Oonagh O’BrienInstitute for International Health and Development Queen Margaret University
Winnie Sseremu from Uganda diagnosed 1988 aged 27. Today: 50Jaime Tovar fromColombia.Diagnosed 1987with HTLV 111 aged24, today 48.
Since1999 (the year the epidemic is thought to have peaked) new infections have fallen by 19%. In33 countries HIV incidence (number of new cases per year) has fallen by 25% between 2001 and 2009. 22 of these countries are in Sub Saharan Africa. The biggest African epidemics are stabilising or declining (UNAIDS 2010).
In seven countries,5 in eastern Europeand central Asia,HIV incidenceincreased by 25% between 2001 and 2009. Decrease not evenly spread in population groups Gains are fragile…
Successes Reduction in new infections in young people- delayed first sex, higher use of condoms Treatment as prevention- Greatest reductions adherence to in HIV incidence treatment with (new infections)are undetectable viral in the countries with load over a sustained the highest numbers period can lead to of people living with 96% reduction in HIV transmission to partner. May 2011 Reduction in Huge increase of transmission from numbers of people parent to child on treatment and including during reduction in AIDS breast feeding. diagnosis and deaths Concerted including a 19% less programme based deaths in children on evidence
Challenges: Numbers still extremely high….. Still a huge gap in funding treatment- approximately 36% of those who need treatment in poor countries have access Women still highly Health systems struggling with burden vulnerable in of treatment roll out in all sorts of multiple ways different ways linked to HIV Stigma still in evidence Legacy of loss: orphans and abuse of human Growing economic and vulnerable rights to men who have crisis- struggle to children, loss of sex with men (MSM) maintain national and communities, material and drug users international funding loss. increased
Goal6. Combat HIV/AIDS, malaria and other diseases • Target 7. Have halted by 2015 and begun to reverse the spread of HIV and AIDS • Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Have we halted the rise of HIV? November 2010 BBC report - UN claim HIV epidemic has halted. Unexpected consequence-malaria reduces 75%over 4 years in patientson ART(Kasirye et al IAS abstracts 2009 )
Inthe report of the 2010 review of MDGS the UN don’t use the word halted. It is stated that cases are declining in some areas of the world, but not all, and as well as the success they highlight a number of areas of concern: • The continuing high number of cases • Lack of knowledge about how to protect oneself • Lack of condom use especially in poor countries
Human Rights • Have HRs been ignored in MDGs? activists • Focus on targets too technical and too narrow? • Are the Millennium Development Goals (MDGs)Symposium MDGs and human rights complementary or conflicting? and HR • Harvard and IDS March 2010 Interventions • MDGs do not call into question the benefits of rather than liberalization of international trade and finance.questioning system • Established at time of economic stability
MDGs – loss of focus on wider impacts of gender inequality- No linking of Too focussed on issues- i.e. narrow goals andreducing gender outcomes- noinequality should focus on gender be embedded rights (UN into poverty conferences of the reduction 1990s)
June 2011: United Nations General Assembly High Level Meeting on AIDS Political Declaration on HIV/AIDS: Intensifying our Efforts to eliminate HIV/AIDSAgreed new AIDS targets for 2015 including: increase number of people on treatment to 15 million advance efforts towards reducing sexual transmission of HIV and halving HIV infection among people who inject drugs by 2015. push towards eliminating new HIV infections among children in the next five years. reduce tuberculosis related deaths in people living with HIV by half in the same time period.
Some good news…. But world economic crisis- reduced income and spending may lead to upsurge in infections and mortality What has been the importance of MDG 6 and where do we go with the target after 2015? Implications for Scotland and Malawi