HIV/AIDS epidemic update
Presented at the Regional Workshop on
HIV/AIDS and Housing
Biziwick Mwale
UNAIDS Regional Support Team- ESA
Johannesburg, South Africa : 15 September 2014
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Presentation outline
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2011 Dream: The 3 Zeros
Achieving the dream
Progress towards achieving HLM targets
UNAIDS PCB call for new targets
Proposed new targets
HIV/AIDS mainstreaming
Conclusion
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2011: Dream
ZERO NEW INFECTION
ZERO DEATH
ZERO DISCRIMINATION
Promise and Accountability
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Dream turned into
global action
Global leaders decide to
achieve:
 50% reduction of sexual
transmission of HIV
 15 Million people on treatment
 Elimination Targets
Reaching MDG Goal 6 by
2015 as well.
High Level Meeting (HLM) in
New York, June 2011
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Achieving 2011: Dream
• Achieving the vision of zero new HIV infections, zero discrimination
and zero AIDS-related deaths requires that everyone needing HIV
treatment has access to life-saving medication and HIV prevention
services.
• Antiretroviral therapy (ART):
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Saves lives
Prevents new HIV infections
Prevents illness
Saves money and promotes development
Keeps people productive
• The 2013 WHO HIV treatment guidelines have greatly expanded the
number of people eligible for antiretroviral therapy
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Number of people
living with HIV
Total
Adults
Women
Children (<15 years)
35.0 million [33.2 million – 37.2 million]
31.8 million [30.1 million – 33.7 million]
16.0 million [15.2 million – 16.9 million]
3.2 million [2.9 million – 3.5 million]
2014 epidemiology core slides
Global summary of the AIDS
epidemic2013
Total 2.1 million [1.9 million – 2.4 million]
People newly
Adults 1.9 million [1.7 million – 2.1 million]
infected
Children (<15 years) 240 000 [210 000 – 280 000]
with HIV in 2013
Total 1.5 million [1.4 million – 1.7 million]
AIDS deaths in 2013
Adults 1.3 million [1.2 million – 1.5 million]
Children (<15 years) 190 000 [170 000 – 220 000]
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Adults and children estimated to be living with
HIV2013
Eastern Europe &
Central Asia
North America and Western and Central Europe
2.3 million
1.1 million
[980 000– 1.3 million]
[2.0 million – 3.0 million]
Middle East & North Africa
Caribbean
250 000
[230 000 – 280 000]
Latin America
1.6 million
[1.4 million – 2.1 million]
230 000
[160 000 – 330 000]
Asia and the Pacific
4.8 million
Sub-Saharan Africa
[4.1 million – 5.5 million]
24.7 million
[23.5 million – 26.1 million]
Global total: 35.0 million
Sub-Saharan Africa: 24.7 million
Eastern and Southern Africa (ESA) Region: 18.5 million
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Fifteen countries account for nearly 75% of all people living with HIV.
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Ten countries—Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Africa, Uganda,
United Republic of Tanzania, Zambia and Zimbabwe—account for 81% of all people living
with HIV in the region and half of those are in only two countries—Nigeria and South 9
Africa.
Source: South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town: Human Sciences Research
Council; 2014.
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Estimated number of adults and children
newly infected with HIV2013
Eastern Europe & Central
Asia
110
000
North America and Western and Central Europe
[86 000 – 130 000]
88 000
[44 000 – 160 000]
Middle East & North Africa
Caribbean
12 000
[9400 – 14 000]
Latin America
94 000
[71 000 – 170 000]
25 000
[14 000 – 41 000]
Asia and the Pacific
350 000
Sub-Saharan Africa
[250 000 – 510 000]
1.5 million
[1.3 million – 1.6 million]
Total: 2.1 million
Sub-Saharan Africa: 1.5 million
Eastern and Southern Africa (ESA) Region: 1.1 million
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Fifteen countries account for nearly 75% of the 2.1 million new HIV infections
that occurred in 2013.
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Estimated adult and child deaths from AIDS2013
Eastern Europe & Central
Asia
53
000
North America and Western and Central Europe
[43 000 – 69 000]
27 000
[23 000 – 34 000]
Middle East & North Africa
Caribbean
11 000
[8300 – 14 000]
Latin America
47 000
[39 000 – 75 000]
15 000
[10 000 – 21 000]
Asia and the Pacific
250 000
Sub-Saharan Africa
[210 000– 290 000]
1.1 million
[1.0 million – 1.3 million]
Global total: 1.5 million
Sub-Saharan Africa: 1.1 million
Eastern and Southern Africa (ESA) Region: 730,00
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Global total number of people on ART: 12.9 million
ESA Region total number of people on ART: 7.7 million
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Gaps in global antiretroviral coverage under the 2010
and 2013 WHO HIV treatment guidelines
Total eligible:
14,000,000
28,600,000
100%
37%
61%
50%
*Numbers of people receiving treatment in
December 2013 versus
39%
(a) the numbers eligible in December 2012
under the 2010 WHO guidelines;
(b) the numbers eligible in December 2013,
under the 2013 WHO guidelines.
63%
18,563,000
0%
2010 guidelines*
2013 guidelines*
Eligible and receiving treatment
Eligible but not receiving treatment
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Treatment coverage in Eastern and Southern
Africa
18.5 million people living with HIV in ESA in 2013
7.7 million people receiving ART in 2013
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HIV Treatment access gap
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UNAIDS Programme Coordinating Board (PCB) calls for
new targets
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Targets drive progress
New scientific evidence
New targets for Post 2015
Bold new targets needed
to end the epidemic
demonstrates that AIDS is
a winnable challenge
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New targets - For….
• Last push to meet the Ten HLM Targets of the 2011
Political Declaration
• Shaping the 2015 agenda …the unfinished business
• Sustaining the Response
• Laying a foundation for Ending AIDS
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Proposed new treatment target
90
90
tested
on treatment
%
%
90
%
virally suppressed
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90-90-90 Treatment Approach
• 90% of all people living with HIV know their
serostatus
• 90% of all who are eligible receive
antiretroviral therapy
• 90% of all people on antiretroviral therapy
achieve durable viral suppression.
• Achievement : reduce AIDS-related deaths by
more than 95% and bring the rate of new HIV
infections below epidemic thresholds.
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Rapid Treatment Scale up …
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Prevents death
Prevents new HIV infection
Saves money
Lays the foundation for the end
of the AIDS epidemic
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Progress towards HLM targets
• Progress has been made in the HIV/AIDS response –
we need to vision beyond 2015
• Potential to accelerate adult treatment, reinvigorate
HIV prevention and improve pediatric treatment
• HIV/TB co-infection is an opportunity for building on
synergies to improve health outcomes
• Our ultimate goal is the End of AIDS.
• New and ambitious targets for treatment and
prevention will lay the foundation towards ending
AIDS by 2030.
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HIV/AIDS Mainstreaming
Know Your
Epidemic!
Know Your
Response!
Know Your
Capacity!
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Adopting the dynamic planning process
in HIV/AIDS Mainstreaming
Step 1: Taking a
stand for HIV
mainstreaming
Defining and
communicating the
commitment
Step 5:
Monitoring and
reviewing
progress
Step 2:
Assessing
impacts, gaps
and key available
Mainstreaming
HIV in the
Housing sector
Step 4:
Implementation
resources
(technical, human
and financial)
Step 3:
Formulating
strategies &
setting
milestones
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HIV Mainstreaming
Housing sector comprehensive
HIV/AIDS Response
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Internal HIV mainstreaming
Workplace/wellness programs
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External HIV mainstreaming
Mandate driven interventions
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Informed by Housing sector impact
study/KAP studies
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Informed by sector mandates/specific
studies/possible synergies
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Implemented through basic minimum
package by each organization
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Integrated in organization’s overall
annual management plans
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Monitored and reviewed annually
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Monitored & reviewed annually
Human Development, MDGs, NDPs, NSP goals and country specific
visions
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Important to mobilize all sectors for HIV/AIDS
response: leaving no one behind
Ambition will
be required to
get ahead of
the epidemic
and save
millions of
lives
Thank you !
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