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We can still win the war on Aids

01.01.70

SAY it takes you five minutes to read this article. In that time, on average, 47 people will become infected with HIV, and 29 will die from Aids. At least 13 of those newly infected will be children, as will 11 of the fatalities.

I wonder sometimes whether the shock-horror statistics might be too much. Forty million living with HIV, five million new infections and three million deaths a year are difficult figures to grasp. And there is a danger that people may conclude that the battle is lost and is no longer worth fighting.

But progress is possible - and some progress has been made.

At the end of this month, experts from around the world will meet in New York to see whether targets for HIV prevention, treatment, and care have been met. Five years ago the world's leaders agreed the Declaration of Commitment on HIV/AIDS, and the time has come to see how we have done.

There is some good news. The amount of money the world spends fighting HIV has more than quadrupled since 2001. Prevention work has reduced the spread of HIV in some countries, including Uganda, Senegal, Thailand and Brazil. The number of people treated in the developing world nearly doubled last year to 1.3 million.

Clearly though, far more needs to be done. For every five people in the developing world who need HIV drugs, only one gets them.

Today the House of Commons will debate the provision of HIV drugs in the developing world.

Last year the G8 - led by the UK - promised to get as close as possible to universal access to HIV treatment by 2010. The world's leaders then adopted this commitment at the UN.

If we are to meet that 2010 commitment, catching up will require a huge increase in effort. For every one person in the developing world who got on to HIV treatments last year, eight became newly infected.

There's still not enough money to fight AIDS. About $15 billion is needed this year, yet only about $9 billion is available. In 2008, about $22 billion will be needed. The UK has increased the money we make available - 1.5bn will be spent in this three-year spending round, including 100m per year to the Global Fund to Fight Aids, TB and Malaria - but no cash is yet available for Round 6 of the Global Fund's projects.

The cost of some HIV drugs in the developing world has come down. Companies have lowered prices in poorer countries, and cheaper generic drugs are now available. However, resistance to HIV drugs is developing, and treatment for drug-resistant HIV remains expensive. That is why the UN Secretary General has asked countries like the UK to work with their pharmaceutical industries to lower the prices of these treatments.

Meeting the 2010 target requires action across society, including the private sector. The business group, the World Economic Forum, has warned that "businesses are doing too little, too late in the battle against HIV/Aids". While some firms have responded to the need of their workforce - businesses deliver antiretrovirals to 60,000 people in South Africa - UN Secretary General Kofi Annan described the level of drug provision as "lamentable". Clearly the private sector must raise its game.

Getting treatment to all who need it is not just about getting enough affordable drugs. For a start, health workers can only treat people who have tested positive for HIV. While access to testing has improved, still only a fraction of the 40 million people living with HIV know about their infection.

Yet the health service in many countries has been weakened. In some, health workers have died with Aids, while in other countries staff are not paid enough to live on. Also, some rich countries rely on the developing world for health care workers. The infrastructure of countries hit by the epidemic must be strengthened if the world is to meet the 2010 commitment.

Without improving the world's efforts to prevent the spread of HIV, we do not have a hope of reaching the commitment to treat everybody by 2010. Last year an extra 630,000 people in the developing world received HIV drugs - but in that same year there were nearly five million new infections.

Clearly, HIV prevention is not reaching many of the people most at risk. Across the world less than one person in five has access to basic HIV prevention services. Less than a third of young people in the developing world know how to protect themselves from HIV. Failures in prevention lead to 1800 babies becoming infected with HIV every day.

In the last few weeks there have been reports that the Catholic Church is considering whether using a condom may be a lesser evil to the transmission of Aids. Married couples may not be forbidden from using condoms when one spouse is HIV positive. We do not know how soon a decision is expected. We must wait and see.

As I said at the start, despondency is as much our enemy as complacency. Behind the familiar litany of missed targets and mind-boggling infection rates lie grounds for hope that we can meet the goal of getting HIV treatment to all who need it by 2010.

Gavin Strang is MP for Edinburgh East and Musselburgh

Expert opinion

Halter Marek

02.12.06

Halter Marek
Le College de France
Olivier Giscard dEstaing

02.12.06

Olivier Giscard dEstaing
COPAM, France
Mika Ohbayashi

02.12.06

Mika Ohbayashi
Institute for Sustainable Energy Poliy
Bill Pace

02.12.06

Bill Pace
World Federalist Movement - Institute for Global Policy
Peter I. Hajnal

01.12.06

Peter I. Hajnal
Toronto University, G8 Research Group