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UNAIDS Outlook Report 2010

New UNAIDS report shows that young people are leading the prevention revolution, with 15 of the most severely affected countries reporting a 25% drop in HIV prevalence among this key population. New global opinion poll shows that AIDS continues to be of major importance for the public around the world.

The new UNAIDS Outlook report outlines a radically simplified HIV treatment platform called Treatment 2.0 that could decrease the number of AIDS-related deaths drastically and could also greatly reduce the number of new HIV infections. Evidence shows that new HIV infections among young people, in the 15 countries most affected by HIV, are dropping significantly as young people embrace safer sexual behaviours.

Also in the report, a sweeping new UNAIDS and Zogby International public opinion poll shows that nearly 30 years into the AIDS epidemic, region by region, countries continue to rank AIDS high on the list of the most important issues facing the world.

And an economic analysis makes the case for making health a necessity, not a luxury, outlining the critical need for donor countries to sustain AIDS investments and calling on richer developing countries to invest more in HIV and health.

The report was launched in Geneva ahead of the XVIII International AIDS Conference in Vienna. The UNAIDS Executive Director, Mr Michel Sidibé, stressed that innovation in the AIDS response can save more lives. “For countries to reach their universal access targets and commitments, we must reshape the AIDS response. Through innovation we can bring down costs so investments can reach more people.”

According to UNAIDS’ estimates there were 33.4 million people living with HIV worldwide at the end of 2008. In the same year there were nearly 2.7 million new HIV infections and 2 million AIDS-related deaths.

Treatment 2.0 saves lives:

Treatment 2.0 is a new approach to simplify the way HIV treatment is currently provided and to scale up access to life saving medicines. Using a combination of efforts it could bring down treatment costs, make treatment regimens simpler and smarter, reduce the burden on health systems and improve the quality of life for people living with HIV and their families. Modelling suggests that compared with current treatment approaches, Treatment 2.0 could avert an additional 10 million deaths by 2025.

In addition, the new approach could also reduce new HIV infections by up to 1 million annually if countries provide antiretroviral therapy to all people in need, following revised WHO treatment guidelines. Today, 5 million of the 15 million people in need are accessing these life-saving medicines.

“Not only could Treatment 2.0 save lives, it has the potential to give us a significant prevention dividend,” said Mr Sidibé, speaking at the launch of the report.

Young people leading the prevention revolution:

A new UNAIDS study shows that young people are leading the HIV prevention revolution. HIV prevalence among young people has declined by more than 25% in 15 of the 25 countries most affected by AIDS. These declines are largely due to falling new HIV infections among young people.

In eight countries—Côte d’Ivoire, Ethiopia, Kenya, Malawi, Namibia, the United Republic of Tanzania, Zambia and Zimbabwe—significant HIV prevalence declines have been accompanied by positive changes in sexual behaviour among young people.

For example, in Kenya there was a 60% decline in HIV prevalence between 2000 and 2005. HIV prevalence dropped from 14.2% to 5.4% in urban areas and from 9.2% to 3.6% in rural areas in the same period. Similarly in Ethiopia there was a 47% reduction in HIV prevalence among pregnant young women in urban areas and a 29% change in rural areas.

Young people in 13 countries, including Cameroon, Ethiopia, and Malawi, are waiting longer before they become sexually active. Young people were also having fewer multiple partners in 13 countries. And condom use by young people during last sex act increased in 13 countries.

There are 5 million young people living with HIV worldwide, making up about 40% of new infections.

By Thoraya Ahmed Obaid, UNFPA Executive Director

World Population Day: On this day, the UN marks the anniversary of the day, in 1987, when the world's population exceeded 5 billion. This is a day to think about population-related issues in an ever more crowded world.

Every country counts its people. The numbers tell decision-makers about current and future needs. “Everyone counts” is the theme for this year’s World Population Day.

If people and their characteristics aren’t counted, governments can’t plan. If identification is not granted, it is impossible to track progress over a lifetime. If a birth certificate indicates a need for schooling, that informs the education system. If death records specify, to the extent possible, cause of death, health systems can be oriented to meet actual needs. If death records specify causes related to HIV/AIDS and other infectious diseases, pregnancy and childbirth, specific health services can be prioritized. Government planning depends on local and regional information that is supplemented by interviews with the groups most concerned. Such data makes it possible to meet real needs.

Good data is critical for evidence-based policies and programmes for improving people’s lives. Yet while timely and reliable data is routine in richer countries, many resource-constrained developing countries struggle to conduct the censuses and surveys that they need for effective planning.

For the past 30 years, UNFPA, the United Nations Population Fund, has played a lead operational role in helping to build countries’ capacities for data collection and analysis. A current focus of UNFPA support is successful implementation of the 2010 round of population and housing censuses (2005-2014).

In 2009, UNFPA supported 77 governments’ national population and housing censuses and paved the way for other censuses in 2010. This work is often complex, as in Iraq, the Occupied Palestinian Territories and Sudan. In Eastern Europe and Central Asia, UNFPA is promoting new data collection technologies and assisting Bosnia and Herzegovina to conduct a census. In Africa, UNFPA is helping to analyze data collected by recent censuses in Chad, Liberia and Nigeria. All these countries could not complete their censuses in 2000 and Liberia’s successful census ended a period of more than 30 years in which no statistical work could be done. In Asia and the Pacific, the enumerations have successfully concluded in Bhutan, Democratic People’s Republic of Korea and Viet Nam and censuses are being prepared for East Timor and Mongolia. In Latin America and the Caribbean national statistical institutes are participating in training to enhance skills for data collection and
analysis.

Census data reveals compelling characteristics about employment, education and health services in countries. It provides information about population growth, the movements of people, age structures, poverty levels, urbanization and the spatial distribution of a country’s population. Countries can use that information to plan investments, save lives and improve opportunities for present and future generations.

With world attention focused on achieving the Millennium Development Goals by 2015, and the upcoming MDG10 Summit at the United Nations in September, the availability of consistent and comparable statistical information has become even more crucial. Data for development plays a prominent role in monitoring progress, assessing and realigning plans and strategies, and conducting effective advocacy. Data, and public access to it, contributes to transparency and accountability.

Increased vaccination could save more than 8 million children by 2020; significant funding gaps remain, others must join effort

Bill and Melinda Gates announced today that their foundation will commit $10 billion over the next 10 years to help research, develop and deliver vaccines for the world’s poorest countries.

The Gateses said that increased investment in vaccines by governments and the private sector could help developing countries dramatically reduce child mortality by the end of the decade, and they called for others to help fill critical financing gaps in both research funding and childhood immunization programs.

“We must make this the decade of vaccines,” said  Bill Gates “Vaccines already save and improve millions of lives in developing countries. Innovation will make it possible to save more children than ever before.”

Bill and Melinda Gates made their announcement at the World Economic Forum’s Annual Meeting, where they were joined by Julian Lob-Levyt, CEO of the GAVI Alliance.

“Vaccines are a miracle—with just a few doses, they can prevent deadly diseases for a lifetime,” said Melinda Gates. “We’ve made vaccines our number-one priority at the Gates Foundation because we’ve seen firsthand their incredible impact on children’s lives.”

The foundation used a model developed by a consortium led by the Institute of International Programs at the Johns Hopkins Bloomberg School of Public Health to project the potential impact of vaccines on childhood deaths over the next 10 years.

By significantly scaling up the delivery of life-saving vaccines in developing countries to 90 percent coverage—including new vaccines to prevent severe diarrhea and pneumonia—the model suggests that we could prevent the deaths of some 7.6 million children under 5 from 2010-2019. The foundation also estimates that an additional 1.1 million children could be saved with the rapid introduction of a malaria vaccine beginning in 2014, bringing the total number of potential lives saved to 8.7 million.

If additional vaccines are developed and introduced in this decade—such as for tuberculosis—even more lives could be saved. The new funding announced today is in addition to the $4.5 billion that the Gates Foundation has already committed to vaccine research, development and delivery to date across its entire disease portfolio since its inception.

Public-Private Partnerships Drive Progress in Vaccine Development, Delivery:

Bill and Melinda Gates said their pledge was inspired by the remarkable progress made on vaccines in recent years. For example:

• Record-breaking vaccine access: New WHO data show that global vaccination rates have reached all-time highs, rebounding from years of decline in the 1990s. Between 2000 and 2009, the percentage of children receiving the basic DTP3 vaccine in the poorest countries of the world jumped from 66 percent to 79 percent, the highest on record. The number of people who died of measles worldwide fell by 77 percent between 2000 and 2008, and in Africa, measles deaths fell by 92 percent.
• Improved routine immunization: Partnerships focused on reducing diseases like polio and measles are also helping build a stronger foundation for the delivery of both new and existing vaccines. Trained health workers, proper cold chain function, and surveillance are all necessary to ensure vaccines reach every child who needs them.
• New vaccine introduction: Important new vaccines for the two leading causes of global child deaths—severe diarrhea and pneumonia—are becoming available. Research published this week in The New England Journal of Medicine shows that introducing a rotavirus vaccine in South Africa and Malawi reduced severe diarrhea caused by the virus by more than 60 percent.
• R&D momentum: The vaccine research and development pipeline is more robust than ever. Late-stage trials have begun on a promising vaccine to protect children from malaria, and a new vaccine to prevent meningitis outbreaks in Africa is likely to be introduced this year.

Commenting on the announcement, WHO Director-General Margaret Chan said, “The Gates Foundation’s commitment to vaccines is unprecedented, but just a small part of what is needed. It’s absolutely crucial that both governments and the private sector step up efforts to provide life-saving vaccines to children who need them most.”