South Africa still has the largest HIV positive population in the world, but adult HIV prevalence is either stable or has started to decline ‘€“ like many other countries in southern, eastern and western Africa.

 

This is according to the 2007 annual HIV/AIDS report released today (20  Nov) by the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Declining HIV rates were most striking in Kenya and Zimbabwe, according to the report, while Côte d’€™Ivoire, Mali and urban Burkina Faso also experienced declines.

 

In southern Africa, ‘€œwhile there is evidence of a significant decline in the national HIV prevalence in Zimbabwe, the epidemics in most of the rest of the sub-region have either reached or are approaching a plateau,’€ said the report.

 

‘€œOnly in Mozambique, latest HIV data has shown an increase in prevalence over the previous period.’€

 

UNAIDS estimates that there are some 33.2 million people living with HIV in the world ‘€“ over six million fewer than last year’€™s estimate.

 

However, the main reason for this reduction in numbers is related to how the numbers have been estimated rather than effective prevention campaigns ‘€“ although there were encouraging evidence of risk reduction in 11 countries.

Speaking from Geneva yesterday, Dr Paul De Lay, UNAIDS Director of Evidence, Monitoring and Policy, said the reduction in the numbers was due to ‘€œmethodology’€.

 

HIV prevalence had been particularly overestimated in India, and to a lesser extent in Kenya, Mozambique, Nigeria and Zimbabwe.

 

‘€œBetter data collection, better epidemiology and a better understanding of the disease, especially survival time, had contributed to the reductions,’€ said De Lay.

 

People with HIV in both the developed and developing world were now estimated to live for an average of 11 years after infection, which was slightly longer than previously though, added De Lay.

 

De Lay rejected the notion that UNAIDS had initially over-estimated HIV statistics in order to get donors to allocate more resources to HIV/AIDS.

‘€œIt is critical that countries understand the epidemic as accurately as possible.. so we try to avoid any politicization of data collection or how estimates are performed,’€ he said.

 

Southern Africa remains the worst hit area in the world, accounting for over one-third of all new infections and deaths globally. Some 1.6 million people have died of AIDS in the sub-Saharan Africa in the past year.

 

Over 15% of adults were living with HIV in eight southern African countries, namely Botswana, Lesotho, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.

 

Of all the African countries, Kenya seems to have done best over the past year at combating HIV, with HIV among young pregnant women reported to have been slashed by more than a quarter.

 

Côte d’€™Ivoire, Malawi and Zimbabwe and rural Botswana also reported significant decreases in infection rates amongst young women.

 

However, UNAIDS officials also cautioned that the leveling off of HIV prevalence did not mean that HIV/AIDS was now under control.

‘€œA country such as Botswana, where prevalence exceeds 15% is an example of an epidemic that has levelled off at an unacceptably high rate, a clear demonstration that not enough is being done to respond to AIDS in the country.

 

‘€œIn addition, even if an epidemic has levelled off, it can mask a situation in which many

 

people are becoming infected and equal numbers are dying. This is happening in a number of countries in sub-Saharan Africa.’€

 

‘€œHIV/AIDS remains the leading epidemic in the world, and the long term nature of the epidemic, with acute infection that manifests itself as a chronic disease over a long period, means we are going to be dealing with this for years to come,’€ said Dr Kevin de Cock, director of HIV/AIDS at the World Health Organisation (WHO).

 

De Lay also cautioned that countries that had become complacent about HIV and relaxed their prevention efforts   ‘€“ such as the USA, Britain and Germany ‘€“ ‘€œhave seen a return of the epidemic’€.

 

De Cock also cautioned that it would be ‘€œunrealistic to think that the reduction in estimates would have a major beneficial effect on reducing the resources necessary for antiretroviral therapy’€ as sub-optimal treatment was being used in the developing world.

 

‘€œTreatment is started too late and the drug regimens being used, while cheaper are also more toxic   and there is a need to adapt to more patient-friendly regimens that might cost more,’€ said De Cock.

 

However, De Lay said that based on current reduced estimates by 2010, there could be a 5% reduction in global HIV/AIDS budget.