), S22-S32. Potts,M & Walsh, J, 2003, Tackling Indias epidemic: lessons from Africa. BMJ, 326, 1389-1392. SIPAA, 2005, Building bridges with SIPAA:lessons from an African response to HIV and AIDS. www.

30 Reading List (continued) UNAIDS, 2003, AIDS epidemic update December 2003. UNAIDS, 2004, AIDS epidemic update December 2004. UNAIDS, 2005, AIDS epidemic update December 2005. UNAIDS, 2006, AIDS epidemic update December 2006. UNAIDS, 2006, Report on the global AIDS epidemic. UNAIDS, 2010, Report on the global AIDS epidemic 2010. UNESCO, 2005, UNESCOs response to HIV and AIDS. World Bank, 1997, Confronting AIDS: public priorities in a global epidemic. OUP, Oxford. WHO, 2006, Progress on global access to HIV antiretroviral therapy: a report on 3 by 5 and beyond.

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