Endangered
.
Such is the title that heads the recently published report on the state of the AIDS pandemic in the world, this July 27.
It is issued annually by the United Nations Agency for the fight against HIV, Onusida, which is the world authority on the matter.
Every year, in the summer, it updates the information, and the latter leaves no room for interpretation.
“The new data is terrifying.
Progress has been faltering, resources have dwindled, and inequalities have increased.
Insufficient investment and action are putting us all at risk: we face millions of deaths and millions of new infections if we continue on the current trajectory”, warned Winnie Byanyima, executive director of UNAIDS, during a press conference prior to the 24th International AIDS Conference,
The name chosen by the UN recognizes that the turn is very worrying in the AIDS pandemic, due to the growing crises, specifically covid-19 and the war in Ukraine.
Every minute last year four people were infected and one more died from direct or indirect causes.
Or, what is the same: around 1.5 million new HIV infections occurred and 650,000 people lost their lives, despite the fact that there are already effective treatments and tools to detect and stop the virus.
In the case of infections, it is 3.6% less than in the previous period, although it represents the smallest annual decrease since 2016. Deaths also decrease, as they are 30,000 fewer than in 2020. And, in total, There are already 38.4 million people living with this infection.
They are declines, but in a fight that is being waged at too slow and unequal a pace, because there are population groups and regions where the figures worsen instead of improving.
For this reason, Matthew Kavanagh, deputy executive director of Onusida, who spoke to some of the media before the report was published, describes the news as "forceful" and "worrying".
And the deaths, as avoidable.
Among the most commented findings is the increase in infections in Eastern Europe -Ukraine is the second country in Europe with the highest incidence, after Russia-, Central Asia, Latin America, the Middle East and North Africa, that is, in almost all regions of the world.
What's more, in Asia-Pacific, which is the largest and most populous, the data shows for the first time that new infections are rising when they were falling before.
“Infections are rising in many countries and communities such as the Philippines, Congo, South Sudan and others…In Eastern and Southern Africa, where the majority of HIV-positive people are found, the rapid progress of previous years has slowed considerably in 2021,” warned Kavanagh.
Infections have only decreased in West and Central Africa and in the Caribbean,
In Asia-Pacific, which is the largest and most populous region, data shows for the first time that new infections are rising when they were falling before.
That "in danger" that the UN warns about has to do with the possibility, each year more real, that humanity will not achieve the goals set in the 2030 Agenda. It is the 90-90-90 strategy, and it means that , within eight years, 90% of those who suffer from HIV should know their status;
that 90% of them should be on treatment, and that 90% of those who are should have an undetectable viral load and, therefore, not be contagious.
But if the current rate is maintained, the number of new infections per year will exceed 1.2 million in 2025, the year in which the UN has set a goal of fewer than 370,000 new cases.
"Together, world leaders can end AIDS by 2030, as they promised, but we must be frank: that promise and the answer are in jeopardy," said Byanyima.
“In too many countries and communities we see a growing number of new infections when what we need is a rapid decline.
We can change the situation, but in this emergency, the only safe response is boldness.”
During the last two years, that is, since the outbreak of covid-19, prevention, diagnosis and treatment services have been interrupted in many countries.
The impact was already noted in last year's report, and is still being felt in this one even though the scourge of the coronavirus has subsided.
"Resources have been reduced and now there are millions of lives in danger," the UN expert warned.
The graphs and numbers in the report reflect the rapid progress that has been made in recent decades in the battle against the disease, but also how those advances have slowed down in 2021.
The most affected by the HIV pandemic are, once again, women and adolescent girls, and especially in sub-Saharan Africa.
Every two minutes, a young woman or minor was infected.
They are three times more likely to contract the virus than boys and men of the same age, due in large part to the interruption of essential prevention and treatment services during the covid-19 pandemic.
During periods of confinement and mobility restrictions, millions of girls were left out of school and out of health and family planning centers, and this led to
an increase in teenage pregnancies and gender-based violence.
Nearly half of minors (48%) living with HIV do not have access to the medicines that will save their lives
There is another particularly vulnerable group in which the prevalence of infection has increased in the last year: men who have sex with other men.
For example, in El Salvador, between 2019 and 2021, prevalence nearly doubled, and increased eightfold among transgender people for causes directly related to service interruptions.
The third group most vulnerable to the disease is childhood.
In 2021, there was no progress in treatment for children, and meanwhile, almost half of minors (48%) living with HIV do not have access to the medicines that will save their lives.
According to the most recent data, the gap in treatment coverage between children and adults is growing rather than narrowing.
The number of people on treatment continued to rise in 2021, but more slowly than it has in more than a decade.
And while three-quarters of all HIV-positive people now have access to antiretroviral treatment, approximately 10 million people still do not.
What is the good new?
"We have good news: we have seen a remarkable resistance in the midst of the crisis, in the action against the pandemic," Kavanagh announced.
And he has referred to the strong investments by various national governments, the United States President's Emergency Plan for AIDS Relief (Pepfar), and the Global Fund in the fight against HIV, malaria and tuberculosis. (The Global Fund) among others.
Significant declines in new infections have also been observed, even in the midst of a pandemic, in countries such as South Africa, Nigeria and India, where there is a high incidence.
But these programs are also at significant risk due to the financial crisis.
In fact, in 2021 international resources were 6% lower than in 2010, despite the increase in needs.
While it is true that national funding to deal with this pandemic had grown significantly in low- and middle-income states, over the last two years it has decreased.
On the one hand, many of the affected countries are facing a domestic financial crisis due to the war in Ukraine, the covid-19 pandemic and other problems.
And meanwhile, the debt payments of the world's poorest countries have reached 171% of all spending on health care, education and social protection combined, making it difficult for them to allocate resources to the battle against HIV.
“This is stifling the ability of countries to respond to AIDS.
We are already seeing it”, indicated the expert.
The response to HIV in low- and middle-income countries stays now
$8 billion (€7.8 billion) short of the amount needed in 2025, and aid from bilateral donors other than the United States has fallen by 57% over the past decade.
“When international support has been most needed, global solidarity has stagnated.
Leaders should not mistake the huge red warning light for a
stop
sign .
This must be the time for a wave of international support,” Byanyima said.
Last year at the UN General Assembly, world leaders agreed on a roadmap to end AIDS by 2030. But only with commitment and funding will it be possible to deliver.
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