There were 37.9 million people living with HIV in 2018 worldwide, up from 37.2 million in 2017, according to a new report by the Joint United Nations Programme on HIV/AIDS (UNAIDS).
The report also says 24.5 million infected people using antiretroviral therapy (ART) are living healthier and longer lives, indicating that there has been a drop in death rate.
Annual new infections, which indicate whether an epidemic is growing or ebbing, reduced to 1.7 million in 2018, down from 1.8 million the year before, according to the report.
Though new infections have declined by 40% worldwide since the peak of the AIDS epidemic in 1997, it is critical to reach out to all, including high-risk groups, to end AIDS as a public health threat by 2030, said the report.
“We are in the last lap, which is the harder one because we need to target the most marginalised and vulnerable for prevention, testing and treatment,” said Winnie Byanyima, executive director, UNAIDS.
The report warns that laws and policies in many countries are excluding key populations at risk, who account for 54% of new HIV infections globally. Key populations at risk include same-sex male couples, injecting drug users, sex workers and transgender people.
In India, new HIV infections declined by 27% between 2010 and 2017, the last year for which data is available. The number people living with HIV fell from 2.30 million to 2.14 million during that period despite a 1.24% annual rate of increase in the country’s population that stands at 1.36 billion.
“Yes, India can end HIV by 2030, I’m very optimistic. Our immediate goal is to meet UNAIDS 90–90–90 targets that aim to diagnose 90% of all HIV-positive persons, provide ART to 90% of those diagnosed, and achieve viral suppression for 90% of those treated by 2020,” said Sanjeeva Kumar, director general, National AIDS Control Organisation (NACO), which has an annual budget of Rs 2,500 crore for 2019-20.
During the same period, annual new infections fell from 120,000 to 87,580, and AIDS-related deaths more than halved from 160,000 to 69,110, according to data from NACO India HIV Estimation 2017 report.
“Since 2017, people in India accessing ART treatment have increased from 1.2 million to 1.35 million and is growing steadily. Getting people on treatment is easy, the hard part is ensuring they stay on it and keep the viral load suppressed, which not only keeps them disease-free but also lowers the risk of infecting their partners,” said Kumar. In India, unprotected sex and injecting drug use are the leading causes of new infection.
“We are engaging with populations at risk through social media to increase their access to prevention, testing and treatment services,” said Kumar. NACO has started Mission Sampark (contact) to bring patients back on ART who were lost to follow-up. Integrating programmes, such testing for HIV and syphilis, HIV and tuberculosis, and HIV and Hepatitis C — will help take HIV services to a wider population.
“Test-and-treat has increased access to treatment and first-, second- and third-line ART medicines are available. Some supply issues remain, as we need buffer stock to ensure people do not miss doses, which leads to drug resistance. We need also more community drop-in centres to increase access to information and also offer livelihoods to people living with HIV,” said Brijesh Dubey, president of Rajasthan Network of People Living with HIV.