For first time in history, half of all people with HIV are getting treatment

A new update on the global HIV/AIDS epidemic offers “scorecards” for countries that starkly highlight successes in green and failures in red (for an example, see here).

Collectively, the world receives high marks for its HIV/AIDS efforts from the Joint United Nations Programme on HIV/AIDS (UNAIDS) in Geneva, Switzerland. It notes in Ending AIDS that 19.5 million of the estimated 36.7 million people living with the virus now receive lifesaving antiretroviral (ARV) drugs. This is the first time in history that more than half the infected people are being treated.

But several countries are falling far short of the UNAIDS prescription of what it takes to bring an epidemic to an end, which essentially requires slowing the rate of virus transmission to the point that new infections peter out.

The report dramatically documents the power of ARVs, which both stave off disease and make people less likely to infect others. AIDS deaths have almost been cut in half since 2005, when only 564,000 HIV-infected people received ARVs. In the past 6 years, the hard hit eastern and southern Africa region has seen new infections plummet by one-third. Recognizing that proper treatment also makes people less likely to transmit HIV, many countries have adopted the World Health Organization’s 2015 recommendation to treat everyone who tests positive, abandoning the practice of reserving ARVs for those with evidence of immune system damage. “Families, communities, cities and countries have witnessed a transformation,” writes UNAIDS director Michel Sidibé in the foreward to the 196-page report.

For countries to achieve the UNAIDS goal, 73% of their HIV-infected populations must have fully suppressed the virus. Seven countries have managed to hit the suppression milestone. They are Botswana, Cambodia, Denmark, Iceland, Singapore, Sweden, and the United Kingdom.

In contrast, countries with the worst suppression levels include Madagascar (3%), Pakistan (4%), Gabon (7%), Iran (8%), Egypt (12%), Lithuania (17%), Dominica (17%), Bahamas (18%), and Ecuador (19%).