A major new analysis from the Global Burden of Disease 2015 (GBD 2015) study, published today in The Lancet HIV
The new GBD estimates show a slow pace of decline in new HIV infections worldwide, with a drop of just 0.7% a year between 2005 and 2015 compared to the fall of 2.7% a year between 1997 and 2005. The study is being launched at the International AIDS meeting in Durban, South Africa on Tuesday 19 July.
Improvements and updates in GBD's data sources and methodology indicate that the number of people living with HIV has been increasing steadily from 27.96 million in 2000 to 38.8 million in 2015. Annual deaths from HIV/AIDS have been declining at a steady pace from a peak of 1.8 million in 2005, to 1.2 million in 2015, partly due to the scale-up of antiretroviral therapy (ART). Furthermore, the proportion of people living with HIV on ART increased rapidly between 2005 and 2015, from 6.4% to 38.6% for men, and from 3.3% to 42.4% for women (figure 1D). Yet, most countries are still far from achieving the UNAIDS 90-90-90 target of 81% by 2020.
While the annual number of new infections has decreased since its peak at 3.3 million per year in 1997, it has stayed relatively constant at around an estimated 2.5 million a year worldwide for the past decade.
"Although scale-up of antiretroviral therapy and measures to prevent mother-to-child transmission have had a huge impact on saving lives, our new findings present a worrying picture of slow progress in reducing new HIV infections over the past 10 years", says lead author Dr Haidong Wang from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, USA.[1]
"Development assistance for HIV/AIDS is stagnating and health resources in many low-income countries are expected to plateau over the next 15 years. Therefore, a massive scale-up of efforts from governments and international agencies will be required to meet the estimated $36 billion needed every year to realise the goal of ending AIDS by 2030, along with better detection and treatment programmes and improving the affordability of antiretroviral drugs", says the Director of IHME, Professor Christopher Murray.[1]
The findings come from a comprehensive new analysis of HIV incidence, prevalence, deaths and coverage of antiretroviral therapy (ART) at the global, regional, and national level for 195 countries between 1980 and 2015 (see table 1 for country-by-country data).
Despite years of strong progress in reducing HIV at the global level, success in different countries and regions varies as the HIV epidemic has peaked and declined at different times, and depending on access to, and quality of ART, and other care.
Key regional and country GBD 2015 findings include:
In a linked Comment, Dr Virginie Supervie and Dr Dominique Costagliola from the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, Inserm/UPMC, Paris, France discuss the reliability of current approaches to estimate trends in HIV incidence and say that even the most recent estimates of the worldwide HIV burden may still underestimate the scale of the problem. They say, "The GBD estimates of HIV incidence are significantly lower (two to ten times) than the reported number of newly diagnosed HIV cases for most countries in North America, Europe, central Asia, and Australia (table). The study reveals that there are still large uncertainties and gaps in knowledge about the HIV incidence in many settings. Without timely and reliable assessment of HIV incidence it will be impossible to end the HIV epidemic."[1]
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NOTES TO EDITORS:
This study was funded by the Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health, USA.
[1] Quotes direct from authors and cannot be found in text of Article or Comment.
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The Lancet HIV