Mural campaign about HIV/AIDS in South Africa.
Photo: Kim Ludbrook/EPA/Scanpix
Thanks to major global efforts, considerable progress has been made in the prevention of new HIV infections and treating people who are living with HIV. The number of people infected with HIV has fallen by 35% since 2000. Access to antiretroviral drugs has been crucial to saving lives and contributing to a reduction in the number of new infections.
One of the new global Sustainable Development Goals is to eradicate AIDS before 2030. Continued concerted efforts by many players in the world will be required to achieve that goal.
The sub-Saharan countries in Africa are still those most affected by HIV and AIDS. The number of new infections in the region is decreasing, but HIV continues to be one of the major causes of morbidity and mortality in sub-Saharan Africa, where 25 million people live with HIV.
Even though the number of new infections is decreasing, it is important to remember that an estimated 6,000 people still are infected with HIV every day.
Not only has the number of new HIV infections declined in recent years, but the number of AIDS-related deaths has also fallen. This is largely thanks to massive efforts to deliver treatment with antiretroviral medicines. More than 15 million people in the world had access to Antiretroviral Therapy (ART) in March 2015. Other important measures include treating pregnant women, thereby reducing the number of children born with HIV.
Despite these achievements, the AIDS epidemic has major implications for millions of people around the world and much work remains to be done. One particular concern is the fact that the number of HIV infections among young people is still at a high level, and girls and young women are over-represented in this group. Other groups where the number of new infections has not decreased is men who have sex with men, prisoners, and both male and female sex workers.
Different scenarios in different regions
HIV epidemics vary in different regions and in different countries, and for this reason it is important that HIV measures focus on the groups and the areas that are most vulnerable. UNAIDS, the joint UN HIV/AIDS programme, adopted a new strategy in September 2015 which will be applied between 2016-2021. UNAIDS believes that it is of particular important to focus efforts on those people and geographical areas that are most in need of support and assistance. Methods of combating the spread of HIV must be used where they make the greatest difference, according to UNAIDS.
One important aspect of the work in counteracting the continued spread of HIV is an open discussion of contraception and access to sex education in schools. The debate on the right to decide over one's own body is included in this subject. Young people in sub-Saharan Africa generally have little knowledge of sexuality or contraception. Access to care and contraception for young people is still very limited, and there are many who still question whether sex education should in fact be allowed at school.
The need for greater gender equality is another important area that is closely linked to HIV and AIDS. One of the reasons why many young women suffer from HIV is that women generally have a low status in society and violence against women is widespread. There are very many teenage pregnancies as a result of this lack of equality in the region.
The prevention and treatment of HIV makes great demands on health systems in those countries that have a high disease burden, particularly in southern Africa. In South Africa, for example, it is estimated that 18.9% of the adult population are living with HIV; in Botswana the figure is 25.2% and in Mozambique 10.6%. The costs for care and treatment of HIV require an increasingly large proportion of healthcare budgets. The effects of the disease are hard on individuals, communities and countries, but also on the region as a whole, including its economy and its future prospects. As a result, the epidemic is still a major obstacle to social and economic development in the region.
HIV and AIDS have been a priority for Sweden and Sida for many years. Sida has a specialized team working on a regional basis with sexual and reproductive health and rights (SRHR), in which work against HIV and AIDS is an important part. The team is based at the Swedish Embassy in Lusaka, Zambia and follows a strategy that the Swedish government established in July 2015, "Strategy for Sexual and Reproductive Health and Rights (SRHR) in sub-Saharan Africa 2015-2019".
Although major challenges still remain to be addressed, it is important to continue building on results achieved so far. It is crucial to safeguard continued funding and support for the prevention of HIV. There is a great interest around the world in the Sustainable Development Goals, including the goal to eradicate AIDS by 2030.