Latest progress

The deadline has now passed for achieving universal access to HIV/AIDS treatment. Despite a global response that has seen urgent action taken, this target has been missed. Whilst the number of infections continues to grow at a rate faster than treatment is given [1], other targets with a 2015 deadline may also be missed[2]. The scale and complexity of the epidemic continues to frighten and amaze (see especially page 7 of AIDS and MDG report [3]).

However, huge improvements have been made in the past decade, in virtually every country affected by the disease, and the fight against AIDS has much it can teach policy makers and workers in the fight to reach the other MDGs. A key recent document shows how the fight against HIV is really a fight to achieve every MDG [3]. Previous approaches have focussed almost solely on the medical approach – and the improvements in healthcare and provision of condoms have undoubtedly slowed the spread of HIV. But with no vaccine yet developed, the solely medical approach shows no signs of halting and reversing trends. The use of antiretroviral treatments does contribute to a great success, and a feasible attainment of the target to eliminate mother-to child transmission, with UNICEF [4] showing that in 2009, 53% of HIV-positive mothers were treated to prevent transmission, up from 15% in 2005. This treatment gives hope for the possibility of an AIDS free generation.

Across time and boundaries, the most ‘at-risk’ groups have been subjected to second-class status. More than 60% of HIV positive youth aged 15-24 are female [DFID 2009]. Legal discrimination against drug users, homosexual men, prisoners, people caught up in prostitution and women has impeded progress, but the HIV law commission [5] claims major advances in policy and law across the world.  Steps have been made in many areas to reduce the stigma of HIV [6]. The indicators concerning education of orphans are the most likely to be met, thanks in part to progress on MDG2 and a ‘rights-based’ approach. These interactions can inform how other MDGs can be met [3]. 

The emergency nature of the response has led to vast sums of money being pledged by governments, businesses and individuals – a sixfold increase from 2002-2008 [3]. In western popular culture, it is becoming fashionable to join the fight against AIDS, with the (Red) campaign involving brands such as GAP, Starbucks and Apple [7], whilst the World Cup provided an opportunity for the world’s most affected country, South Africa, to tell the world about its plight [1]. The Global Fund is one of the major contributors to this total, and also supports work to combat other diseases highlighted in the MDGs, notably malaria and tuberculosis [8].

Malaria has the potential to affect half the world’s population, and the sobering statistic that one child in Africa dies every 45 seconds of the disease remains true [9]. It especially affects pregnant mothers [10], with 11% of the maternal mortality rate in Nigeria caused by malaria [9]. It is both preventable and treatable, and innovative, yet incredibly simple local programmes are changing lives. UKaid have both distributed and educated about malaria nets to people in Nigeria via the local Town Crier, who implores proper usage using a carefully developed message [9]. In the Philippines, uneducated women in remote villages have been taught how to use microscopes to detect malaria in blood smears, which can speed up the process of treatment, saving valuable time - and lives [11].

The progress in thinking, financing and culture in the past decade is hugely encouraging, but if it does not continue in the same way, the situation will remain as bleak as it currently is, or worse. A levelling off in financial levels – due to the global financial crisis – means promising programmes are less likely to be sustained. The necessary changes in culture to detach the stigma from infectious diseases will be slow and require education and local responsibility. The promise that an improved performance towards MDG 6 will necessarily improve the other MDGs causes hope and surely inspiration to heal and save many lives.

[1] UK Department for International Development article

[2] UNDP List of Goals and Indicators

[3] UN AIDS and MDGs report. Go to pdf link via this page

[4] UNICEF’s Children and HIV report

[5] HIV Law Commission web page

[6] Teafund Story of reducing stigma

[7] The Red Project

[8] The Global Fund

[9] UK Department for International Development report on malaria

[10] Malaria Consortium

[11] Global Fund report on Phillipines malaria scheme