United Nations: 4 million people now on AIDS drugs

LONDON — United Nations health officials estimate about 4 million people who need AIDS drugs worldwide are now getting them, according to a report issued Wednesday.

The figure represents a major increase in rolling out the drugs to patients across Africa, where the AIDS epidemic is focused, but an estimated 5 million or more across the globe are still waiting for the drugs.

The numbers, based on incomplete data and modeling, are only a guess. They were released in an annual AIDS report jointly published by the World Health Organization, UNICEF and the U.N. AIDS program.

“There remain uncertainties related to the quality of data reported,” officials wrote. Of the U.N.’s 192 member countries, 158 provided government-approved data, most of which were not independently verified.

“Even though some of the data are not fully clear and there are some unanswered questions, this is a dramatic improvement,” said Daniel Halperin, an AIDS expert at Harvard University. “It shows that all this money that has gone to treatment has made some difference.”

In 2008, officials estimated more than 4 million people were on AIDS drugs in low- and middle-income countries, a 10-fold jump in five years. The biggest increase was in sub-Saharan Africa, where nearly 3 million people are now on the drugs.

Overall, about 44 percent of people with HIV in sub-Saharan Africa who need AIDS drugs are now taking them.

“It’s actually not radically less coverage than you would get in Europe or the U.S.,” Halperin said. In the U.S., about 71 percent of patients who need the AIDS drugs are taking them, according to 2003 data from the Centers for Disease Control and Prevention.

“We have invested a lot of funds into HIV/AIDS, but it has been a worthwhile investment because we have saved lives,” said Dr. Teguest Guerma, WHO’s acting AIDS director.

Last year, the global community spent nearly $9 billion on AIDS. For every dollar spent on public health, AIDS gets about 23 cents. It causes about 4 percent of deaths globally.

Guerma said the numbers of people who need AIDS drugs might double by the end of the year, as WHO is considering revising its treatment guidelines. Several studies have suggested AIDS patients could live longer if they started taking drugs sooner. If WHO changes its threshold for when patients should get the drugs, which Guerma said could happen later this year, the numbers of people who qualify for the treatment could double.

Now that millions of AIDS patients are on treatment, some experts said it is time for the U.N. to focus on other strategies for stopping the outbreak.

“We really need to do something about preventing HIV because there are more people getting infected every year than there are being put on treatment,” said David Ross, an AIDS expert at the London School of Hygiene and Tropical Medicine.

Ross also warned it would be challenging to continue financing AIDS programs, given the financial crisis. Because patients must take AIDS drugs for the rest of their lives, the cost of treatment programs will continue to increase in the future, particularly when drug resistance develops and more expensive drugs are needed.

“The fact that WHO has come closer to meeting its target of universal AIDS treatment is certainly a good public relations coup,” said Philip Stevens, a director at International Policy Network, a London-based think tank. “Whether or not this is sustainable as billions more dollars are needed in the future is an entirely different question.”

On the Net:

www.who.int

www.unaids.org

www.unicef.org