UNAIDS Director Michel Sidib's statement is reckless and premature: The Lancet

[Guest guest]

UNAIDS Director Michel Sidib's statement is reckless and premature: The Lancet

HIV: the fight is far from over

The Lancet, Volume 376, Issue 9756, Page 1874, 4 December 2010

The Joint UN Programme on HIV/AIDS (UNAIDS) has hailed a turning point in the

fight against HIV/AIDS, reporting that the trajectory of the epidemic has been

broken. Their global report, released ahead of World AIDS Day on Dec 1, showed

20% decreases in new infections in the past decade and in AIDS-related deaths in

the past 5 years. Of 63 countries monitored during 2001—09, the yearly rate of

new HIV infections had stabilised or decreased by more than 25% in 56 countries,

including 34 in sub-Saharan Africa.

Prevention programmes will be further boosted by Pope Benedict XVI's indication

that use of condoms is acceptable in certain circumstances, such as sex work, if

the intention is to reduce risk of infection.

However, amidst the media fanfare surrounding UNAIDS' figures, a US Institute of

Medicine (IOM) report released on Nov 29 painted a bleaker picture for the

immediate future of HIV/AIDS in Africa. Sub-Saharan Africa bears 68% of the

worldwide burden of HIV infection, and the gap is growing between the number of

people needing treatment and the availability of resources.

The IOM report calls for prevention programmes to become the focus of a

sustainable response.

Serwadda, co-chair of the writing committee and co-author of a Comment

published in The Lancet on Dec 1 said: " If we don't act to prevent new

infections, we will witness an exponential increase in deaths and orphaned

children in sub-Saharan Africa in just a couple of decades. " Worldwide, existing

prevention programmes are inadequate—two new HIV infections occur for every

person starting treatment—and in eastern Europe and central Asia, the yearly

rate of new infections has increased by more than 25% since 2001.

Therefore, Executive Director Michel Sidibé's statement in the UNAIDS report is

surprising: " We have halted and begun to reverse the epidemic. " These words,

from the head of a UN agency, are reckless and premature, and have overshadowed

the challenges outlined in the UNAIDS report.

International funding decreased between 2008 and 2009, and although US$15·9

billion was available for HIV/AIDS programmes in 2009, this figure is $10

billion less than what is needed in 2010.

Complacency is dangerous when governments and international agencies should be

building on the progress achieved so far.

For the UNAIDS report on the global AIDS epidemic 2010 see

http://www.unaids.org/globalreport

For the IOM report Preparing for the future of HIV/AIDS in Africa: a shared

responsibility see

http://iom.edu/Reports/2010/Preparing-for-the-Future-of-HIVAIDS-in-Africa-A-Shar\

ed-Responsibility.aspx